Level of Knowledge of the Human Papilloma Virus in Women of a Primary Care Unit in Tijuana B.C.

Research Article

J Fam Med. 2020; 7(7): 1219.

Level of Knowledge of the Human Papilloma Virus in Women of a Primary Care Unit in Tijuana B.C.

Hernandez-Navarro R¹* and Bermudez-Villalpando VI²

¹Department of Family Medicine, Family Medicine Unit #27 (IMSS), Baja California Delegation, Mexico

²Department of Family Medicine, Family Medicine Unit #33 (IMSS), Baja California Delegation, Mexico

*Corresponding author: Hernandez-Navarro Roxana, Department of Family Medicine, Family Medicine Unit #27 (IMSS), Baja California Delegation, Mexico

Received: October 04, 2020; Accepted: October 13, 2020; Published: October 20, 2020


Background: The prevalence of the Human Papillomavirus (HPV) in Mexico fluctuates between 10-12%. Due to the low knowledge about HPV, women do not perceive the risk and ignore the possible consequences of this sexually transmitted infection.

Aim: The purpose of this study is to determine the level of knowledge of the HPV in women of the Family Medicine Unit #27 (FMU 27) of Tijuana, Mexico.

Design and Setting: Analytic cross-sectional study.

Methods: An analytical cross-sectional study was carried out, the level of knowledge of Human Papilloma Virus was measured in women from FMU 27 during August-October 2019. Qualitative variables were expressed in frequencies and percentages; central tendency and dispersion measures were used for quantitative variables. Chi-square was used for the bivariate analysis, a p <0.05 was considered significant.

Results: 194 patients were analyzed, 41% had a free union, 47.9% had secondary education (p= 0.003), 69.1% were employed and 55.2% had a lower middle socioeconomic level (p= 0.003). Regarding the level of knowledge, 71.1% was high, 25.8% medium and 3.1% low.

Conclusion: A high level of knowledge about HPV was evidenced. We recommend continuing to implement educational programs at different ages to further increase awareness of this disease.

Keywords: Level of Knowledge; Human Papillomavirus


The HPV is a virus that belongs to the papolomaviridae family [1]. It infects and replicates in the nucleus of epithelial cells, its main site of involvement is the transitional epithelium of the cervix, affecting basal cells of the squamous epithelium. It has the ability to infect on contact with the skin, by sexual and vertical transmission at the time of delivery. The benign manifestations are condyloma and genital warts produced by non-oncogenic genotypes 6 and 11 (HPV6, HPV11); oncogenic genotypes 16 and 18 (HPV16, HPV18) cause 70% of cervical cancer. The highest prevalence rates are observed in women under 25 years of age, with a significant decrease between 25- 40 years [2].

Cervical cancer is the second most common cancer in women [3]. In Mexico it constitutes one of the main public health problems, with an incidence of 15.5% and a mortality of 12.8%, although it occurs in developing countries, a common denominator is the scarce economic resource and the low educational level [4]. HPV penetrates the suprabasal cells of the cervical epithelium where by viral transcription and repression of its late genes L1 and L2, it infects the keratinocyte [5]. The beginning of an active sexual life and the first pregnancy at an early age, multiparity, illiteracy, low socioeconomic level, hormonal contraceptives, smoking, a diet low in antioxidants, HIV co-infection and no access to social security, are the risk factors most strongly associated with the development of cervical HPV-cancer [4-6].

The Department of Epidemiology of the Ministry of Health in Mexico has established that cervical cancer detection programs should focus on three factors: achieving 80% coverage in the screening of the target population; ensure diagnosis and offer adequate and timely treatment in women with abnormal results [7]. The screening method is cervical cytology (Papanicolaou), a primary tool for the detection of premalignant lesions [8]. There are two vaccines against HPV, the bivalent vaccine (Cervarix) that contains antigens for types 16 and 18; and the quadrivalent vaccine (Gardasil) with antigens for types 16, 18, 6 and 11. The schedule used in Mexico is 0-6-60 months, or a two-dose schedule (0-6 months/0-12 months) [9]. According to the World Health Organization (WHO), vaccination is recommended for girls between 9 and 13 years of age [10]. In the acceptability of vaccines, prior knowledge of the vaccine by parents could be the main determining factor for its application [11].

The level of knowledge about the human papillomavirus is defined as the result of the assimilation of information by a person about the virus that is transmitted through sex, which affects the genitalia of men and women [12]. It is important for the general population to know about HPV and related risk factors, which affect women's health [13]. Therefore, the main objective of the research was to determine the level of knowledge of HPV in women from Tijuana.

Material and Methods

Study Design and Population

An analytical cross-sectional study was conducted between August-October 2019 at FMU 27 of the Instituto Mexicano del Seguro Social (IMSS). Women between 25-45 years old who agreed to participate in the study by informed consent were included. Patients with some mental disability or psychiatric illness were excluded from the study; patients with incomplete information were eliminated. A structured interview was conducted on a data collection form, which allowed obtaining personal, sociodemographic and clinical data.


The collection of variables was done with a standardized data form; the variables collected were age, marital status, education and occupation, which were asked directly; the knowledge about HPV was measured through the questionnaire “The Human Papilloma Virus and its health”, which has 16 questions, validated in Spanish with a Kuder-Richardson reliability coefficient of 0.76; this instrument classifies knowledge as low (0-5 points), medium (6-10 points) and high (11-16 points) [14]; finally, the socioeconomic level was obtained using the Graffar-Mendez Castellanos scale, a validated instrument in Spanish (Cronbach's alpha 0.75), it measures four dimensions and classifies the family into 5 categories, upper class (4-6 points), high average (7-9 points), low average (10-12 points), worker (13-16 points) and marginal (17-20 points) [15,16].

Statistical Analysis

Descriptive statistics were performed; qualitative variables were expressed in frequencies and percentages; mean and standard deviation were used for quantitative variables. Chi-square was used for the bivariate analysis. The results were evaluated in a 95% confidence interval, a p <0.05 was considered significant. For data analysis, the IBM SPSS program, version 21 was used.


The study was approved by the Local Committee of Ethics and Health Research number 204; with registration number R-2019-204- 022. The research was conducted under the General Health Law on Health Research, the Helsinki declaration and Bioethical principles. The participants signed the informed consent.


194 women were analyzed, with a mean age of 33.98 ± 6.07 years. According to their marital status, 41% were in free union, 37% married, 16% single, 5% divorced and 1% widowed. In schooling, 47.9% had secondary school, 21.6% primary, 19.6% high school, 8.8% university and 2.1% lacked studies. The majority were employed (69.1%), 24.7% dedicated to the home, 5.6% merchants, and 0.5% pensioners; 55.2% had a lower middle socioeconomic level, 33% working class, 10.3% middle class, and only 1.5% marginal stratum. The level of knowledge of the human papillomavirus was high in 71.1%, 25.8% medium level and 3.1% low level (graphic 1). The sociodemographic characteristics are described in Table 1.