Background: Human Papillomavirus (HPV) infection poses a significant global public health concern, particularly among adolescent girls. Understanding their knowledge and attitudes toward the HPV vaccine is crucial for designing effective preventive strategies. This study aimed to assess the knowledge and attitude regarding the HPV vaccine among adolescent girls in selected schools at Kuppam. Methods: A descriptive cross-sectional study was conducted among 385 adolescent girls studying in 6th to 10th grade in selected schools at Kuppam, Chittoor District, Andhra Pradesh. A convenient sampling technique was used to select the participants. Data were collected using a self-structured questionnaire comprising sections on demographic variables, knowledge about HPV and the vaccine (25 items), and attitude toward the HPV vaccine (10 items rated on a 0–4 Likert scale). The reliability of the knowledge and attitude tools was established with a Cronbach’s Alpha of r = 0.82. Ethical clearance was obtained from the Institutional Research Committee and Institutional Human Ethics Committee of PESIMSR, Kuppam. Results:This study assessed demographic characteristics, knowledge, and attitude toward the HPV vaccine among 386 adolescent girls in Kuppam. Most participants had basic (59.6%) to average (39.1%) knowledge and overwhelmingly held a positive attitude (95.6%) toward the vaccine. Statistical analysis revealed significant associations between age in years (p = 0.002), academic year (p = 0.001), and mother’s education (p = 0.010) with the level of knowledge, indicating higher knowledge among older students, those in higher grades, and those whose mothers had primary or secondary education. Furthermore, significant associations were found between age in years (p < 0.001), academic year (p < 0.001), and mother’s occupation (p < 0.001) with attitude, with older students, those in higher grades, and daughters of daily wage laborers showing more positive attitudes. Conclusion: The findings indicate a high positive attitude toward the HPV vaccine among adolescent girls in Kuppam despite a generally basic to average level of knowledge. The significant associations of age, academic year, and mother’s education with knowledge, and age, academic year, and mother’s occupation with attitude, highlight the importance of considering these demographic factors when designing targeted educational interventions to enhance understanding and potentially improve HPV vaccination uptake in this population. Future efforts should focus on addressing the knowledge gap and leveraging the existing positive attitudes, particularly among younger students and those with less educated mothers.

