Desconhecimento sobre a campanha de vacinação contra o HPV entre estudantes brasileiros: uma análise multinível

Abstract

Resumo O objetivo deste artigo é analisar a associação entre o desconhecimento sobre a campanha de vacinação contra o HPV entre adolescentes e fatores individuais e contextuais. Estudo transversal com dados da Pesquisa Nacional de Saúde do Escolar (2015). Foi realizada a análise bivariada e calculadas as Razões de Prevalência em uma Regressão de Poisson multinível (IC95%) para verificar o efeito das variáveis no desfecho. O desfecho esteve associado significativamente a ter 15-19 anos de idade (RP=1,36), estudar no turno da tarde/noite (RP=1,05), já ter tido relações sexuais (RP=1,10), com autopercepção do estado de saúde ruim ou muito ruim (RP=1,23), insatisfeito (RP=1,14) ou indiferente (RP=1,15) à sua imagem corporal, que falta às aulas sem consentimento dos pais (RP=1,10) e que estuda em escola pública (RP=1,24). Houve menor prevalência do desfecho entre o sexo feminino (RP=0,24) e em estados com maior desigualdade de renda (RP=0,80). O desconhecimento sobre a campanha de vacinação contra o HPV entre adolescentes foi associado às características individuais e do contexto da escola e da unidade de federação. Esses achados indicam a importância de fortalecer a promoção à saúde voltada aos jovens em vulnerabilidade.

Vaccination against human papillomavirus in Brazilian schoolchildren: National Survey of School Health, 2019

“…The unawareness of HPV vaccination was the most frequent reason among those listed to justify non-vaccination by schoolchildren. This result was also reported by a study with data from PeNSE 2015, revealing that 10.30% of the students did not know or had not heard of the HPV vaccination campaign 5 . The same study found a positive association between the unawareness of the campaign against HPV and the age group from 15 to 17 years, studying in the afternoon/night shift, having had sex, presenting self-perception of health status as poor or very poor, being dissatisfied or indifferent about body image, and studying in public school 5 .…”

“…Considering that an analysis by sex is essential for the proper evaluation of health indicators in Brazil and that the results of our study showed a lower proportion of male adolescents vaccinated against HPV compared to females in all regions of the country, interventions should consider gender differences when developing health strategies aimed at improving immunization indicators in this group. A study with data from PeNSE 2015 also showed a higher proportion of unvaccinated male adolescents and a positive association between males and unawareness of the HPV campaign 5 .…”

“…Despite the importance of disseminating information on HPV to increase vaccination adherence by the adolescent public 5 ), ( 24 ), ( 25 , evidence shows that many health professionals do not discuss or recommend this protection method 14 . Moreover, inadequate communication strategies are adopted, compromising the acceptance of the vaccine by adolescents 14 .…”

“…In this study, memory bias represented a limitation since adolescents had to evoke previous facts to answer questions from the PeNSE questionnaire. Additionally, the target audience of the research tends to answer complex questions inaccurately, which may lead to underestimation or overestimation of the information provided 5 . The fear of judgment and feelings of shame from prior experience may prevent students from responding in a reliable way, representing a potential risk of obtaining inadequate information 25 .…”

“…To control possible confounding factors, the adjusted analysis considered the model proposed by Boakye et al 18 . The adjustment was made since the literature reports that girls vaccinate more against HPV than boys 5 , making it possible to consider the influence of this sociodemographic factor 18 . To analyze the quality of the fit in the Poisson models, the adjustment quality test (F test) was used.…”