Health Literacy and Factors Associated with HPV Vaccination among Adolescent Students: A Cross-Sectional Analytic...

Human papillomavirus (HPV) vaccination is a key strategy for cervical cancer prevention. Health literacy may influence vaccine uptake, but evidence among adolescents remains limited in Thailand. This study aimed to examine the association between health literacy, social support, and HPV vaccination among female secondary school students.

A cross-sectional analytical study was conducted between November 2024 and January 2025 in Chalerm Phrakiat District, Nakhon Si Thammarat Province, Thailand. A total of 296 female students aged 13-18 years were included, comprising 148 unvaccinated participants and 148 vaccinated controls. Data were collected using a validated questionnaire covering demographic characteristics, health literacy (six subscales), and perceived social support and role modeling (two subscales). Logistic regression analyses were performed to identify factors associated with HPV vaccination.

Approximately one-third of both groups had fair overall health literacy (33.11% and 37.84%, respectively). Participants in senior high school were significantly less likely to be vaccinated (AOR = 2.27, 95% CI: 1.37-3.76). Interestingly, participants with low knowledge and understanding were more likely to be vaccinated (AOR = 0.34, 95% CI: 0.16-0.69), while those with low communication skills were more likely to be unvaccinated (AOR = 1.91, 95% CI: 1.05-3.48). Overall health literacy was not significantly associated with vaccination status.

Specific dimensions of health literacy, particularly knowledge and communication skills, were significantly associated with HPV vaccination. These findings highlight the need for targeted health education interventions focusing on improving communication and reinforcing key knowledge to increase vaccine uptake among adolescents.