Holly B. Fontenot

Stage of adoption of the human papillomavirus vaccine among college women.

BACKGROUND Certain types of human papillomavirus (HPV) can cause cervical and other cancers. A vaccine that protects against HPV types responsible for 70% of cervical cancers is available to females ages 9-26. OBJECTIVE To examine correlates of stage of vaccine adoption among women ages 18-22. METHODS In 2007, female students (n=4774) at a New England University in the U.S. were invited to complete an on-line survey that assessed knowledge of HPV, perceived susceptibility, severity, vaccine benefits/barriers, social and subjective norms, and stage of vaccine adoption RESULTS 1897 women (40%) responded; complete data were available for 1401. About half (53%) were planning to be vaccinated, 12% had received the vaccine, 15% were undecided, and 7% had decided against vaccination. HPV knowledge was low (mean 58%). In multivariate analyses, social norms was the strongest correlate of stage; each standard deviation increase in social norms score was associated with more than four times the odds of intending to be vaccinated within the next 30 days, compared with those who had decided against vaccination (OR=4.15; 95% CI 2.17-6.36). CONCLUSIONS Acceptance of the vaccine was high, although misconceptions about viral transmission, availability of treatment, and the role of Pap tests were common. Perceived norms were strongly associated with intentions. Interventions on college campuses should stress vaccination as a normative behavior, provide information about viral transmission, and stress the role of continued Pap screening.

College Men's Knowledge, Attitudes, and Beliefs about the Human Papillomavirus Infection and Vaccine

Men enrolled in an urban university participated in focus groups (k=6; n=45) to explore knowledge about human papillomavirus and attitudes toward prophylactic vaccine. Results suggest that regardless of whether vaccines become available to men, educational efforts should include them, as men tend to have many misconceptions and do not perceive themselves to be vulnerable.

Human papillomavirus (HPV) risk factors, vaccination patterns, and vaccine perceptions among a sample of male college students.

Abstract Objective: To examine human papillomavirus (HPV) vaccination rates, including initiation and completion of the vaccine series, and barriers to vaccination in a sample of male college students. Participants: Male students between the ages of 18 and 25 who reported being currently or previously sexually active (N = 735). Methods: A cross-sectional Web-based survey was administered during October 2012 at a large public university in the northeast United States. Student e-mail addresses were obtained from the university after institutional review board approval. Results: Although condom use was low and number of lifetime sexual partners was high, 93% reported they were not at risk for sexually transmitted infections. The college men in the sample had low HPV vaccine awareness, knowledge, perceived severity, and perceived susceptibility, and 74% of the sample had not obtained the HPV vaccine. Conclusions: There is a disconnect between actual and perceived risks of HPV and barriers to HPV vaccination exist.

Global Delivery of Human Papillomavirus Vaccines.

Worldwide, cervical cancer is the fourth most common cancer among women. Human papillomavirus (HPV) vaccination, if broadly implemented, has the potential to significantly reduce global rates of morbidity and mortality associated with cervical and other HPV-related cancers. More than 100 countries around the world have licensed HPV vaccines. As of February, 2015, there were an estimated 80 national HPV immunization programs and 37 pilot programs. This article discusses global implementation of HPV vaccination programs and issues such as vaccine financing and different approaches to HPV vaccine delivery.

Chronicity of partner violence, contraceptive patterns and pregnancy risk

BACKGROUND Partner violence may interfere with a womans ability to maintain continuous contraception and therefore contribute to increased risk of pregnancy among childbearing women. STUDY DESIGN A retrospective review of medical records (N=2000) was conducted from four family planning clinics in the northeast United States. Eligibility criteria for inclusion were as follows: (1) female, (2) reproductive age (menarche through menopause), (3) seeking reproductive services and (4) clinic visit for annual gynecologic exam between 2006 and 2011. RESULTS Partner violence was documented in 28.5% (n=569) of medical records. Chronicity of violence influenced contraceptive patterns and pregnancy risk. Women reporting past year partner violence only [odds ratio (OR)=10.2] and violence during the last 5 years (OR=10.6) had the highest odds of not using a current method of contraception. Women reporting recent exposure to violence were most likely to change birth control methods and use emergency contraception (OR=6.5). Women experiencing any history of violence reported more frequent contraceptive method changes during the previous year. CONCLUSIONS A history of partner violence was common among women utilizing family planning services. The chronicity of violence appeared to play a significant role in contraceptive method changes, types of methods used and pregnancy risk. These results may be one explanation for increased pregnancies among women who experience partner violence.

What do you mean you want me to teach, do research, engage in service, and clinical practice? Views from the trenches: The novice, the expert.

