Knowledge of human papillomavirus and self-sampling, including vaccination practices among female students in Free...

Human papillomavirus (HPV)-related cancers, especially cervical cancer, remain highly prevalent in low- and middle-income countries, despite the availability of preventive measures such as vaccination and self-sampling screening, due to limited HPV awareness. The study aimed to assess the knowledge of HPV, HPV vaccination practices, and HPV self-sampling awareness and perceptions among female students at the University of the Free State in Bloemfontein, South Africa.

Data were collected from female university students through a self-administered questionnaire distributed via the secure web-based platform Research Electronic Data Capture (REDCap). HPV infection and vaccination knowledge were measured using a self-administered questionnaire. Knowledge was assessed by assigning one (1) point for each correct answer, while incorrect or "don't know" responses received a score of zero (0). A knowledge score above 75% was categorized as "good knowledge." The data were analyzed using SAS version 9.4.

The study included 381 participants with a median age (interquartile range, IQR) of 23.0 (20-26) years. The findings showed that while 40.9% of participants had good knowledge of HPV infection, only 9.7% demonstrated good knowledge of HPV vaccination, and 13.3% had good overall knowledge. Only 13.4% of participants reported having received the HPV vaccine, while 19.1% expressed unwillingness to receive the vaccine. Barriers to vaccine uptake included lack of information about the HPV vaccine (46.0%) and safety concerns (46.0%). The majority (78.2%) were unaware of HPV self-sampling. Having heard about HPV self-sampling was predictive for HPV knowledge (OR: 2.684, 95% CI: 1.389-5.188, p = 0.003).

These findings suggest that while some participants are informed about HPV infection, the majority are not well-informed about HPV vaccination and are unaware of HPV self-sampling. Additionally, barriers to HPV vaccination persist. Targeted educational interventions are needed to address awareness and knowledge gaps and vaccine hesitancy. These interventions could significantly improve HPV and cervical cancer prevention outcomes.