Keywords: HPV vaccination, adolescent girls, knowledge, attitudes, vaccine

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1. Human Papillomavirus (HPV). [cited 2023 Jul 19]. Available from: https://www.who.int/teams/health-product-policy-and-standards/standards-and-specifications/norms-and-standards/vaccine-standardization/human-papillomavirus.
2. Cervical cancer. [cited 2023 Jul 19]. Available from: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer.
3. WHO updates recommendations on HPV vaccination schedule. [cited 2023 Jul 19]. Available from: https://www.who.int/news/item/20-12-2022-WHO-updates-recommendations-on-HPV-vaccination-schedule.
4. Lubeya MK, Chibwesha CJ, Mwanahamuntu M, Mukosha M, Frank S, Kawonga M. “When you get the HPV vaccine, it will prevent cervical cancer; it will act as a shield”: Adolescent girls’ knowledge and perceptions regarding the human papillomavirus vaccine in Zambia. Front Health Serv. 2023 Sep 13;3:1208458. doi: 10.3389/frhs.2023.1208458. PMID: 37780403; PMCID: PMC10534003.
5. Daniel CL, McLendon L, Green CL, Anderson KJ, Pierce JY, Perkins A, et al. HPV and HPV Vaccination Knowledge and Attitudes Among Medical Students in Alabama. J Cancer Educ. 2021 Feb;36(1):168–177. doi: 10.1007/s13187-019-01613-3. PMID: 31502236.
6. Dochez C, Al Awaidy S, Mohsni E, Fahmy K, Bouskraoui M. Strengthening national teams of experts to support HPV vaccine introduction in Eastern Mediterranean countries: Lessons learnt and recommendations from an international workshop. Vaccine. 2020 Jan 29;38(5):1114–1119. doi: 10.1016/j.vaccine.2019.11.027. Epub 2019 Nov 23. PMID: 31771862.
7. Yohannes E, Beyen MW, Bulto GA, Chaka EE, Debelo BT, Erena MM, et al. Knowledge and attitude toward human papillomavirus vaccination and associated factors among adolescent school girls in Ambo town, Ethiopia, 2021: A multicenter cross-sectional study. Health Sci Rep. 2023 May 31;6(6):e1305. doi: 10.1002/hsr2.1305. PMID: 37266064; PMCID: PMC10230424.
8. Yin G, Zhang Y, Chen C, Ren H, Guo B, Zhang M. Have you ever heard of Human Papillomavirus (HPV) vaccine? The awareness of HPV vaccine for college students in China based on meta-analysis. Hum Vaccin Immunother. 2021 Aug 3;17(8):2736–2747. doi: 10.1080/21645515.2021.1899731. Epub 2021 Mar 31. PMID: 33787459; PMCID: PMC8475627.
9. Wortsman J, Glaser Chodik N, Chodick G. Correlations of HPV vaccine uptake among eighth-grade students in Israel: The importance of ethnicity and level of religious observance. Women Health. 2023 Jul 3;63(6):464–72.
10. Voidăzan TS, Budianu MA, Rozsnyai FF, Kovacs Z, Uzun CC, Neagu N. Assessing the Level of Knowledge, Beliefs and Acceptance of HPV Vaccine: A Cross-Sectional Study in Romania. Int J Environ Res Public Health. 2022 Jun 6;19(11):6939.
11. Trucchi C, Amicizia D, Tafuri S, Sticchi L, Durando P, Costantino C, et al. Assessment of Knowledge, Attitudes, and Propensity towards HPV Vaccine of Young Adult Students in Italy. Vaccines (Basel). 2020 Feb 7;8(1):74.
12. Santos AC da S, Silva NNT, Carneiro CM, Coura-Vital W, Lima AA. Knowledge about cervical cancer and HPV immunization dropout rate among Brazilian adolescent girls and their guardians. BMC Public Health. 2020 Mar 6;20(1):301.
13. Liu Y, Di N, Tao X. Knowledge, practice and attitude towards HPV vaccination among college students in Beijing, China. Hum Vaccin Immunother. 2020;16(1):116–23.
14. Khalil J, Boutros S, Hassoun A, Hallit S, Barakat H. Human papillomavirus vaccine knowledge and conspiracy beliefs among secondary school students in Lebanon. BMC Pediatr. 2023 Jul 15;23(1):363.
15. Bitariho GK, Tuhebwe D, Tigaiza A, Nalugya A, Ssekamatte T, Kiwanuka SN. Knowledge, perceptions and uptake of human papilloma virus vaccine among adolescent girls in Kampala, Uganda; a mixed-methods school-based study. BMC Pediatr. 2023 Jul 17;23(1):368.
16. Beyen MW, Bulto GA, Chaka EE, Debelo BT, Roga EY, Wakgari N, et al. Human papillomavirus vaccination uptake and its associated factors among adolescent school girls in Ambo town, Oromia region, Ethiopia, 2020. PLoS One. 2022;17(7):e0271237.
17. Quang C, Chung AW, Frazer IH, Toh ZQ, Licciardi PV. Single-dose HPV vaccine immunity: Is there a role for non-neutralizing antibodies? Trends Immunol. 2022 Oct;43(10):815–25.
18. Goldstone SE. Human papillomavirus (HPV) vaccines in adults: Learnings from long-term follow-up of quadrivalent HPV vaccine clinical trials. Hum Vaccin Immunother. 2023 Dec 31;19(1):2184760.
19. Lahijani AY, King AR, Gullatte MM, Hennink M, Bednarczyk RA. HPV Vaccine Promotion: The church as an agent of change. Soc Sci Med. 2021 Jan;268:113375. doi: 10.1016/j.socscimed.2020.113375. Epub 2020 Sep 18. PMID: 32979772; PMCID: PMC7755816.

