Human Papillomavirus Knowledge, Attitudes, and Vaccination-Related Practices Among Medical Students in Himachal...

Medical students will play an important role in counseling patients about human papillomavirus (HPV) vaccination. Evidence on the gap between HPV awareness, detailed knowledge, and actual vaccine uptake among future healthcare providers is particularly relevant as HPV vaccination is incorporated into India's nationwide vaccination program.

A multicenter cross-sectional survey was conducted from February to July 2026 across seven medical colleges. Participating students completed an expert-reviewed and pilot-tested 52-item online questionnaire. Knowledge scores ranged from 0 to 15, and attitude scores ranged from 8 to 40, while practice-related items were analyzed individually. Knowledge and attitude scores were compared across participant characteristics; their relationship was assessed using Pearson's correlation coefficient, and factors independently associated with vaccination uptake were examined using multivariable binary logistic regression.

Among 1,159 participants, 1,078 (93.0%) had heard of HPV, but only 134 (11.6%) had been vaccinated. The mean knowledge score was 7.77 ± 3.63; 483 (41.7%) participants had lower knowledge and 181 (15.6%) had higher knowledge. The mean attitude score was 30.8 ± 4.58, with 853 (73.6%) demonstrating a favorable attitude. Knowledge and attitude scores were moderately correlated (r = 0.418, p < 0.001). The leading reasons for nonvaccination among the 1,025 unvaccinated were the absence of a recommendation, reported by 288 (28.1%), and lack of awareness, reported by 287 (28.0%). In the adjusted analysis, vaccination uptake was associated with a higher knowledge score (adjusted odds ratio (aOR) per point: 1.073, 95% confidence interval (CI): 1.009-1.141; p = 0.023), female gender (aOR: 1.748, 95% CI: 1.149-2.658; p = 0.007), and urban residence (aOR: 2.212, 95% CI: 1.488-3.290; p < 0.001). Attitude score and study phase were not independently associated with vaccination uptake.

Despite high awareness and generally favorable attitudes, detailed HPV knowledge and vaccination uptake remained low. Medical colleges should strengthen practical, gender-neutral HPV education and combine counseling with accessible and affordable vaccination services.