KNOWLEDGE, ATTITUDE, AND PRACTICES REGARDING HPV VACCINATION AMONG MOTHERS OF ADOLESCENT GIRLS IN KANPUR NAGAR DISTRICT, UTTAR PRADESH, INDIA: A COMMUNITY-BASED CROSS-SECTIONAL STUDY

Abstract

Background: Cervical cancer remains a leading gynaecological malignancy among Indian women, and maternal knowledge, attitude, and practice (KAP) strongly determine HPV vaccine uptake among adolescent daughters. Following the 2022 approval of the indigenous CERVAVAC vaccine and the phased national HPV vaccination rollout, contemporary, methodologically robust maternal KAP data from Tier-2 Indian districts remain scarce. Objectives: To assess knowledge, attitude, and practice regarding HPV vaccination among mothers of adolescent girlsand to determine sociodemographic factors independently associated with knowledge, attitude andpractice. Methods: A community-based cross-sectional study was conducted over one year (1 March 2024–28 February 2025) among 400 mothers of adolescent girls across urban, peri-urban, and rural areas of Kanpur Nagar district, selected through multistage stratified random sampling. Data were collected using a pre-tested, interviewer-administered KAP questionnaire. Descriptive statistics, Mann-Whitney U/Kruskal-Wallis tests, chi-square tests, and multivariable binary logistic regression were used; internal consistency was assessed with Cronbach's alpha. Results: Mean knowledge, attitude, and practice scores were 11.6±3.9 (/22), 71.2±2.8 (/75), and 8.7±1.9 (/12) respectively. Good knowledge was seen in 23.5%, positive attitude in 99.8%, and satisfactory practice in 61.5% of mothers. Higher maternal education (AOR 12.65, 95% CI 5.83–27.43), upper socio-economic class (AOR 5.73, 95% CI 2.85–11.51), urban residence (AOR 5.20, 95% CI 2.39–11.32), and prior awareness of HPV (AOR 30.58, 95% CI 13.64–68.56) were independent predictors of good knowledge. No sociodemographic, knowledge, or attitude variable was independently associated with satisfactory practice. Conclusion: Despite near-universal favourable attitude, knowledge remained modest and unevenly distributed across residence, education, and socio-economic strata, while practice was comparatively better but structurally disconnected from knowledge and attitude. Targeted, equity-focused information-education-communication strategies for peri-urban/rural and less-educated, lower-income mothers are needed to close the residual knowledge gap and consolidate the national HPV vaccination rollout.