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. 2025 Jun 22.
doi: 10.1007/s10552-025-02023-1. Online ahead of print.

The relationship between human papillomavirus (HPV) knowledge and HPV vaccine acceptance among women and affecting factors in Türkiye

Halime Abay  1 , Betül Çakmak  2 , Feride Mualla Alagöz  3 , Özlem Uzunlar  3
Affiliations

The relationship between human papillomavirus (HPV) knowledge and HPV vaccine acceptance among women and affecting factors in Türkiye

Halime Abay et al. Cancer Causes Control. .

Abstract

Purpose: The most effective method for preventing cervical cancer is the human papillomavirus (HPV) vaccine, but the vaccine is not included in the national immunization program. This study aimed to investigate the relationship between HPV knowledge and attitudes, intentions and behaviors toward HPV vaccination among Turkish women.

Methods: This analytical cross-sectional study was conducted in with 320 women aged 18-49 years in Türkiye. Data were collected using the Human Papillomavirus Knowledge Scale (HPV-KS) and the Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS). Data were analyzed using Mann-Whitney U test, Kruskal-Wallis test, and Bonferroni correction the effects of independent variables (sociodemographic characteristics, vaccination intentions, etc.) on scale scores. Spearman's correlation coefficient was used to investigate the relationship between all total and subscale scores. The backward logistic regression analysis was performed to investigate the effects of all total and subscale scores on HPV vaccination behaviors.

Results: Of the participants, 51.2% had knowledge about the HPV vaccine, 90.9% had not been vaccinated against HPV, and 65.9% intended to receive the HPV vaccine. A negative correlation was found between the HPV-KS subscale mean scores and CHIAS subscale mean scores (p < 0.05). As attitudes that perceived HPV vaccine as harmful increased, vaccination behaviors decreased (Z = - 2.326; p = 0.020). Backward logistic regression analysis showed that for every 1-unit increase in "Uncertainty" subscale scores, the uptake of the HPV vaccine decreased by by 54.3% (OR = 0.457; 95% CI 1.015-1.152). Backward logistic regression analysis showed that for every 1-unit increase in "Ineffectiveness" subscale scores, the uptake of the HPV vaccine for yourself/children if it is free decreased by 35.8% (OR = 0.642; 95% CI 0.449-0.197).

Conclusion: Women's HPV knowledge and acceptance of vaccination were low. There was a positive correlation between women's HPV knowledge levels and their attitudes and behaviors toward HPV vaccination. HPV awareness should be increased in the community, and HPV vaccines should be integrated into the national immunization program.

Keywords: Attitude; Behavior; Human papillomavirus knowledge; Human papillomavirus vaccines; Vaccine acceptance.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests. Ethical approval: The study was approved by the Ethics Committee of University (Approval Number: 15.03.2023/03-45) and the hospital management (Approval Number: E-90739940-799-219072034). The WHO defines reproductive age as 15–49 years [16]. However, for ethical reasons, only women aged 18 years or older who were able to make their own decisions were included in the study. Women under the age of 18 years were excluded. This study was performed in line with the principles of the Declaration of Helsinki. Participation in the study was voluntary. Written informed consent was obtained from all individual participants included in the study. Informed consent: Participation was voluntary. Signed informed consent was obtained from all participants included in this study.

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