J Pediatr Adolesc Gynecol (2000) 13:15–20 Original Studies Adolescents’ Knowledge of Human Papillomavirus and Cervical Dysplasia Cynthia A. Gerhardt, PhD, 1,3 Kathleen Pong, RN, MSN, 2 Linda M. Kollar, RN, MSN, 2 Paula J.A. Hillard, MD, 2,3 and Susan L. Rosenthal, PhD 2,3 1 Division of Hematology/Oncology, 2 Division of Adolescent Medicine, Children’s Hospital Medical Center; and 3 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio Abstract. Study Objective: This study examined adoles- Key Words. Cervical dysplasia—Human papilloma- cents’ knowledge of human papillomavirus (HPV) and cer- virus—Sexually transmitted diseases, adolescents vical dysplasia (CD). Factors associated with knowledge and self-reported change in health-related behaviors were identified. Design: Interviews were conducted at an average of 2.5 Introduction years following the diagnosis of HPV/CD. Medical charts were reviewed. Sexually transmitted diseases (STDs) are a major Setting: The study was conducted at a university-based public health concern, particularly for adolescents. 1 adolescent dysplasia clinic. One of the most common infections, human papillo- Participants: Fifty females, ages 15–23 participated in mavirus (HPV), has estimated prevalence rates of the study: 88% African-American, 12% Caucasian. 24%–60% based on DNA detection. 2–4 Although Results: On average, participants responded correctly rates of HPV cytological abnormalities range from to 86% of the questions regarding HPV/CD. However, the 12%–16%, 2,5 the occurrence of cervical dysplasia following key points were routinely missed: 52% did not (CD) has increased significantly over the past de- know cigarette smoking increased the risk for cervical can- cade. 6 Several types of HPV have been linked to cer; 42% believed that HPV/CD was always symptomatic; the pathogenesis of cervical cancer. 7–9 Moscicki et al. and 22% did not know condoms decreased the transmission found that 60% of HPV-positive females, ages 13–19, of HPV. According to participants, their health care pro- had at least one of the cancer-related HPV types (i.e., vider explained the diagnosis and treatment of HPV/CD 16, 18, 31, 33, or 35). 3 In fact, the risk for carcinoma using words they understood “some” or “most of the time.” in situ more than doubles if women are under age Higher academic skills significantly correlated with greater 25 when first diagnosed with HPV. 10 Factors which knowledge of HPV/CD. Forty-one percent of participants increase adolescents’ vulnerability to HPV/CD and with a smoking history reportedly increased their smoking cervical cancer include being single, involvement with since the diagnosis, and only 40% used condoms “most of multiple sexual partners, lack of condom use, history the time.” However, 90% had maintained or increased of prior infections, cigarette smoking, and biological their frequency of Pap tests. Conclusions: Adolescent girls had knowledge of most immaturity of the cervix. 3,4,11–13 factors related to HPV/CD, but many did not understand Fortunately, with appropriate evaluation, treat- the risks of cigarette smoking and failure to use condoms. ment, and follow-up, invasive cervical carcinomas are To improve understanding and compliance, health care largely preventable. 14–16 However, 20%–39% of ado- providers should tailor educational strategies to the func- lescents fail to comply with follow-up appointments tional level of adolescents. and treatment recommendations following abnormal Pap tests. 5,17 Research has demonstrated that adoles- cent women often have a poor understanding of Pap Address reprint requests to: S.L. Rosenthal, PhD, Division of Ado- test results and HPV/CD, which may account for lescent Medicine, Children’s Hospital Medical Center, 3333 Burnet their noncompliance. 18–20 Recent efforts have focused Avenue, Cincinnati, OH 45229. on improving women’s understanding of and adher- Presented at the Great Lakes Regional Conference on Child Health Psychology, May 14–16, 1998, Louisville, KY. ence to medical recommendations to prevent the pro-  2000 North American Society for Pediatric and Adolescent Gynecology 1083-3188/00/$20.00 Published by Elsevier Science Inc. PII S1083-3188(99)00031-5