The purpose of this column is to explicate two points of view-the novice and the expert nurse practitioner (NP) faculty member, highlighting the importance of mentoring new faculty NP members into the diverse faculty roles relating to both general academic requirements and those particular roles related to NP education. For example, arranging clinical placements is one of the most important and time-consuming responsibilities of NP faculty. Learning to juggle all the roles is a challenge to new faculty members. Such mentoring may help alleviate the phenomenon of young faculty members leaving academia and returning to full-time clinical practice. Mentoring is crucial to integrating new NP faculty members into academic life.

The Sexual Safety of Adolescents

In this article, the authors review issues that affect the sexual safety of adolescents. First and foremost, these issues include risks for unintended pregnancy and sexually transmitted infections. Clinicians also need to understand other critical issues that affect sexual safety. These include adolescent dating patterns, decision making, communication and negotiation skills, social and environmental influences, and risks related to violence. Suggestions for clinical interventions to promote sexual safety are discussed.

Mentorship: the heart and soul of health care leadership

The key to the development of leaders for the health care professions is mentoring. Both leaders and mentors need to develop their own self-knowledge, strategic visions for their own careers, engage in risk-taking, express creativity through all aspects of their lives, feel inspired and inspire others. Communication is central to a positive mentoring relationship and a successful role in a health care leadership position. Thus, when neophyte health care lead- ers have the opportunity to be mentored, the development of good communication skills will benefit them in their future leadership positions. An important gift health care leaders can give to their professions is to serve as mentors for those who will lead health care organizations and institutions into the next decades. In this article, the authors will discuss the mentoring role integral to assuming leadership roles and present a number of models for mentoring programs in the health care professions.

The Effects of Intimate Partner Violence Duration on Individual and Partner-Related Sexual Risk Factors Among Women

INTRODUCTION Intimate partner violence (IPV) is associated with risk of sexually transmitted infections (STIs) and HIV among women, but less is known about mechanisms of this association and if length of relationship violence is a factor. The purpose of this study was to explore the relationship between the duration of IPV and both individual and partner-related sexual risk factors that may increase womens risk for STIs and HIV. METHODS This was a secondary analysis of data collected from the medical records of 2000 women. Four distinct categories defined the duration of partner violence: violence in the past year only, past year and during the past 5 years, past year plus extending for greater than 5 years, and no past year violence but a history of partner violence. Logistic regression models were used to examine the associations between the duration of partner violence and individual sexual risk behaviors (eg, number of sexual partners, drug and/or alcohol use, anal sex) and partner-related sexual risk factors (eg, nonmonogamy, STI risk, condom nonuse). RESULTS Nearly 30% of the women in the study reported a history of partner violence during their lifetime. All of the individual risk factors, as well as partner-related risk factors, were significantly associated (P < .05) with partner violence and duration of violence. DISCUSSION The study findings extend the knowledge related to partner violence as a risk factor for STIs/HIV, highlighting the effects of partner violence duration on the health of women. Assessing for lifetime experiences of partner violence may improve outcomes for women and their families.

Increasing HPV vaccination and eliminating barriers: Recommendations from young men who have sex with men

BACKGROUND There is a disparity in HPV vaccination rates in particular among young men who have sex with men (YMSM) and until very recently there has been a dearth of research examining factors related to HPV vaccination for YMSM. The purpose of this study was to elicit YMSMs beliefs about HPV and the HPV vaccine as well as describe perceived barriers and facilitators of vaccine initiation and completion. METHODS A qualitative, descriptive study that utilized a focus group design was conducted among an urban and racially diverse sample of YMSM. Questionnaire data were analyzed using descriptive statistics, and focus group data were analyzed using content analysis. FINDINGS 34 YMSM with a mean age of 20.8years participated. The sample was diverse, with the largest proportion of youth identifying as Black (35.4%). Over 90% reported having an annual exam each year, 61.8% reported obtaining a flu vaccine during the past year, and 58.8% reported initiating the HPV vaccine 3-dose series. Themes identified included low HPV knowledge and awareness, positive vaccine beliefs, perceived stigmas, and HPV vaccine facilitators. Participants identified 3 ways health providers/ researchers could facilitate vaccination: creative use of mobile technology, bundling vaccination with other health services, and increasing HPV and HPV vaccine awareness. CONCLUSIONS Our findings point to some clear avenues to pursue in research and practice to improve HPV vaccination rates among YMSM, including increased use of mobile health strategies, making HPV vaccination a co-occurring part of other health-related services (e.g., HIV testing), and providing information on the relevance of HPV and HPV vaccination to YMSM.