Knowledge, Attitudes, and Practices (KAP) Regarding Sexually Transmitted Infections, Human Papillomavirus, and HPV-Related Oropharyngeal Cancer Among Italian Adolescents: A Cross-Sectional Study.

Background/

Objectives

Human papillomavirus (HPV) is now responsible for the majority of oropharyngeal squamous cell carcinomas (OPSCCs), an HPV-related cancer of direct relevance to the dental profession; oral-health providers may be well-positioned to perform routine oral examination, recognize suspicious signs, refer appropriately, and educate patients about HPV-related oropharyngeal cancer and HPV vaccination. This study assessed knowledge, attitudes and practices regarding sexually transmitted infections (STIs), HPV, HIV/AIDS and HPV-related oral and oropharyngeal cancer among secondary-school students in Apulia, Italy, with particular attention to the dental setting.

Methods

A cross-sectional study was conducted by the University of Foggia among 1224 students from three secondary schools at the end of the 2025/2026 school year) using a self-administered 108-item questionnaire. A 63-item composite knowledge score was computed; "don't know" answers were scored as incorrect and adequate knowledge defined a priori as ≥60% (Bloom's cut-off). The minimum required sample (737) was derived using Cochran's formula adjusted for a cluster-sampling design effect.

Results

Overall knowledge was low (mean 28.5%, SD 18.2); only 5% reached the ≥60% threshold (Bloom's cut-off). Only 14.8% of students were aware that HPV can cause oropharyngeal cancer, the lowest figure among all oncogenic outcomes assessed and significantly lower in boys (11.2%) than girls (17.3%; p = 0.003), despite boys carrying the higher OPSCC risk. Knowledge was independently associated with female sex, age and sexual experience. Despite poor knowledge, 61.2% of students would like to receive the HPV vaccine.

Conclusions

The dental visit may represent an under-used opportunity to address this oral-cancer-prevention knowledge gap; the integration of oral-health professionals into school-based and clinical HPV-prevention strategies is a plausible public-health implication.