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Are Boys Ready for Human Papillomavirus Vaccine? A National Study of Boys in Malaysia

Wong, L.P. PhD*; Alias, H. MSc*; Yusoff, R.N.A.R.M. MSc*; Sam, I.C. FRCPath; Zimet, G.D. PhD

doi: 10.1097/OLQ.0000000000001024
Original Studies

Background The aim of this study was to investigate factors associated with the willingness of boys to accept the human papillomavirus (HPV) vaccine.

Methods A nationwide cross-sectional survey among Secondary One male students in Malaysia.

Results Among 2823 respondents, knowledge about HPV infection and the HPV vaccine was extremely poor. The mean total knowledge score was only 3.17 (SD ± 2.14), out of a possible score of 10. The majority of respondents were unaware that vaccinating boys can help protect girls against HPV infection (81.6%), and HPV is a sexually transmitted infection (70.1%). Many had the misconception that only females get HPV (78.9%). In multivariable analysis, the factors associated with the intention to receive the HPV vaccination were: agreeing boys need to be vaccinated against HPV infection (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.57–2.68), perceiving their parents might allow them to get the HPV vaccine (OR, 1.66; 95% CI, 1.18–2.34), perceived susceptibility to HPV infection (OR, 1.63; 95% CI, 1.06–2.52), and attending a rural school (OR, 1.49; 95% CI, 1.14–1.95).

Conclusions Public health educational programs that are focused and tailored on parents consenting to HPV vaccination for boys at a young age can be useful in improving HPV vaccination rates among boys. There is also a pressing need to educate boys about the benefits of HPV vaccination in males and about HPV disease susceptibility to facilitate adoption of the HPV vaccine by young adults in the future.

A study of boys' intention to receive human papillomavirus vaccination found that community intervention is essential to educate parents consenting to human papillomavirus vaccination for boys at a young age.

From the *Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine

Department of Medical Microbiology, Faculty of Medicine, University of Malaya Kuala Lumpur, Malaysia

Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN

Acknowledgments: This study would like to thank the schools and school teachers that were involved in this study.

Conflicts of Interest and Source of Funding: G.D.Z. has received an honorarium from Sanofi Pasteur for work on the Adolescent Immunization Initiative. For the remaining authors none were declared. This study was supported by the University of Malaya Research Grant (RG411-12HTM).

Correspondence: Li Ping Wong, PhD, Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya 50603, Kuala Lumpur, Malaysia. E-mail:,

Received for publication January 13, 2019, and accepted May 24, 2019.

Online date: June 10, 2019

© Copyright 2019 American Sexually Transmitted Diseases Association