Öz
Giriş
Türkiye dâhil olmak üzere birçok düşük ve orta gelirli ülkede insan papilloma virüsü (HPV) aşısı henüz ulusal bağışıklama programına dâhil edilmemiştir. İnsan bağışıklık yetmezliği virüsü (HIV) ile yaşayan kişiler, HPV enfeksiyonu ve buna bağlı kanserlere karşı artmış duyarlılıkları nedeniyle aşılama açısından öncelikli bir risk grubudur. Aşılama önündeki engellerin belirlenmesi, etkili korunma stratejilerinin geliştirilmesi için önem taşımaktadır.
Gereç ve Yöntem
Çalışma Nisan-Temmuz 2024 tarihleri arasında, üçüncü basamak bir eğitim ve araştırma hastanesinde HIV ile yaşayan kişiler arasında yürütüldü. Yapılandırılmış bir anket aracılığıyla katılımcıların sosyodemografik özellikleri, HPV hakkındaki bilgi düzeyleri, aşı öyküleri ve aşıya ilişkin tutumları değerlendirildi. HPV bilgisi ve aşılama oranlarıyla ilişkili faktörler istatistiksel olarak analiz edildi.
Bulgular
Çalışmaya toplam 120 kişi katıldı; katılımcıların %92,5’i (n = 111) erkek, %6,7’si (n = 8) kadın ve %0,8’i (n = 1) transgender olarak tanımlandı. Katılımcıların ortalama yaşı 34,6 idi. Katılımcıların %60,0’ı HPV hakkında bilgi sahibi olduğunu bildirmiş, ancak yalnızca %12,5’i en az bir doz HPV aşısı yaptırmıştı. HPV konusunda bilgi sahibi olanlar arasında aşılama oranı %18,1 olarak bulundu. Aşılanma oranı, önceden HPV enfeksiyonu geçirenlerde (%25,0; p < 0.05) ve hekimden bilgi alanlarda (%45,8; p < 0,001) anlamlı olarak daha yüksek saptandı. Aşılanmamış bireylerin %48.8’i (n = 51) aşının yalnızca ücretsiz olması durumunda aşı yaptıracağını belirtti. Daha yüksek eğitim düzeyi, genç yaş ve heteroseksüel olmayan yönelim, HPV konusunda daha yüksek bilgi düzeyi ile anlamlı olarak ilişkili bulundu.
Sonuç
Türkiye’de HIV ile yaşayan bireylerde HPV farkındalığı orta düzeyde olmasına rağmen aşılama oranı belirgin biçimde düşüktür. Ekonomik ve bilgiye erişimle ilgili engeller bu durumu belirleyen temel faktörlerdir. Ücretsiz aşılama programlarının yaygınlaştırılması ve hekimlerin aşı önerilerinin güçlendirilmesi, bu yüksek riskli grupta HPV ilişkili hastalık yükünü azaltmak açısından kritik öneme sahiptir.
Anahtar Kelimeler:
Engeller, maliyet, sağlık hizmetleri, HIV, HPV, bilgi düzeyi, aşılama
Kaynaklar
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