Introduction Female sex workers (FSW) are at risk for HPV-induced diseases but are currently not targeted by the HPV vaccination program in the Netherlands. We explored the determinants of their intention to get vaccinated against HPV in case vaccination would be offered to them in the near future.
Methods In 2016, FSW aged >18 years having an STI consultation with the Prostitution and Health Centre (P and G292) in Amsterdam, either at the clinic or at their working location, were invited to complete a questionnaire assessing the socio-psychological determinants of their HPV vaccination intention (scale ranging from −3 to +3). Determinants of HPV vaccination intention were assessed with uni- and multivariable linear regression. Additionally, we explored the effect of out-of-pocket payment on intention.
Results Between May and September 2016, 293 FSW participated; 98 (34%) worked in clubs/private houses/massage salons, 111 (38%) worked at ‘prostitution windows’, and 81 (28%) worked as escorts or from home. The median age was 29 years (IQR 25–37). HPV vaccination intention was relatively high (mean 2.0; 95% CI:1.8–2.2). In multivariable analysis attitude (β=0.6; 95% CI:0.5–0.7), descriptive norm (β=0.3; 95% CI:0.2–0.4), self-efficacy (β=0.2; 95% CI:0.1–0.3), beliefs (β=0.1; 95% CI:0.0–0.2) and anticipated regret (β=0.1; 95% CI:0.0–0.2) were the strongest predictors of HPV vaccination intention. Demographic variables did not improve the multivariable regression model. The explained variance in the model (R2) was 0.54. HPV vaccination intention decreased significantly when vaccination would require out-of-pocket payment (€50 mean: 1.2 (95%CI: 0.8–1.7); €100 mean: 1.6 (95%CI: 1.1–2.0); € 200 mean: 1.0 (95%CI: 0.5–1.5); € 350 mean: 0.2 (95%CI: −0.2–0.7).
Conclusion HPV vaccination intention among FSW in Amsterdam appears to be very high. The included socio-psychological factors explained most of the variance in HPV vaccination intention among FSW. Out-of-pocket payment had a significant negative effect on HPV vaccination intention.