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Foundation Scholar Studies HPV Vaccine Uptake in College Women

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ANF Scholar Nop Ratanasiripong evaluates a patient
 on a medical mission trip in Thailand in June 2012.
A student at the University of Missouri-Kansas City, Nop Ratanasiripong, PhD, MSN, RN, received a 2011 American Nurses Foundation (ANF) research grant made possible by the Clinton Foundation. She was selected as the Virginia Kelley Scholar, named in honor of President Clinton’s late mother, who was a certified registered nurse anesthetist. ANF’s work with scholars helps nurses like Ratanasiripong contribute to the profession. In this interview, she explained how ANF has helped her achieve her research goals.

How did you become interested in studying college women’s knowledge about human papillomavirus (HPV) and the HPV vaccine ?

My interest started 17 years ago, when I was taking care of end-stage cervical cancer patients in Thailand. When I saw the hopeless eyes of those women, I wanted to do something to prevent cervical cancer.

When the HPV vaccine became available, I thought that all young girls would get the vaccine. Surprisingly, the vaccine uptake rate was low, and there were many controversies over the vaccine. One of them is the belief that women may participate in higher risk sexual behaviors after they get the vaccine. So, I wanted to study what factors influence young women’s decisions to receive the vaccine, and if there are any sexual behavior changes after women have received the vaccine.

What are some of the things that have surprised you in your work to date in this area?

While more than 95 percent of college women are aware of HPV and the HPV vaccine, and more than 90 percent of them know that HPV causes cervical cancer, they still do not obtain the vaccine. My study showed that only 47 percent of college women have received at least one dose of the vaccine.

Another surprise is that more than 90 percent of women, in both vaccinees and non-vaccinees, know that they need to obtain a routine Pap test after the vaccination. They also know that HPV vaccine does not provide protection from all sexually transmitted diseases (STDs). So, concerns by parents and advocates that young women may misunderstand that they do not need Pap tests and to use condoms after vaccination may be disregarded.

What does a nursing perspective bring to this area of research?

I believe that nursing care does not start at an outpatient clinic or a hospital. Nursing care needs to take a holistic approach, and it needs to start before a disease begins. Nurses can have more freedom, authority and creativity in health promotion roles. My research is a reflection of what nurses can do to take care of patients and the community. Nurses, as a part of a health care provider team, can influence young women to obtain the vaccine (based on my findings).

What do you hope to do with your findings?

I hope to publish and present my findings so that they can be applied for larger populations. The key points I want to share are that college women already have good HPV and HPV vaccine knowledge, so an intervention focused on increasing knowledge may not help increase the vaccine uptake rate. Also, college women support the mandatory vaccine option. However, they do not support calling it an anti-cancer or STD vaccine. Additionally, there are indifferences in sexual behaviors between non-vaccinated and vaccinated women and the number of sexual partners before and after vaccination. This may help dispel the myth that vaccinated women practice riskier sexual behaviors.

Now, I am ready to expand my role into HPV/cervical cancer prevention for young women in the United States, and bring knowledge and research to Thailand, where cervical cancer is still the second killer among all cancers in Thai women.

What would you like nurses to know about HPV based on your work?

Nurses are the key factor to help increase the HPV vaccine uptake rate. In particular, public health and school nurses are in an ideal position to take an active role in the development and implementation of HPV and cervical cancer prevention programs.

— Kate Judge is the executive director of the American Nurses Foundation.

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