婦女感染人類乳突狀病毒之危險因素分析

人類乳突狀病毒(Human Papillomavirus, HPV)，被認為是導致子宮頸內上皮細胞瘤及子宮頸癌的首要原因。本研究目的欲瞭解婦女感染人類乳突狀病毒之現狀及其危險因子，並探討婦女之社會人口學變項、人類乳突狀病毒知識、安全性行為，對感染人類乳突狀病毒與子宮頸抹片檢查結果的影響。研究採取橫斷式相關性研究法，以高雄縣接受子宮頸抹片檢查及人類乳突狀病毒篩檢之婦女為研究對象，共計140名。研究工具採結構式問卷，內容包括：社會人口學變項、安全性行為量表、及人類乳突狀病毒知識量表，所得資料以SPSS/PC 10.0套裝軟體進行描述性及推論性統計。研究結果主要發現如下：(1)婦女感染人類乳突狀病毒的比率為47.9%。(2)教育程度、人類乳突狀病毒知識、及年齡為婦女執行安全性行為之重要預測因子，總解釋變異量為42.6%。(3)婦女感染人類乳突狀病毒之重要危險因子，為有配偶者(AOR=2.75, 95% CI=1.17-4.43)及從未執行子宮頸抹片檢查行為者(AOR=2.87, 95% CI=1.04-7.90)。(4)婦女子宮頸抹片檢查結果之重要危險因子，為有配偶者(AOR=8.13, 95% CI=.02- .48)、安全性行為較差者(AOR=4.06, 95% CI=1.03-7.11)、及感染人類乳突狀病毒者(AOR=25.65, 95% CI= .02- .14)。本研究結果，可提供醫療衛生相關人員進一步了解婦女感染人類乳突狀病毒與子宮頸抹片檢查結果之情形及危險因子，並可作為護理實務、教學、研究及衛生政策制定之參考。社區衛生護理人員除了加強婦女人類乳突狀病毒與安全性行為相關知識之衛教外，未來更應持續推廣子宮頸抹片檢查，以發揮「及早發現、及早治療」之成效。

關鍵字

子宮頸癌；安全性行為；人類乳突狀病毒；危險因子；人類乳突狀病毒知識；子宮頸抹片檢查

並列摘要

Human papillomavirus (HPV) is though to be the primary cause of cervical intraepithelial neoplasia and cervical cancer. The purpose of research was to determine the prevalence of cervical HPV infection and its risk factors in women, and explore the relations among HPV knowledge, safe sex behaviors, cervical HPV infection, and Pap smear result. The study’s design was cross-sectional and correlational. Subjects consisted of 140 women who lived in Kaohsiung County and underwent a Pap smear and HPV-PCR test. A structured questionnaire was used to collect data via a face to face interview. The content of the questionnaire included subject characteristics, HPV knowledge scale, safe sex behaviors questionnaire. The data was analyzed using SPSS 10.0 for windows. The major findings of this study were as follows: (1)The prevalence of cervical HPV infection was high (47.9%). (2)The most important predictive variables for safe sex behaviors were women’s education, HPV knowledge, and age. These variables explained 42.6% of the variance in women’s safe sex behaviors. (3)Risk factors for cervical HPV infection were being married (AOR=2.75, 95% CI= 1.17-4.43) and never had Pap smear test in the past (AOR=2.87, 95% CI= 1.04-7.90). (4)Risk factors for abnormal Pap smear result were being married (AOR=8.13, 95% CI=.02- .48), risky safe sex behaviors (AOR=4.06, 95%CI=1.03-7.11), and cervical HPV infection (AOR=25.65, 95% CI=.02-.14). The results of this study make a contribution to public health workers to understanding the risk factors of HPV infection and abnormal Pap smear result. These findings could also serve as indices for nursing practice, education, research, and policy making to reduce the prevalence of cervical cancer further. Community health nurses should educate the public about HPV knowledge and safe sex behavior knowledge. Besides, they should keep inspiring women to take Pap smear tests in order to achieve the objective of the earlier its found, the earlier it can be cured.