Knowledge and Awareness of HPV, the HPV Vaccine, and Cervical Cancer Among Women From a Brazilian Community: A Community-Based Cross-Sectional Study.

BACKGROUND AND AIMS: Cervical cancer (CC) remains a major public health problem despite effective screening and vaccination strategies. This study aimed to assess women's knowledge and awareness of human papillomavirus (HPV), HPV vaccination, and CC in a Brazilian community-based Family Health Strategy/Primary Health Care (FHS/PHC) setting, and to evaluate factors associated with knowledge of HPV transmission, awareness of the HPV-CC association, and certainty about vaccinating children against HPV.

METHODS

A community-based cross-sectional survey was conducted from August 2023 to February 2024 among women aged ≥ 18 years registered at a Brazilian FHS/PHC unit, using a structured closed-ended questionnaire that included a health services evaluation component based on the Brazilian version of the Primary Care Assessment Tool.

RESULTS

Three hundred and two women participated, most with low educational attainment and low household income. Overall, 56.6% were aware of HPV, whereas only 18.5% were aware of the HPV-CC association. Although 96.4% had heard of the Pap smear test, only 19.9% reported screening according to the recommended protocol. Among women aged ≤ 22 years, 87.5% reported HPV vaccination. Women aged ≤ 22 years had lower awareness across several preventive domains and of the HPV-CC association than women aged ≥ 23 years (p = 0.047). Increasing age was independently associated with lower knowledge of the HPV transmission through unprotected sexual intercourse (OR: 0.962; 95%CI: 0.904-0.984; p < 0.001), whereas higher income was associated with greater knowledge (OR: 2.404; 95%CI: 1.556-3.715; p < 0.001). Greater certainty about vaccinating children was independently associated with television as an information source (OR: 2.295; 95%CI: 1.335-3.950; p = 0.003) and awareness of the HPV-CC association (OR: 2.376; 95%CI: 1.086-5.200; p = 0.030).

CONCLUSION

These findings suggest that substantial knowledge and awareness gaps persist despite favorable vaccination attitudes, reinforcing the need to strengthen health education, screening adherence, and communication strategies within FHS/PHC services.