Assessment of Knowledge and Attitudes Toward HPV, Cervical Cancer, and Vaccination Barriers among Undergraduates in Ghana: A Cross-Sectional Study

Abstract Background: Human papillomavirus (HPV) infection is a leading cause of cervical cancer globally, disproportionately affecting women in developing countries like Ghana. Despite the recent introduction of national HPV vaccination programs, vaccine uptake among young adults remains suboptimal. This study aimed to assess the levels of knowledge, attitudes, and perceived barriers toward HPV, cervical cancer, and vaccination among undergraduate students in Ghana to inform future public health interventions. Methods: A cross-sectional study was conducted among 699 undergraduate students at the University of Cape Coast, Ghana. A multistage stratified random sampling technique was employed to ensure disciplinary representation. Data were collected using a validated, semi-structured digital questionnaire covering socio-demographics, knowledge of HPV, attitudes toward vaccination, and perceived barriers. Descriptive statistics were utilized to summarize findings. Chi-square tests were performed to assess bivariate associations, and binary logistic regression analysis was conducted to identify predictors of good knowledge and positive attitudes toward vaccination, with statistical significance set at p < 0.05. Results: 51.9% of students demonstrated good knowledge of HPV and vaccination. A significant gender disparity was observed: while male students displayed higher levels of clinical knowledge, female students held significantly more positive attitudes toward vaccination (p < 0.05). Major barriers included profound social stigma, with 77.9% of students expressing concern over partner perception and 65.6% reporting embarrassment regarding the association between the vaccine and sexually transmitted infections. Misconceptions were prevalent, with 46.6% of participants incorrectly believing the vaccine could cure existing infections. Conclusion: A clear knowledge-attitude gap exists among Ghanaian undergraduates, complicated by pervasive psychosocial barriers. Current vaccine delivery models, which often center on reproductive health or STI clinics, inadvertently reinforce stigma. To improve vaccination coverage, public health initiatives must transition toward a stigma-neutral model of care that integrates HPV immunization into routine primary health services, framing it as a preventive cancer-fighting strategy rather than a sexual health intervention.