Bridging the gap: Using the theory of planned behavior to predict HPV vaccination intentions in men

BRIDGING THE GAP: USING THE THEORY OF PLANNED BEHAVIOR TO PREDICT HPV VACCINATION INTENTIONS IN MEN By: Daniel James Snipes, B.A. A thesis submitted in partial fulfillment of the requirement of the degree of Master of Science at Virginia Commonwealth University Virginia Commonwealth University, 2013 Major Director: Eric G. Benotsch, Ph.D Associate Professor of Psychology Department of Psychology Virginia Commonwealth University Richmond, Virginia March, 2013 Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the US, with an estimated incidence rate of 6.2 million new cases each year. Men have higher instances of certain HPV related outcomes (e.g., head/neck cancers) when compared to women, so male vaccination with the HPV vaccine is also paramount to preventing cancer. The present study examined the theory of planned behavior (TPB) as a model for predicting HPV vaccination intentions among men. Results suggest the TPB was a well-fitting model to the data, but not all aspects of the TPB model were predictive of HPV vaccination intentions. Behavioral beliefs (e.g.., the belief that vaccination will provide a beneficial outcome) were the only significant predictor of HPV vaccination intention in the next 6 months. Perceived norms, motivations to comply with norms, attitudes towards the HPV vaccine, and self-efficacy were not significant predictors of HPV vaccination intentions. 1 Bridging the gap: Using the theory of planned behavior to predict HPV vaccination intentions in men Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI; CDC, 2011a), with an incidence rate of approximately 6.2 million new cases each year in the United States (Weinstock et al., 2004). HPV is part of the papillomaviridae family of viruses, which affect all parts of the body. For instance, HPV type 1 affects the soles of the feet primarily. Over 100 strains of HPV have been identified, with around 40 causing warts (Koutsky & Kiviat, 1999). In general, HPV is a virus that replicates deep within the epidermis, creating small tumors called “papillomas”. Certain strains are more of a public health concern than others, as HPV strains 6 and 11 cause 90% of genital warts, while strains 16 and 18 can cause cervical, anal, penile, oropharyngeal, and head/neck cancers (Markowitz et al., 2009; CDC, 2011b; Pisani et al., 1997; Koutsky, 1997; Kreimer et al., 2005). HPV does not cause immediate symptoms (CDC, 2011a), and as such can go unnoticed until more serious symptoms (genital warts and/or cancer) become apparent (CDC, 2011a). High-risk strains of HPV can be transmitted sexually, and condoms may not be very effective in preventing HPV infection (Schiffman & Kjaer, 2003). HPV can be transmitted through vaginal, anal and oral sex, as well as genital to genital contact (CDC, 2009). High-risk strains (e.g., HPV strains 16 and 18) are found in 99% of cervical cancers (Bosch & de Sanjose, 2003). Genital HPV infection may cause other forms of cancers, as it has been linked with breast cancer (Antonsson et al., 2011) and lung cancer (Li et al., 2011). It is estimated that at least 50% of sexually active individuals have contracted one or more strains of HPV at some point in their lives (CDC, 2011b).