HPV Vaccination in Port Harcourt- Exploring Caregiver Perceptions and the Need for a Gender-neutral Health Education in the Post-rollout Era

Abstract

Background: Human Papillomavirus (HPV) has significant links with anogenital neoplasia in both sexes. While Nigeria has implemented free HPV vaccination for girls aged 9–14, the program's sustainability and gender-specific focus remains a concern. This study assessed the knowledge and perceptions of parents in Port Harcourt in the post-rollout era. Methodology: A cross-sectional study was conducted between July and September 2024 among 272 caregivers at the University of Port Harcourt Teaching Hospital. Data on sociodemographic, knowledge, and attitudes were collected via a pretested questionnaire and analysed using descriptive statistics. Results: Most participants were female (80.9%) with tertiary education (83%). While awareness of HPV (79.4%) and its link to cervical cancer (73.5%) was high, a critical knowledge gap existed regarding male risks; only 19.1% knew HPV causes cancer in males. Despite the national rollout, only 22.1% of caregivers were aware the vaccine is currently free for girls. Although 75.0% perceived the vaccine as safe, only 47.1% were "very likely" to vaccinate their children. Notably, 35.3% reported being advised against vaccination by religious or community leaders, and 19.1% held cultural reservations. The age of parents (p 0.007), sex (p 0.005), level of education (p 0.001) and occupation significantly (p 0.001) determined the level of knowledge of HPV and cervical cancer.   Conclusion: High level of awareness is undermined by poor knowledge of male HPV risks and low awareness of free vaccination schemes. The findings suggest that HPV vaccination is largely perceived as a "female-only" issue. Effective public health interventions must transition toward gender-neutral education and community engagement to overcome religious hesitancy and ensure equitable vaccine uptake.