Awareness and practice of female beauty salon staff about human papilloma virus and its transmission in pubic hair removal using wax in Shiraz, Southwest of Iran

Document Type : Original Article


1 Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Midwifery, School of Nursing and Midwifery, Community-Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran


Background: The most common sexually transmitted infection is infection by human papilloma virus (HPV). Although the main transmission route of HPV is through sexual intercourse, the contact of the skin with the genital area skin is another known method for transmission. This study aims to examine the awareness and practice of female beauty salon staff about HPV and its transmission in pubic hair removal using wax. Materials and Methods: This cross-sectional study was conducted on 200 female beauty salon staff who do bikini waxing in Shiraz, Iran. Demographic information, awareness, and practice of them were gathered using the researcher-constructed questionnaire. The statistical analysis was performed using the SPSS software version 18. Results: Mean awareness and practice scores of beauty salon staff about HPV and its transmission in bikini waxing were 26.6 ± 12.8 and 5.5 ± 0.8, respectively, and in average range. The results showed that there was a significant relationship between practice and education (P = 0.04), but the relationship between the awareness and education was not seen (P = 0.72). There was no statistically significant relationship between age and work experience with awareness and practice of staff (P > 0.05). Conclusion: The awareness and practice of beauty salon staff about HPV and its transmission in bikini waxing are moderate. Therefore, it seems that the implementation of continuous educational program by the Union of women's beauty salons is necessary to increase and improve the awareness and practice of female beauty salon staff.


