Knowledge and Attitudes Toward Cervical Cancer and Human Papilloma Virus Vaccination in Rafiki Area, Rongai Sub-County, Nakuru County, Kenya: A Cross-sectional Study

Abstract

The human papillomavirus (HPV) has been proven to be a primary driver in the development of cervical cancer. Despite increasing awareness efforts, Human Papillomavirus (HPV) vaccine uptake remains low in many low-resource settings. This study assessed knowledge and attitudes towards cervical cancer and human papillomavirus vaccination, and predictors of HPV vaccine uptake among individuals aged 15-49 years in Rafiki area, Rongai sub-county, Nakuru County, Kenya. A cross-sectional survey was conducted with 328 participants selected through convenience sampling. Structured interviewer-administered questionnaires were used to collect data on sociodemographic characteristics, cervical cancer and HPV vaccine awareness and attitudes, sources of information, and perceived barriers. Data were analysed using R version 4.2.2. Descriptive statistics such as mean, frequencies and proportions were used to summarise sociodemographic characteristics, knowledge, attitudes and barriers, and multivariable binary logistic regression was used to identify predictors of HPV vaccine uptake. The participants of this study were predominantly female (219, 66.8%), single (74.4%), unemployed (68.0%), had a tertiary level of education (74.1%) and a mean age of 25.9 ± 7.4 years. Although 240 (73.2%) of respondents were aware of the existence of the HPV vaccine and 306 (93.3%) had heard about cervical cancer before, only 37 (11.3%) had received it. Barriers to uptake included fear of adverse effects (32.0%), lack of awareness of vaccine availability (17.8%), cost (15.5%) and lack of access (13.1%). Positive predictors of HPV vaccine uptake identified through multivariable binary logistic regression included being female (aOR 2.9, 95% CI 1.2-8.4, p=0.031), being divorced (aOR 12.1, 95% CI 1.4, 81.1, p=0.011) and having heard about the vaccine before (aOR 10.5, 95% CI 3.2-50.0, p=0.001). While general awareness of the HPV vaccine is high, uptake remains alarmingly low due to structural, informational, and perceptual barriers. Targeted interventions should focus on improving vaccine availability, leveraging trusted information channels particularly healthcare providers and addressing misconceptions. The findings of the study can be used as a basis for more robust studies. Additionally, it serves as a starting point in the development of a useful tool with real-world value for guiding localised public health strategies aimed at increasing HPV vaccination coverage in similar settings.