# Presentation: 047255

## Physician Attitudes and Receptiveness to STD Vaccines

**MVD Business Research**** Merck & Company, Inc.**

## Objectives 

- To determine physicians’ perceptions of adolescent sexual activity
- To assess the comfort-level, timing, and content of sexual risk discussions among physicians and their female adolescent patients
- To examine any behavioral differences between pediatricians and family practitioners regarding sexual risk discussions
- To describe physicians’ knowledge of STDs and to assess their perceived need for STD vaccines

## Methodology

- 642 physicians were selected at random from the AMA master file and contacted by mail, e-mail and telephone to participate in an internet-based study
- 309 pediatricians
- 333 family practitioners

## Methodology

**Selection Criteria:**
- _Physician_
- Has been in practice between 2-50 years
- Has not participated in vaccine-related research in the past three months
- Spends 70% of time seeing/treating patients
- Involved in vaccine decision-making in practice
- Does not work for a manufacturer of pharmaceutical products (nor has family that does)
- _Practice_
- At least 20% of patients are between the ages of 9-18
- No more than 75% of patients 19 years of age or older

## Methodology

- Quotas were set for the following physician characteristics to obtain a balanced sample:
- Specialty (Pediatrician 50%, GP-FPs 50%)
- Gender (Male 50%, Female 50%) within specialty
- Region (evenly distributed across 6 regions)*
- All results were tested at the 95% confidence level, two-tailed

- *Northeast (CT, DE, MA, ME, NH, NY, NJ, RI, VT), Mid Atlantic (DC, KY, MD, OH, PA, VA, WV), Southeast (AL, FL, GA, MS, NC, SC, TN), North Central (CO, IL, IN, MI, MN, ND, NE, SD, WI, WY) , South Central (AR, IA, KS, LA, MO, NM, OK, TX), West (AK, AZ, CA, HI, ID, MT, NV, OR, UT, WA)

## Results

## Sample Characteristics

- 	GP/FPs	Peds
- 	n=309	n=333
- Average % time seeing patients	98%	98%
- Average number of years in practice	16.9	16.8
- Number of patients per week	136	122
- Solo practice	24%	14%
- Single specialty practice 	69%	78%
- Staff Model HMO	4%	8%

## Perception of Patient Sexual Activity

**Perception of Patient Sexual Activity**

**9-10**

**11-12**

**13-15**

**16-18**

**9-10**

**11-12**

**13-15**

**16-18**

**% of Patients****Sexually Active**

**% of Patients****Sexually Active**

**Patient Age**

**Patient Age**

**GP/FPs**
**n=309**

**Pediatricians**
**n=333**

- Physicians believe that sexual activity is highest at age 16-18 compared with younger age groups.

- What percent of your adolescent/teenage (age 9-18) patients in the following age groups do you believe are sexually active?

## Perceptions of Specific Female Sexual Activity

|  | n = 642 | Average Age | Youngest Age |
| --- | --- | --- | --- |
| Masturbation | 635 | 12.9 | 9.9 |
| Mutual Masturbation | 633 | 15.4 | 12.7 |
| Oral Sex | 636 | 15.8 | 12.6 |
| Vaginal Intercourse | 638 | 16.1 | 12.7 |
| Anal Intercourse | 589 | 17.4 | 15.2 |

- Thinking about your female adolescent/teenage (age 9-18) patients, what is the average age they engage in the following types of behavior?  What is the youngest age?

## Comfort Level with Discussions

**	****9-10****	****11-12****	****13-15****	****16-18****	****9-10****	****11-12****	****13-15****	****16-18**

**	****Among Patients Aged:****	****Among Patients Aged:**
**	****GP/FPs (n=309)****	****Pediatricians (n=333)**

**GP/FPs and pediatricians report increasing levels of comfort with sexual risk discussions as patients get older**

- Using the scale below, please indicate how comfortable you feel discussing sex with your adolescent/teenage patients?

