PENGETAHUAN, PERSEPSI, DAN KESEDIAAN VAKSINASI HPV PADA REMAJA PUTRI DI YOGYAKARTA

KURNIAWATI ARIFAH, dr. Mei Neni Sitaresmi, Ph.D, Sp.AK.; dr. Wahyu Damayanti, M.Sc, Sp.A(K).

2017 | Tesis | S2 Ilmu Kedokteran Klinik

Latar Belakang: Kanker serviks merupakan keganasan terbanyak keempat pada wanita di dunia. Jumlah kasus baru setiap tahun di Indonesia sebanyak 20.928 kasus dengan kematian 9498. Infeksi Human Papilloma Virus (HPV) risiko tinggi adalah penyebab utama kanker serviks. World Health Organization (WHO) merekomendasikan vaksinasi HPV untuk wanita 9-14 tahun. Meskipun vaksin HPV efektif, cakupan vaksinasi belum optimal. Tujuan: Penelitian ini bertujuan untuk mengetahui pengetahuan dan persepsi infeksi HPV, kanker serviks, dan vaksinasi HPV; kesediaan vaksinasi; dan faktor yang berkaitan dengan vaksinasi HPV. Metode: Penelitian cross-sectional dengan kuesioner tentang pengetahuan dan persepi, diisi secara anonim oleh 319 remaja SMP di kota Yogyakarta mulai September-Oktober 2016. Kriteria inklusi adalah pelajar putri SMP di kota Yogyakarta, bersedia mengikuti penelitian, mendapat persetujuan dari pihak sekolah dan orang tua. Lima dieksklusi karena data tidak lengkap. Hasil dan Pembahasan: Remaja memiliki pengetahuan yang buruk. Persepsi remaja terhadap infeksi HPV dan vaksinasi negatif. Persepsi kanker serviks positif, mayoritas remaja menyadari penyakit ini berbahaya tetapi tidak beranggapan bahwa mereka rentan mengalami kanker serviks. Kesediaan vaksinasi sebesar 9,9%. Mayoritas menolak karena ingin berdiskusi dengan orang tua. Persepsi infeksi HPV (p=0,000), persepsi kanker serviks (p=0,001), dan persepsi vaksinasi HPV (p=0,000) terbukti bermakna berkaitan dengan kesediaan vaksinasi HPV. Kehalalan dan keamanan vaksin termasuk hal yang dipertimbangkan dalam menentukan vaksinasi. Kesimpulan: Kesediaan vaksinasi HPV yang rendah berkaitan dengan persepsi negatif tentang infeksi HPV, kanker serviks, dan vaksinasi HPV. Upaya peningkatan vaksinasi HPV selain inisiasi program berbasis sekolah perlu disertai edukasi untuk meningkatkan pengetahuan dan memperbaiki persepsi remaja.

Background: Cervical cancer ranks the fourth most frequent cancer in women worldwide. Each year 20,928 women are diagnosed with cervical cancer, and 9498 die of the disease in Indonesia. Persistent infection with high-risk human papilloma virus (HPV) is a necessary step in the pathogenesis of cervical cancer. HPV vaccines are most effective if provided prior to the onset of sexual activity, as recommended by World Health Organization (WHO) young adolescent aged 9-14 years. Despite vaccine efficacy, the coverage is low. Objective: To determine knowledge and perceptions of HPV infection, cervical cancer, and HPV vaccination, vaccine acceptability and factors associated with HPV vaccination. Methods: September-October 2016, a cross-sectional survey of 319 junior high school students using anonymously completed questionnaires was done. Inclusion criteria were female junior high school student in Yogyakarta who willing to participate in the study, school and parental consent. Five incomplete data were excluded. Results and Discussion: Knowledge among adolescent were poor, most perceptions were negative. HPV vaccine acceptability was 9.9%. The main reason of vaccine refusal was they want to discuss with the parents prior to accepting vaccination. HPV vaccination was significantly associated with perception of HPV infection (p=0.000), cervical cancer (p=0.001), and HPV vaccination (p=0.000). Adolescent mentioned concern about vaccine halal and safety as possible barrier towards HPV vaccine implementation. Conclusions: Negative perception towards HPV infection, cervical cancer, and HPV vaccination were related to low vaccine acceptability. Increasing acceptability could be done through school vaccination program and adequate education to increase knowledge with special attention to adolescent perceptions.

Kata Kunci : HPV, kanker serviks, vaksinasi, remaja, cervical cancer, adolescent, vaccination