DOI: 10.3390/vaccines14110936 ISSN: 2076-393X

HPV Knowledge, Vaccination Awareness, and the Knowledge–Practice Gap in Cervical Cancer Prevention Among Turkish Women: A Cross-Sectional Study

Ümmügülsüm Esenkaya, Melike Geyik Bayman

Background/Objectives: Human papillomavirus (HPV) vaccination and cervical cancer screening are key components of cervical cancer prevention; however, awareness may not translate into preventive practice. This study aimed to assess HPV knowledge, HPV vaccine awareness and uptake, Pap smear testing history, and sociodemographic factors associated with HPV knowledge among women attending a gynecology outpatient clinic in Türkiye. Methods: This cross-sectional study included 403 women aged 18–49 years who attended the Gynecology and Obstetrics Outpatient Clinic of Konya City Hospital between July and October 2025. Following a brief explanation of the study, participants independently completed self-administered questionnaires, including a demographic questionnaire and the validated Turkish HPV Knowledge Scale (HPV-KS). Group comparisons were performed using the Mann–Whitney U and Kruskal–Wallis tests, with Bonferroni-adjusted post hoc comparisons where appropriate. An exploratory multivariable binary logistic regression analysis was performed to identify factors independently associated with having any HPV knowledge (HPV-KS > 0). Results: The median total HPV-KS score was 8 (Q1–Q3: 0–15). Overall, 52.6% of participants had heard of HPV and 44.2% had heard of the HPV vaccine, whereas 18.9% reported previous Pap smear testing and only 3.2% reported HPV vaccination. Knowledge of HPV vaccine availability/use was particularly limited, with a median score of 0 (Q1–Q3: 0–1). Total HPV-KS scores were significantly higher among women with university education, employment, urban residence, contraceptive use, previous Pap smear testing, and prior awareness of HPV or the HPV vaccine (p < 0.05). In the multivariable analysis, compared with university graduates, participants with primary-level education (aOR = 0.26, 95% CI: 0.14–0.49) and high-school education (aOR = 0.41, 95% CI: 0.25–0.70) had lower odds of having any HPV knowledge, whereas employment (aOR = 2.45, 95% CI: 1.41–4.23) and previous Pap smear testing (aOR = 4.38, 95% CI: 2.05–9.36) were associated with higher odds. Conclusions: HPV and vaccine awareness exceeded reported vaccination and Pap smear testing uptake, although awareness itself remained limited. Particularly low knowledge of HPV vaccine availability/use highlights an actionable knowledge gap. Educational and healthcare-contact factors were associated with HPV knowledge, supporting accessible counseling that provides practical information on vaccine eligibility, schedules, access, and cervical cancer prevention.

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