## Timing of Sexual Risk Discussions

| 
 |  |  |
| --- | --- | --- |
|  | GP/FPs
n=309 |        Peds 
n=333 |
| Before patient is sexually active | 22% | 34% |
| When I suspect a patient is sexually active | 51% | 27% |
| Only when patient/parent asks me | 4% | 2% |

- When do you _most commonly_ speak to your teenage/adolescent patients (age 9-18) about sexually transmitted diseases?

## Discussions with Patients

|  | GP/FPs
n=309 |  Peds
n=333 |
| --- | --- | --- |
| I stress the importance of using protection against STDs to my patients  | 56% | 50% |
| Before speaking to a patient about sex, I typically ask his/her parent’s consent | 56% | 43% |
| I take it upon myself to discuss sex with my patients.  After all, I don’t know from whom they receive their information | 38% | 48% |
| I believe that my patients should not engage in any sexual activity before marriage | 69% | 64% |

- Percentage of top 2 box on a 5-point scale.
- Thinking about your adolescent patients age _9-12,_ please indicate how much you agree or disagree with the following statements

## Perception of Disease Severity

- Base:  Total respondents (642 Physicians) .
- Using the scale below, please rate how serious the following diseases or infections are for an adolescent/teenage (age 9-18) patient

## Likelihood of Infection/Diseases 

- Base:  Total respondents (642 Physicians) .
- Using the scale below, please rate the chances of _**your**_ sexually active adolescent/teenage (age 9-18) patients getting the following diseases or infections.

## Physician Concern About HPV

**	****       ****9-10****	****      11-12****	****     13-15****	****    16-18****	****9-10****	****11-12****	****13-15****	****16-18**

**	****GP/FPs****	****Pediatricians**
**	****(n=309)****	****(n=333)**

**Physician Concern About HPV**

- Percentage of top 2 box on a 5-point scale.
- How concerned are you about Humanpapilloma Virus (HPV) infection with regards to your adolescent/teenage (age 9-18) patients?

**Years of Age**

## Need for Vaccines Against STDs

**Physicians reported that they believe vaccines against STDs are important for their 9-18 year old patients**

- Percentage of top 2 box on a 5-point scale
- Thinking about your adolescent patients age 9-12 or 13-18 please indicate how much you agree or disagree with the following statements.

## Vaccination Recommendation

**Physician likelihood to recommend a hypothetical vaccine for HPV for teenagers is high**

**Vaccination Recommendation**

- Mean percentage.
- Based on the information you just read, how likely are you to recommend this vaccine to each of the age groups below?

## Parental Resistance

- Base: All physicians (n=642) – 5-point scale
- Looking at the list below, please indicate how important each of the factors are when considering not to recommend this vaccine to your adolescent/teenage (age 9-18) patients.

**Among almost all physicians (73%), parental resistance to a hypothetical vaccine for HPV was considered an extremely, very, or somewhat important barrier to vaccination**

## Summary

- Physicians (pediatricians and FP/GPs) have similar beliefs about the sexual activity of their patients
- Physicians believe female patients engage in vaginal intercourse at an average age of 16
- Physicians are more comfortable having sexual risk discussions as their patients get older
- Pediatricians are more likely to start discussions before patients are sexually active
- Over 60% of physicians believe that their patients aged 9-12  should not engage in any sexual activity before marriage

## Summary

- While physicians perceive HPV to be serious, they do not believe it to be as serious as HIV or Hepatitis B infections
- Of the sexually transmitted diseases asked about,  physicians believe that their patients are most likely to become infected with HPV or chlamydia
- Physicians are more likely to be concerned about HPV infection among their older patients
- Physicians believe vaccines for STDs are needed for their 9-18 year old patients
- Physicians are more likely to recommend a hypothetical HPV vaccine for their older patients

## Summary

- Physicians are concerned that parents will resist  vaccination
- Other data suggest that parents are receptive to vaccination and that a strong recommendation increases parental acceptance1

- 1Lenar AJ, Parental Receptiveness to a Hypothetical HPV Vaccine