{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T19:47:00Z","timestamp":1761767220360,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T00:00:00Z","timestamp":1688083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"American University of Antigua College of Medicine","award":["050922-1"],"award-info":[{"award-number":["050922-1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Cervical cancer is the fourth leading cause of cancer-related deaths in women. Human papilloma virus (HPV) is known to cause cervical cancer. The incidence and mortality of cervical cancer has drastically reduced due to effective vaccination against HPV in developed countries. The projected rise in cervical cancer cases in Latin American and Caribbean countries necessitates a study to evaluate awareness about HPV, cervical cancer, the HPV vaccine, and prevention among women in Antigua and Barbuda. Materials and methods: This was an observational, cross-sectional study. The participants were women aged between 18 and 65 years, residing in Antigua and Barbuda. The study was conducted over the period of February to April 2023. After taking informed consent electronically, sociodemographic and behavioral data was collected through questionnaires sent out as links and QR-codes and were analyzed by QualtricsXM. The association between the demographic groups and awareness about HPV, cervical cancer, the HPV vaccine, and prevention was analyzed by a Chi-square test. Results: In total, 467 women were included in the study. The percentage of participants aware of HPV was 91.6% (n = 412). A total of 70.7% (n = 318) and 56.7% (n = 255) women were aware that cervical cancer is caused by HPV and is sexually transmitted, respectively. Although 70.6% (n = 315) of participants were aware that the vaccine protects against HPV, only 12.8% (n = 57) were vaccinated. Of the participants, 49.7% (n = 192) were willing to get vaccinated. The percentage of participants aware of the Papanicolaou (Pap) smear procedure was 98.9% (n = 435) and 87.8% (n = 382) had a Pap smear within the last 10 years while 12.2% (n = 53) never had a Pap smear screening. The willingness to know more information about HPV and the HPV vaccine among the participants was 77% (n = 335). Conclusions: The overall awareness among women in Antigua and Barbuda about HPV, cervical cancer, the HPV vaccine, and prevention was high. We recommend a national health education program and vaccine drive to complement our findings.<\/jats:p>","DOI":"10.3390\/medicina59071230","type":"journal-article","created":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T16:06:37Z","timestamp":1688141197000},"page":"1230","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Cervical Cancer and Human Papillomavirus Awareness among Women in Antigua and Barbuda"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3872-4242","authenticated-orcid":false,"given":"Prasanna","family":"Honnavar","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, American University of Antigua College of Medicine, St. Johns 1451, Antigua and Barbuda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmond","family":"Mansoor","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, American University of Antigua College of Medicine, St. Johns 1451, Antigua and Barbuda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cherie","family":"Tulloch","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Sir Lester Bird Medical Centre, St. Johns 1451, Antigua and Barbuda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uttam","family":"Udayan","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, American University of Antigua College of Medicine, St. Johns 1451, Antigua and Barbuda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Cosmello","sequence":"additional","affiliation":[{"name":"Basic Medical Science, American University of Antigua College of Medicine, St. Johns 1451, Antigua and Barbuda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Purva","family":"Patel","sequence":"additional","affiliation":[{"name":"Basic Medical Science, American University of Antigua College of Medicine, St. Johns 1451, Antigua and Barbuda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Bersma","sequence":"additional","affiliation":[{"name":"Basic Medical Science, American University of Antigua College of Medicine, St. Johns 1451, Antigua and Barbuda"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,30]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2023, May 31). Global Cancer Observatory\u2014International Agency for Research on Cancer. Available online: https:\/\/gco.iarc.fr\/."},{"key":"ref_2","unstructured":"PAHO\/WHO|Pan American Health Organization (2023, May 02). Antigua and Barbuda Advances towards the Elimination of Cervical Cancer as a Public Health Problem. (n.d.). Available online: https:\/\/www.paho.org\/en\/news\/3-8-2022-antigua-and-barbuda-advances-towards-elimination-cervical-cancer-public-health."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1080\/01443615.2019.1634030","article-title":"Human papillomavirus and cervical cancer","volume":"40","author":"Okunade","year":"2020","journal-title":"J. Obstet. Gynaecol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3802\/jgo.2015.26.1.3","article-title":"Clinical implication of surgically treated early-stage cervical cancer with multiple high-risk factors","volume":"26","author":"Matsuo","year":"2015","journal-title":"J. Gynecol. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/S0140-6736(07)61416-0","article-title":"Human papillomavirus and cervical cancer","volume":"370","author":"Schiffman","year":"2007","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"E359","DOI":"10.1002\/ijc.29210","article-title":"Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012","volume":"136","author":"Ferlay","year":"2015","journal-title":"Int. J. Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"L1","DOI":"10.1016\/j.vaccine.2008.05.043","article-title":"Burden and trends of type-specific human papillomavirus infections and related diseases in the latin america and Caribbean region","volume":"26","author":"Parkin","year":"2008","journal-title":"Vaccine"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"You, D., Han, L., Li, L., Hu, J., Zimet, G.D., Alias, H., Danaee, M., Cai, L., Zeng, F., and Wong, L.P. (2020). Human Papillomavirus (HPV) Vaccine Uptake and the Willingness to Receive the HPV Vaccination among Female College Students in China: A Multicenter Study. Vaccines, 8.","DOI":"10.3390\/vaccines8010031"},{"key":"ref_9","unstructured":"Adams, S., and Adams, S. (2023, May 02). How Much Do You Know about Cervical Cancer?\u2014Ministry of Health, Wellness and Environment. Ministry of Health, Wellness and Environment. Government of Antigua and Barbuda. 25 January 2023, Available online: https:\/\/health.gov.ag\/elementor-9771\/#:~:text=HPV%20vaccines%20are%20currently%20available,all%20clinics%20free%20of%20charge."},{"key":"ref_10","unstructured":"Lwanga, S.K., and Lemeshow, S. (1991). Sample Size Determination in Health Studies: A Practical Manual, World Health Organization."},{"key":"ref_11","unstructured":"Qualtrics, X.M. (2023, May 02). Experience Management Software. 28 April 2023. Qualtrics. Available online: https:\/\/www.qualtrics.com\/."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Yu, Y., Xu, M., Sun, J., Li, R., Li, M., Wang, J., Zhang, D., and Xu, A. (2016). Human Papillomavirus Infection and Vaccination: Awareness and Knowledge of HPV and Acceptability of HPV Vaccine among Mothers of Teenage Daughters in Weihai, Shandong, China. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0146741"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1111\/jrh.12213","article-title":"Cancer Disparities in Rural Appalachia: Incidence, Early Detection, and Survivorship","volume":"33","author":"Yao","year":"2017","journal-title":"J. Rural. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2349","DOI":"10.1002\/ijc.27485","article-title":"Human papillomavirus types in 115,789 HPV-positive women: A meta-analysis from cervical infection to cancer","volume":"131","author":"Guan","year":"2012","journal-title":"Int. J. Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1586\/eog.11.13","article-title":"Optimizing technology for cervical cancer screening in high-resource settings","volume":"6","author":"Richardson","year":"2011","journal-title":"Expert. Rev. Obstet. Gynecol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1046\/j.1525-1438.1999.99022.x","article-title":"The use of vaccines in treating cervical cancer: Present status and future prospects","volume":"9","author":"Onon","year":"1999","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"(2023, May 02). Antigua and Barbuda\u2014Country Profile. Health in the Americas. 4 April 2023. Available online: https:\/\/hia.paho.org\/en\/countries-22\/antigua-barbuda-country-profile.","DOI":"10.5089\/9798400243240.002"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/j.vaccine.2012.11.083","article-title":"Knowledge of human papillomavirus (HPV) and HPV vaccination: An international comparison","volume":"31","author":"Marlow","year":"2013","journal-title":"Vaccine"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Warner, Z.C., Reid, B., Auguste, P., Joseph, W., Kepka, D., and Warner, E.L. (2022). Awareness and Knowledge of HPV, HPV Vaccination, and Cervical Cancer among an Indigenous Caribbean Community. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19095694"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1136\/sextrans-2013-051402","article-title":"Knowledge of human papillomavirus (HPV) testing in the USA, the UK and Australia: An international survey","volume":"90","author":"Dodd","year":"2014","journal-title":"Sex. Transm. Infect."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1136\/jfprhc-2013-100583","article-title":"Predicting human papillomavirus vaccination behaviour among adolescent girls in England: Results from a prospective survey","volume":"40","author":"Bowyer","year":"2014","journal-title":"J. Fam. Plan. Reprod. Health Care"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1071\/SH09150","article-title":"Knowledge of human papillomavirus (HPV) and the HPV vaccine in a national sample of Australian men and women","volume":"7","author":"Pitts","year":"2010","journal-title":"Sex. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.jegh.2012.11.001","article-title":"Human papillomavirus (HPV) infection and vaccines: Knowledge, attitude and perception among female students at the University of Lagos, Lagos, Nigeria","volume":"2","author":"Makwe","year":"2012","journal-title":"J. Epidemiol. Glob. Health"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ra\u00e7i, P.Z., Ra\u00e7i, F., and Hadri, T. (2021). Kosovo women\u2019s knowledge and awareness of human papillomavirus (HPV) infection, HPV vaccination, and its relation to cervical cancer. BMC Womens Health, 21.","DOI":"10.1186\/s12905-021-01496-x"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/7\/1230\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:03:38Z","timestamp":1760126618000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/7\/1230"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,30]]},"references-count":24,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["medicina59071230"],"URL":"https:\/\/doi.org\/10.3390\/medicina59071230","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2023,6,30]]}}}