Title thesis: Sexual behaviour and HPV in young women. The pre-vaccine era.

Lenselink described in her thesis the Dutch situation of HPV prevalence and related risk factors among young adult women prior to mass vaccination. Risk factors for acquiring new HPV infections as well as factors associated with clearance of HPV infections were described in this thesis. Furthermore, alternatives for the physician-based collection of cervico-vaginal material were described.

Vaccine acceptability may differ in children and parents of children in the vaccination target group. Assessing predictors of intention to receive the vaccine as well as assessing knowledge about HPV will be important to create effective vaccination campaigns and reach high vaccine coverage. These issues are addressed in this thesis.

Lenselink determined whether young Dutch adults had ever heard of HPV in the pre-vaccination era and whether they would accept vaccination, and to assess the factors influencing their decision. Lenselink found that average knowledge levels of HPV and cervical cancer were low. Despite this lack of knowledge, a small majority of the study population would accept a ‘catch-up’ HPV vaccination. Women and younger participants were significantly more willing to accept HPV vaccination.

Furthermore, Lenselink concluded that HPV detection and genotyping in self-obtained cervicovaginal samples with the Viba Brush applied to an FTA elute cartridge is highly reliable. It shows a high level of overall agreement with HPV detection and genotyping in physician-obtained cervical smears obtained with the Cervex-brush and liquid-based self-samples.