Knowledge, Attitude and Practice regarding Human Papillomavirus Infection and HPV Vaccination among Undergraduate Medical Students at a Tertiary Care Teaching Institution in South India: A Cross-sectional Study

Abstract

Background: Cervical cancer is an HPV (human papillomavirus) associated disease with India contributing to a disproportionate share of the worldwide burden. Undergraduate female medical students are an at-risk group and future supporters of vaccination yet the gap between knowledge and personal vaccine uptake remains inadequately characterized, especially since India added HPV vaccine to its national immunization campaign. Methods: A questionnaire based cross-sectional study was conducted among all MBBS undergraduates studying in a tertiary care teaching institution in Tamil Nadu using a pre-tested self-administered instrument consisting of sociodemographic items, 15 items of knowledge scale, six items of Likert attitude scale and practice/barrier items. Vaccine coverage was analyzed in female students, the main target population for prevention of cervical cancer. Results: Among the 285 participants, 53.3% were female, and the mean age was 20.3 ± 1.6 years. Good knowledge was present in 172 (60.4%; mean score 10.59 ± 3.78) and a positive attitude in 175 of 277 (63.2%; Cronbach’s α = 0.875). The poorest-answered items concerned the dosing schedule (34.4% correct) and the national-programme status of the vaccine (57.2%). Among female students, self-reported HPV vaccination uptake was 11.8% (18/152), yet 76 of 134 unvaccinated female students (56.7%) were willing to be vaccinated and 80 (59.7%) would accept vaccination after an educational session; the most frequently reported barrier was intention to be vaccinated later (33.3%), followed by lack of information (21.8%). Good knowledge was independently associated with prior awareness of the vaccine (aOR 2.66, 95% CI 1.40–5.04); a positive attitude was less likely in male students (aOR 0.56, 95% CI 0.33–0.94) and more likely with prior vaccine awareness (aOR 1.98, 95% CI 1.04–3.75). Conclusion: Despite moderate-to-good knowledge and favourable attitudes, self-reported HPV vaccination uptake remained low among female MBBS students, highlighting a clear knowledge–practice gap. High willingness to learn and vaccinate suggests that structured education and campus-based vaccination could improve coverage.