Knowledge and Attitudes towards Human Papillomavirus and HPV vaccination among girls aged 9-14 years in Lira City West, Northern Uganda: A cross-Sectional Study

Abstract

Background: Human papillomavirus (HPV) is the necessary cause of nearly all cervical cancers and remains an important public-health problem, particularly in low- and middle-income countries. Vaccination before exposure to HPV is an effective primary prevention strategy. This study assessed knowledge of HPV and HPV vaccination and attitudes towards HPV vaccination among girls aged 9–14 years attending selected primary schools in Lira City West Division, Northern Uganda. Methods: A quantitative cross-sectional study was conducted among 398 girls aged 9–14 years from three high-enrolment primary schools. Participants were stratified by school and class and selected systematically within strata. Data were collected using an interviewer-administered structured questionnaire in English or Leb Lango. Sociodemographic characteristics, individual knowledge items and five-point Likert attitude items were analysed descriptively using frequencies and percentages in IBM SPSS Statistics version 27. Results: Only 26.4% of participants had heard of HPV and 15.6% identified HPV as a virus associated with cervical cancer. When asked about transmission, 65.8% selected sexual contact and 14.6% selected skin-to-skin contact. Awareness of the HPV vaccine was higher, with 76.9% having heard of it and 86.7% indicating that it can prevent cervical cancer. Favourable attitudes were common: 77.9% intended to receive the vaccine, 79.4% perceived it as safe, 78.6% considered vaccination important and 77.9% would recommend it to friends. Parents or guardians influenced vaccination views among 75.1% of participants. However, 95.0% disagreed or strongly disagreed that sufficient HPV-vaccine information was available to them. Conclusion: Girls in the selected schools were generally receptive to HPV vaccination but had limited understanding of HPV infection and its relationship with cervical cancer. The findings show a mismatch between relatively high vaccine awareness and favourable attitudes, and limited HPV knowledge alongside perceived insufficiency of information. School-based vaccination should be accompanied by repeated, age-appropriate education involving girls, parents and health workers.