Background: Human Papillomavirus (HPV) infection poses a significant global public health concern, particularly among adolescent girls. Understanding their knowledge and attitudes toward the HPV vaccine is crucial for designing effective preventive strategies. This study aimed to assess the knowledge and attitude regarding the HPV vaccine among adolescent girls in selected schools at Kuppam. Methods: A descriptive cross-sectional study was conducted among 385 adolescent girls studying in 6th to 10th grade in selected schools at Kuppam, Chittoor District, Andhra Pradesh. A convenient sampling technique was used to select the participants. Data were collected using a self-structured questionnaire comprising sections on demographic variables, knowledge about HPV and the vaccine (25 items), and attitude toward the HPV vaccine (10 items rated on a 0–4 Likert scale). The reliability of the knowledge and attitude tools was established with a Cronbach’s Alpha of r = 0.82. Ethical clearance was obtained from the Institutional Research Committee and Institutional Human Ethics Committee of PESIMSR, Kuppam. Results:This study assessed demographic characteristics, knowledge, and attitude toward the HPV vaccine among 386 adolescent girls in Kuppam. Most participants had basic (59.6%) to average (39.1%) knowledge and overwhelmingly held a positive attitude (95.6%) toward the vaccine. Statistical analysis revealed significant associations between age in years (p = 0.002), academic year (p = 0.001), and mother’s education (p = 0.010) with the level of knowledge, indicating higher knowledge among older students, those in higher grades, and those whose mothers had primary or secondary education. Furthermore, significant associations were found between age in years (p < 0.001), academic year (p < 0.001), and mother’s occupation (p < 0.001) with attitude, with older students, those in higher grades, and daughters of daily wage laborers showing more positive attitudes. Conclusion: The findings indicate a high positive attitude toward the HPV vaccine among adolescent girls in Kuppam despite a generally basic to average level of knowledge. The significant associations of age, academic year, and mother’s education with knowledge, and age, academic year, and mother’s occupation with attitude, highlight the importance of considering these demographic factors when designing targeted educational interventions to enhance understanding and potentially improve HPV vaccination uptake in this population. Future efforts should focus on addressing the knowledge gap and leveraging the existing positive attitudes, particularly among younger students and those with less educated mothers.

Keywords: HPV vaccination, adolescent girls, knowledge, attitudes, vaccine

🔒 This is a subscription article

Full text is available to subscribers and institutional members. Please choose an option below to access it.

