{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T11:03:56Z","timestamp":1744628636925},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5-6","funder":[{"name":"Clinical Investigations Facility"},{"name":"USAF Medical Center on Travis Air Force Base"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Genital human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. The Center for Disease Control Advisory Committee on Immunization Practices (ACIP) has recognized the potential benefits of immunizing young men beginning at age 11 or 12\u00a0years and continuing through age 21\u00a0years. The maximum age of immunization is extended through age 26 for men who have sex with men, transgender individuals, and immunocompromised men. In spite of these recommendations, vaccination of young men is currently limited by numerous patient and provider variables. The authors sought to delineate these variables as they pertain to members of the U.S. Air Force in order to guide future interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The study consisted of two cross-sectional surveys at a single Air Force Base in California. The protocol was approved by the Institutional Review Board at David Grant Medical Center. The physician survey consisted of 10 questions that were formatted and designed to assess physicians\u2019 knowledge about the quadrivalent HPV vaccine (Gardasil) and 6 questions that were formatted and designed to assess physicians\u2019 counseling practices regarding Gardasil. The physician survey was distributed electronically via email in January 2017 to all 48 Family Medicine physicians, including both residents and staff, within the Family Medicine Residency Clinic at Travis Air Force Base. The email contained a link via Microsoft Share-point to an anonymous online survey. The patient survey was distributed in paper form to all male service members between the ages of 18 and 30\u00a0years who attended Commander\u2019s Calls over a 90-day period between January 2017 and March 2017. The patient survey included the primary outcome: proportion of respondents who had completed the HPV vaccination series. Descriptive statistics, including frequencies and percentages, were used to summarize the data. Contingency tables were constructed and the chi-square test or Fisher\u2019s Exact Test were performed to determine if particular demographic variables were associated with correct answers to individual knowledge questions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The majority of the Family Medicine physicians surveyed have adequate knowledge of HPV and the vaccine but do not routinely offer the vaccine to their male patients. Inadequate time during the office visit was cited as the major limitation to vaccine promotion. Of the Active Duty Air Force males surveyed, only 27% completed the vaccine series. A lack of knowledge regarding the personal benefits of the vaccine and failure to remember to receive subsequent doses were cited as barriers to completion. Only one-quarter of all surveyed males were interested in speaking with a healthcare provider about HPV and\/or the HPV vaccine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Deficiencies in public knowledge and insufficient provider practices are likely contributing to the suboptimal rates of HPV vaccination among eligible males. Additionally, eligible males are not interested in speaking with their healthcare providers about either HPV or the HPV vaccine. If the rates of HPV vaccination within the male population are to increase, health educators, public health proponents, and vaccine advocates need to devise a more effective approach to disseminate this information to eligible male recipients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usz403","type":"journal-article","created":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T15:20:06Z","timestamp":1575645606000},"page":"e878-e886","source":"Crossref","is-referenced-by-count":9,"title":["Understanding Barriers to HPV Vaccination: Perspectives From Air Force Family Medicine Physicians and Active Duty Air Force Males"],"prefix":"10.1093","volume":"185","author":[{"given":"Courtney E","family":"Halista","sequence":"first","affiliation":[{"name":"David Grant USAF Medical Center, Travis Air Force Base, 101 Bodin Circle, Fairfield, CA 94535"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randolph J","family":"Kline","sequence":"first","affiliation":[{"name":"Mike O\u2019Callaghan Federal Medical Center, Nellis Air Force Base, 4700 N. Las Vegas Blvd., Las Vegas, NV 89191"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Bepko","sequence":"first","affiliation":[{"name":"David Grant USAF Medical Center (retired), Travis Air Force Base, 101 Bodin Circle, Fairfield, CA 94535"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,12,6]]},"reference":[{"key":"2020060911043339000_ref1","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/OLQ.0b013e318286bb53","article-title":"Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008","volume":"40","author":"Satterwhite","year":"2013","journal-title":"Sex Transm Dis"},{"key":"2020060911043339000_ref2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.bpobgyn.2017.08.006","article-title":"Epidemiology and burden of HPV-related disease","volume":"47","author":"Serrano","year":"2018","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"2020060911043339000_ref3","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1002\/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F","article-title":"Human papillomavirus is a necessary cause of invasive cervical cancer worldwide","volume":"189","author":"Walboomers","year":"1999","journal-title":"J Pathol"},{"issue":"Suppl 3","key":"2020060911043339000_ref4","first-page":"S3\/35","article-title":"Chapter 4: burden and management of non-cancerous HPV-related conditions: HPV-6\/11 disease","volume":"24","author":"Lacey","year":"2006","journal-title":"Vaccine"},{"key":"2020060911043339000_ref5","volume-title":"The Centers for Disease Control and Prevention","author":"HPV (Human Papillomavirus) Gardasil\u00ae VIS","year":"2014"},{"issue":"15","key":"2020060911043339000_ref6","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1200\/JCO.2016.67.2014","article-title":"American Society of Clinical Oncology statement: human papillomavirus vaccination for cancer prevention","volume":"34","author":"Bailey","year":"2016","journal-title":"J Clin Oncol"},{"key":"2020060911043339000_ref7"},{"key":"2020060911043339000_ref8"},{"key":"2020060911043339000_ref9"},{"key":"2020060911043339000_ref10","volume-title":"Recommendations on the Use of Quadrivalent Human Papillomavirus vaccine in Males\u2014Advisory Committee on Immunization Pratices (ACIP)","author":"Dunne","year":"2011"},{"key":"2020060911043339000_ref11"},{"key":"2020060911043339000_ref12","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.15585\/mmwr.mm6549a5","article-title":"Use of a 2-dose schedule for human papillomavirus vaccination\u2014updated recommendations of the advisory committee on immunization practices","volume":"65","author":"Meites","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"2S","key":"2020060911043339000_ref13","first-page":"S53","article-title":"US health care clinicians\u2019 knowledge, attitudes, and practices regarding human papillomavirus vaccination: a qualitative systematic review","volume":"18","author":"Rosen","year":"2017","journal-title":"Acad Pediatr"},{"issue":"2","key":"2020060911043339000_ref14","first-page":"21","article-title":"Human papillomavirus seroprevalence among men entering military service and seroincidence after ten years of service","volume":"20","author":"Agan","year":"2013","journal-title":"MSMR"},{"issue":"1","key":"2020060911043339000_ref15","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1891\/1061-3749.21.1.96","article-title":"Parental human papillomavirus vaccine survey (PHPVS): nurse-led instrument development and psychometric testing for use in research and primary care screening","volume":"21","author":"Thomas","year":"2013","journal-title":"J Nurs Meas"},{"key":"2020060911043339000_ref16","first-page":"pii\/S0264410X12017343","article-title":"Knowledge of human papillomavirus (HPV) and HPV vaccination: an international comparison","volume":"11","author":"Marlow","year":"2012","journal-title":"Vaccine"},{"key":"2020060911043339000_ref17","volume-title":"HPV vaccination rates on the rise among US males. 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