Community Survey on Human Papillomavirus and HPV Vaccine

HPV Knowledge

Thank you for taking the time to complete this survey on human papillomavirus (HPV). This survey is intended to measure the knowledge and awareness about HPV in Shawano and Menominee Counties. Your responses are anonymous and will be used to evaluate the Shawano-Menominee Counties Health Department's efforts in promoting the HPV vaccine.

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* 1. I feel I know a lot about HPV

True

False

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* 2. HPV is the most common sexually transmitted infection

True

False

Don't Know

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* 3. The most common symptom of HPV is

No symptoms - most people don't know they have HPV

Headaches and migranes that last for several days

An itchy rash on the skin where in infection occurred

Don't know

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* 4. The most common types of HPV can cause (choose all that apply)

Chlamydia

Warts

Varicella

Cancer

Heart Disease

Don't know

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* 5. HPV vaccines protects against the most common HPV types that cause

Chlamydia

Warts

Varicella

Cancer

Heart Disease

Don't know

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* 6. The HPV vaccine series is recommended:

For girls only, ages 11-18

For girls only, ages 18-26

For boys only, ages 18-21

For boys and girls, ages 18-26

For boys, ages 11-21 and girls, ages 11-26

Don't know

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* 7. Getting the HPV vaccine early

Protects against other sexually transmitted infections

Allows for better immune response, giving an individual better protection

Promotes early risky sexual behaviors

Don't know

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* 8. The HPV vaccine is given

With the HCM vaccine

In a pill form

As part of required school immunizations

In a three dose vaccine series

Don't know

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* 9. Would you get your child vaccinated for HPV?

Yes

Please explain why/why not: