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Human papillomavirus and papillomavirus vaccines: knowledge, attitudes and intentions of general practitioners and practice nurses in Christchurch.

INTRODUCTION
General practitioners (GP) and practice nurses (PN) perform the majority of cervical screening in Christchurch and will have a key role in influencing uptake of human papillomavirus (HPV) immunisation.


AIM
To assess and compare GP and PN knowledge about HPV disease, attitudes concerning adolescent sexual behaviour and intentions to recommend HPV immunisation.


METHODS
A self-administered, anonymous questionnaire was distributed to GPs and PNs in Christchurch, New Zealand who attended peer-led small group meetings hosted by Pegasus Health Independent Provider Association in May 2008.


RESULTS
Participation rate was 39%. Overall, 94% of respondents knew that HPV immunisation will not replace cervical cancer screening; 73% knew that HPV is the cause of cervical cancer; 48% knew that most HPV infections will clear without medical treatment; 20% correctly reported that anogenital warts are not cervical cancer precursors. More GPs reported comfort discussing sexual behaviour with adolescents than PNs (p < .008). While 95% of participants intend to recommend immunisation for 13-15-year-old girls, PNs were more likely than GPs to recommend HPV immunisation to older female adolescents and more often indicated that HPV vaccination may lead to risky sexual behaviour (p < .0001).


DISCUSSION
This is the first New Zealand study to assess primary care knowledge and attitudes about HPV and HPV immunisations. The results are encouraging, provide a baseline for future research and may guide the development of training materials for GPs and PNs.