Cervixuteri cancer. International Agency for Research on Cancer. Globocan; 2019. Available from: [Accessed 2 Jan. 2019].  Back to cited text no. 1
Human Papillomavirus and Related Diseases Report, Iran, Fact Sheet 2018. HPV Information Center; 2019. Available from: [Accessed 5 Jan. 2019].  Back to cited text no. 2
Shafaghi B, Jarollahi A, Yousefzadeh B, Ameri A, Moghadam S, Mostafavi M. Human papilloma virus prevalence and types among Iranian women attending regular gynecological visits. Rep Radiother Oncol 2013;1:73-9.  Back to cited text no. 3
Human papillomavirus (HPV) and cervical cancer. World Health Organization; 2019. Available from: [Accessed 5 Apr. 2019].  Back to cited text no. 4
Osterberg EC, Gaither TW, Awad MA, Truesdale MD, Allen I, Sutcliffe S, et al. Correlation between pubic hair grooming and STIs: Results from a nationally representative probability sample. Sex Transm Infect 2017;93:162-6.  Back to cited text no. 5
Bercaw-Pratt JL, Santos XM, Sanchez J, Ayensu-Coker L, Nebgen DR, Dietrich JE. The incidence, attitudes and practices of the removal of pubic hair as a body modification. J Pediatr Adolesc Gynecol 2012;25:12-4.  Back to cited text no. 6
Sabeena S, Bhat P, Kamath V, Arunkumar G. Possible non-sexual modes of transmission of human papilloma virus. J Obstet Gynaecol Res 2017;43:429-35.  Back to cited text no. 7
Baxi LV, Dziadosz M. Complications following “Brazilian” waxing for pubic hair removal. Am J Obstet Gynecol 2014;211:713-4.  Back to cited text no. 8
Begier EM, Frenette K, Barrett NL, Mshar P, Petit S, Boxrud DJ, et al. A high-morbidity outbreak of methicillin-resistant Staphylococcus aureus among players on a college football team, facilitated by cosmetic body shaving and turf burns. Clin Infect Dis 2004;39:1446-53.  Back to cited text no. 9
Kirchhof MG, Au S. Brazilian waxing and human papillomavirus: A case of acquired epidermodysplasia verruciformis. CMAJ 2015;187:126-8.  Back to cited text no. 10
Waller J, McCaffery K, Forrest S, Szarewski A, Cadman L, Wardle J. Awareness of human papillomavirus among women attending a well woman clinic. Sex Transm Infect 2003;79:320-2.  Back to cited text no. 11
Marlow LA, Zimet GD, McCaffery KJ, Ostini R, Waller J. Knowledge of human papillomavirus (HPV) and HPV vaccination: An international comparison. Vaccine 2013;31:763-9.  Back to cited text no. 12
Khan TM, Buksh MA, Rehman IU, Saleem A. Knowledge, attitudes, and perception towards human papillomavirus among university students in Pakistan. Papillomavirus Res 2016;2:122-7.  Back to cited text no. 13
Bowyer HL, Marlow LA, Hibbitts S, Pollock KG, Waller J. Knowledge and awareness of HPV and the HPV vaccine among young women in the first routinely vaccinated cohort in England. Vaccine 2013;31:1051-6.  Back to cited text no. 14
Cunningham SD, Kerrigan D, Pillay KB, Ellen JM. Understanding the role of perceived severity in STD-related care-seeking delays. J Adolesc Health 2005;37:69-74.  Back to cited text no. 15
Nekooi MS, Ayazi S, Gandomi M, Moosavi SG, Fakhri A. Level of Knowledge about Human Papillomavirus Infection among Women of Kashan City, Iran. Int Arch Health Sci 2016;3:7-12.  Back to cited text no. 16
Ataei B, Shirani K. Evaluation of knowledge and practice of hairdressers in men's beauty salons in Isfahan about hepatitis B, hepatitis C, and AIDS in 2010 and 2011. Adv Biomed Res 2012;1:75.  Back to cited text no. 17
Al-Rabeei NA, Al-Thaifani AA, Dallak AM. Knowledge, attitudes and practices of barbers regarding hepatitis B and C viral infection in Sana'a city, Yemen. J Community Health 2012;37:935-9.  Back to cited text no. 18
Jokhio AH, Bhatti TA, Memon S. Knowledge, attitudes and practices of barbers about hepatitis B and C transmission in Hyderabad, Pakistan. East Mediterr Health J 2010;16:1079-84.  Back to cited text no. 19
Mutocheluh M, Kwarteng K. Knowledge and occupational hazards of barbers in the transmission of hepatitis B and C was low in Kumasi, Ghana. Pan Afr Med J 2015;20:260.  Back to cited text no. 20
Amodio E, Di Benedetto MA, Gennaro L, Maida CM, Romano N. Knowledge, attitudes and risk of HIV, HBV and HCV infections in hairdressers of Palermo city (South Italy). Eur J Public Health 2010;20:433-7.  Back to cited text no. 21
Farzaneh F, Shirvani HE, Barouti E, Salehpour S, Khodakarami N, Alizadeh K. Knowledge and attitude of women regarding the human papillomavirus (HPV) infection, its relationship to cervical cancer and prevention methods. Med J Malaysia 2011;66:468-73.  Back to cited text no. 22
Malakouti J, Mirghafourvand M, Gorbani M, Salehi-Poormehr H, Jafari shabiri M, Pourasad Shahrak S. Knowledge of human papillomavirus and its incidence among women referring to Al-Zahra and Taleghani Hospitals in Tabriz-Iran, 2014-2015. Int J Women's Health Reprod Sci 2017;5:143-6.  Back to cited text no. 23
Mojahed S, Karimi Zarchi M, Bokaie M, Salimi T. Attitude and knowledge of Iranian female nurses about human papilomavirus infection and cervical cancer: A cross sectional survey. J Prev Med Hyg 2013;54:187-90.  Back to cited text no. 24
Marlow LA, Waller J, Wardle J. Public awareness that HPV is a risk factor for cervical cancer. Br J Cancer 2007;97:691-4.  Back to cited text no. 25
Marshall H, Ryan P, Roberton D, Baghurst P. A cross-sectional survey to assess community attitudes to introduction of Human papillomavirus vaccine. Aust N Z J Public Health 2007;31:235-42.  Back to cited text no. 26
Tiro JA, Meissner HI., Kobrin S, Chollette V. What do women in the US know about human papillomavirus and cervical cancer? Cancer Epidemiol Biomarkers Prev 2007;16:288-94.  Back to cited text no. 27
Adoba P, Boadu SK, Agbodzakey H, Somuah D, Ephraim RK, Odame EA. High prevalence of hepatitis B and poor knowledge on hepatitis B and C viral infections among barbers: A cross-sectional study of the Obuasi municipality, Ghana. BMC Public Health 2015;15:1041.  Back to cited text no. 28