Evaluation of the knowledge of parents with children aged 9–21 years applying to primary health care services about hpv infection and HPV vaccine, and their attitudes and opinions toward vaccinating their daughters and sons

Evaluation of the Knowledge of Parents with Children Aged 9–21 Years Applying to Primary Health Care Services About HPV Infection and HPV Vaccine, and Their Attitudes and Opinions Toward Vaccinating Their Daughters and Sons Objective: The primary objective of this study is to analyze the thoughts, attitudes, and beliefs of parents who utilize primary healthcare services and have daughters and/or sons aged between 9 and 21 years regarding the HPV vaccine. The study aims to identify differences in HPV-related knowledge and vaccination attitudes between female and male children, determine barriers to HPV vaccination, inform parents about these issues, and ultimately enhance awareness and understanding of HPV and the HPV vaccine. Materials and Methods: This descriptive cross-sectional study collected data through a survey administered to 390 parents of children aged 9 to 21 years who visited primary healthcare services, with the aim of examining their knowledge, attitudes, behaviors, and perceptions regarding HPV and the HPV vaccine. Descriptive statistics, including means and standard deviations, were used to present the data. Reliability and validity analyses of the HPV scale were conducted using Cronbach's Alpha and factor analysis. The normality of the distribution of the scale scores was assessed using the Kolmogorov-Smirnov (K-S) test. In the study, independent samples t-test and analysis of variance (ANOVA) were performed to examine the subscale scores of the HPV scale according to participants' characteristics. Additionally, Pearson correlation analysis was conducted to investigate the relationships between participants' measurements and the dimensions of the HPV scale. All analyses were conducted using SPSS version 25.0. The questionnaire used in the study consisted of two sections; the first section included demographic data and health-related information regarding the participants and their children. The second section comprised the General HPV Knowledge Scale. Each correct response on the questionnaire was awarded one (1) point, with a maximum score of 25; higher scores indicated a greater level of HPV knowledge. Results: In this study, a total of 390 parents were surveyed, of whom 210 were female. The rate of participants who had received the HPV vaccine themselves was 3.8%, while 15% had vaccinated their daughters and 5% had vaccinated their sons. Female participants demonstrated significantly higher levels of general HPV knowledge and awareness, as well as greater awareness of the HPV vaccine, compared to male participants. Participants with a history of sexually transmitted infections exhibited significantly higher levels of general HPV knowledge and awareness, HPV vaccination attitudes, HPV vaccine awareness, and HPV knowledge. The mean score for general HPV knowledge and awareness was 11.52±3.64, indicating a moderate level. Participants whose first and second children were female had significantly higher levels of general HPV knowledge and awareness, HPV vaccine awareness, and HPV vaccination attitudes. Fourteen percent of parents believed that the HPV vaccine is only for girls, whereas 28% reported that it can be administered to both genders. Notably, 41% of parents expressed concern that the vaccine may promote risky sexual behaviors, with the most frequently cited reason for vaccine refusal being the fear that "it may encourage my daughter/son to engage in sexual activity at an early age." If the vaccine were provided free of charge or recommended by a physician, 65% of parents reported willingness to vaccinate their daughters and 55% their sons. A strong positive correlation was observed between general HPV knowledge and awareness, HPV vaccination attitudes, HPV vaccine awareness, and HPV knowledge levels. Conclusions and Recommendations: Human Papillomavirus (HPV) infection has emerged as a widespread public health issue, particularly among women, primarily due to its role as the leading etiological factor in cervical cancer. In recent years, the prevalence of HPV infection has also been on the rise among men, where it has been linked to various HPV-related conditions, notably penile cancer. Vaccination remains the most effective strategy for primary prevention of HPV infection. In our study, HPV vaccination rates were found to be considerably low. It is suggested that these rates could be significantly improved through the implementation of targeted educational campaigns, accessible and well-structured vaccination programs, financial support mechanisms, and comprehensive public awareness efforts. Such measures would facilitate effective and affordable protection against HPV infection—recognized as a major public health concern due to its oncogenic potential—and the associated diseases it may cause. Keywords: HPV vaccine, female adolescents, male adolescents, parents, penile cancer