HPV knowledge, trust in information sources and vaccine uptake among medical students in Serbia

Background

HPV vaccination prevents HPV-related cancers, yet coverage in Serbia remains low despite free access since 2024. Medical students are future immunization advocates; their information environment shapes both their own uptake and future patient counselling. We assessed how HPV-specific knowledge and trust in information sources relate to vaccination status, addressing an evidence gap relevant across the WHO European Region.

Methods

We conducted a cross-sectional study of all first- and second-year students at the Faculty of Medicine, University of Belgrade (N = 882) in early 2026. Participants completed an anonymous self-administered questionnaire with validated instruments. Knowledge was measured with 14 items on HPV transmission, cancer associations and prevention. Frequency of use of and trust in information sources were rated on 5-point Likert scales (1=never/no trust, 5=often/complete trust). We compared vaccinated and unvaccinated students using Mann–Whitney U and χ² tests in SPSS.

Results

Of 882 invited students, 715 (81.1%) completed the questionnaire; HPV vaccination coverage was 27.4%, with a significant gender difference, as 88.0% of vaccinated students were female (p < 0.001). Vaccinated students had higher knowledge scores (median 9 vs 8 of 14, p < 0.001). Internet portals (55.3%) and social networks (55.8%) were the most frequently used information sources, but scientific literature (78.9%) and physicians (75.5%) received the highest trust ratings. Vaccinated students trusted their physicians more than unvaccinated peers (43.0% vs 33.9%, p = 0.043).

Conclusions

Specific HPV knowledge and trust in healthcare providers are key drivers of vaccine uptake among medical students, while high social-media exposure does not translate into trust. HPV vaccination campaigns across the WHO European Region should prioritise physician recommendations and targeted curricular education over reliance on digital reach, to raise coverage in this future health workforce.

Key messages

• Among 715 medical students in Belgrade, vaccinated peers had higher HPV knowledge (median 9 vs 8/14, p < 0.001) and greater trust in their physicians (43.0% vs 33.9%, p = 0.043).

• Internet portals and social networks were the most-used HPV information sources, yet scientific literature (78.9%) and physicians (75.5%) earned the highest trust, supporting clinician-led campaigns.