Knowledge, Attitude, and Practices (KAP) Regarding Vaccination Against Human Papillomavirus (HPV) Among Young People, Caregivers, and Healthcare Professionals (HCPs)

OBJECTIVES: Highly prevalent HPV infection accounts for most cervical, vaginal, oropharyngeal, and anal cancers among men and women. Low vaccination rates are observed despite demonstrated safety and efficacy of HPV vaccine. We aimed to summarize published KAP assessments regarding HPV infection/vaccination among young people, caregivers, and HCPs to understand barriers to vaccine uptake.

METHODS: A systematic review of articles published in English, between January 2018 and October 2023 was conducted in Embase, Medline, and Cochrane databases. Studies providing a quantitative assessment of KAP on HPV infection and/or vaccination were selected.

RESULTS: Among 2906 reviewed records, 77 studies were included, involving 167 KAP assessments. Only 44% of studies used a validated KAP instrument, and 57%, 25%, and 21% reported KAP results among young people, HCPs, and caregivers, respectively.

Knowledge was deemed satisfactory in 22%, 49% and 42% of assessments involving young people, HCPs, and caregivers, respectively. More assessments noted a positive attitude towards HPV infection and vaccination (46%, 56%, and 58%, respectively).

Most studies (85%) reported low rates of HPV vaccination, in less than half of the interviewed population. Most of the assessments (42%) showed that 50%-75% of the individuals were open to vaccination. Only 39% of assessments showed that majority of the interviewed HCPs would recommend HPV vaccination.

Men and women had similar knowledge and attitude patterns. Men showed lower vaccination and willingness to vaccinate rates compared to women. Studies from high income countries showed more often satisfactory knowledge and higher vaccination uptake compared to upper-middle and lower-middle/low-income countries.

CONCLUSIONS: Most studies highlighted low-moderate knowledge, neutral/hesitant or positive attitude and poor practices regarding HPV vaccination. Continuous efforts should be made to increase public awareness, engage HCPs to promote disease prevention, reduce vaccine misperceptions, increase strategies to facilitate immunizations, and diminish the barriers to HPV vaccination, especially among men and in low- and middle-income countries.