1. Human Papillomavirus (HPV). [cited 2023 Jul 19]. Available from: https://www.who.int/teams/health-product-policy-and-standards/standards-and-specifications/norms-and-standards/vaccine-standardization/human-papillomavirus.
2. Cervical cancer. [cited 2023 Jul 19]. Available from: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer.
3. WHO updates recommendations on HPV vaccination schedule. [cited 2023 Jul 19]. Available from: https://www.who.int/news/item/20-12-2022-WHO-updates-recommendations-on-HPV-vaccination-schedule.
4. Lubeya MK, Chibwesha CJ, Mwanahamuntu M, Mukosha M, Frank S, Kawonga M. “When you get the HPV vaccine, it will prevent cervical cancer; it will act as a shield”: Adolescent girls’ knowledge and perceptions regarding the human papillomavirus vaccine in Zambia. Front Health Serv. 2023 Sep 13;3:1208458. doi: 10.3389/frhs.2023.1208458. PMID: 37780403; PMCID: PMC10534003.
5. Daniel CL, McLendon L, Green CL, Anderson KJ, Pierce JY, Perkins A, et al. HPV and HPV Vaccination Knowledge and Attitudes Among Medical Students in Alabama. J Cancer Educ. 2021 Feb;36(1):168–177. doi: 10.1007/s13187-019-01613-3. PMID: 31502236.
6. Dochez C, Al Awaidy S, Mohsni E, Fahmy K, Bouskraoui M. Strengthening national teams of experts to support HPV vaccine introduction in Eastern Mediterranean countries: Lessons learnt and recommendations from an international workshop. Vaccine. 2020 Jan 29;38(5):1114–1119. doi: 10.1016/j.vaccine.2019.11.027. Epub 2019 Nov 23. PMID: 31771862.
7. Yohannes E, Beyen MW, Bulto GA, Chaka EE, Debelo BT, Erena MM, et al. Knowledge and attitude toward human papillomavirus vaccination and associated factors among adolescent school girls in Ambo town, Ethiopia, 2021: A multicenter cross-sectional study. Health Sci Rep. 2023 May 31;6(6):e1305. doi: 10.1002/hsr2.1305. PMID: 37266064; PMCID: PMC10230424.
8. Yin G, Zhang Y, Chen C, Ren H, Guo B, Zhang M. Have you ever heard of Human Papillomavirus (HPV) vaccine? The awareness of HPV vaccine for college students in China based on meta-analysis. Hum Vaccin Immunother. 2021 Aug 3;17(8):2736–2747. doi: 10.1080/21645515.2021.1899731. Epub 2021 Mar 31. PMID: 33787459; PMCID: PMC8475627.
9. Wortsman J, Glaser Chodik N, Chodick G. Correlations of HPV vaccine uptake among eighth-grade students in Israel: The importance of ethnicity and level of religious observance. Women Health. 2023 Jul 3;63(6):464–72.
10. Voidăzan TS, Budianu MA, Rozsnyai FF, Kovacs Z, Uzun CC, Neagu N. Assessing the Level of Knowledge, Beliefs and Acceptance of HPV Vaccine: A Cross-Sectional Study in Romania. Int J Environ Res Public Health. 2022 Jun 6;19(11):6939.
11. Trucchi C, Amicizia D, Tafuri S, Sticchi L, Durando P, Costantino C, et al. Assessment of Knowledge, Attitudes, and Propensity towards HPV Vaccine of Young Adult Students in Italy. Vaccines (Basel). 2020 Feb 7;8(1):74.
12. Santos AC da S, Silva NNT, Carneiro CM, Coura-Vital W, Lima AA. Knowledge about cervical cancer and HPV immunization dropout rate among Brazilian adolescent girls and their guardians. BMC Public Health. 2020 Mar 6;20(1):301.
13. Liu Y, Di N, Tao X. Knowledge, practice and attitude towards HPV vaccination among college students in Beijing, China. Hum Vaccin Immunother. 2020;16(1):116–23.
14. Khalil J, Boutros S, Hassoun A, Hallit S, Barakat H. Human papillomavirus vaccine knowledge and conspiracy beliefs among secondary school students in Lebanon. BMC Pediatr. 2023 Jul 15;23(1):363.
15. Bitariho GK, Tuhebwe D, Tigaiza A, Nalugya A, Ssekamatte T, Kiwanuka SN. Knowledge, perceptions and uptake of human papilloma virus vaccine among adolescent girls in Kampala, Uganda; a mixed-methods school-based study. BMC Pediatr. 2023 Jul 17;23(1):368.
16. Beyen MW, Bulto GA, Chaka EE, Debelo BT, Roga EY, Wakgari N, et al. Human papillomavirus vaccination uptake and its associated factors among adolescent school girls in Ambo town, Oromia region, Ethiopia, 2020. PLoS One. 2022;17(7):e0271237.
17. Quang C, Chung AW, Frazer IH, Toh ZQ, Licciardi PV. Single-dose HPV vaccine immunity: Is there a role for non-neutralizing antibodies? Trends Immunol. 2022 Oct;43(10):815–25.
18. Goldstone SE. Human papillomavirus (HPV) vaccines in adults: Learnings from long-term follow-up of quadrivalent HPV vaccine clinical trials. Hum Vaccin Immunother. 2023 Dec 31;19(1):2184760.
19. Lahijani AY, King AR, Gullatte MM, Hennink M, Bednarczyk RA. HPV Vaccine Promotion: The church as an agent of change. Soc Sci Med. 2021 Jan;268:113375. doi: 10.1016/j.socscimed.2020.113375. Epub 2020 Sep 18. PMID: 32979772; PMCID: PMC7755816.