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