From awareness to acceptance: understanding HPV and vaccine knowledge, attitudes and beliefs among university students in Punjab, Pakistan.

Abstract

Background: Human Papillomavirus (HPV) infections can lead to various cancers globally, and immunization can prevent HPV-associated cancers. This study intended to evaluate university students' knowledge, awareness, and attitudes/beliefs toward HPV and HPV vaccine uptake in Punjab, Pakistan.

Methods: A descriptive cross-sectional study was conducted in ten institutes across six cities using pre-validated questionnaires. Descriptive statistics and Rasch analysis were utilized to describe awareness levels, knowledge, and attitudes scores respectively. Regression analysis was utilized to explore association between demographic factors, knowledge levels, and attitudes/ beliefs. SPSS® (IBM, version 23.0) and Winstep® (version 3.75.0) software were used for analysis.

Results: Out of 1200 students approached, 1056 responded (response rate 88.0%). The mean age of students was 19.5 ± 0.5 years; 31.3% had heard about HPV, 16.4% were aware of the HPV vaccine's availability, and 2.3% were vaccinated against HPV. The mean Rasch knowledge score was -0.368 logits (SD: 0.893; SEM: 0.027), depicting below-average HPV knowledge. The mean Rasch attitudes/beliefs score was 0.049 logits (SD: 1.013; SEM: 0.031), which depicted positive attitudes towards HPV and its vaccination. Females (OR:1.742; 95%CI: 1.352-2.320), health-sciences students (OR: 1.692; 95%CI: 1.290-2.220), and urban residents (OR:1.621; 95%CI: 1.244-2.223) possessed positive attitudes towards HPV vaccination. Recommendations from physicians (Median: 4.0; IQR: 4.0-5.0) followed by parents (Median: 4.0; IQR: 3.0-5.0), and friends (Median: 4.0; IQR: 3.0-4.0) shaped vaccination decisions.

Conclusion: Despite their inadequate knowledge levels and poor vaccine uptake, students showed positive attitudes towards HPV vaccination. Awareness about HPV, including testing and vaccination, should be raised through community outreach programs, social media, and university curricula.