Assessment of behavioral and social drivers influencingcommunity awareness, knowledge, perception, and attitudestoward human papillomavirus vaccination in Sierra Leone

Abstract

Understanding community awareness, knowledge, perceptions, and attitudes toward the Human Papillomavirus (HPV) vaccine is important for improving vaccination coverage. Limited research exists on the behavioral and social factors influencing HPV vaccine uptake in Sierra Leone. As a result, the study seeks to assess the behavioral and social factors influencing HPV vaccination in Sierra Leone. A convenience sampling approach was used for the selection of the participants at the district and chiefdom level. Data were collected via the KOBO collect tool. A total of 1345 respondents took part in filling out the survey. However, due to missing information, 1231 responses were employed for analysis using Excel software. Virtually all participants in the Eastern, Northern, and Western regions had heard of HPV, with healthcare workers being the primary source of information (49.8%). However, a significant knowledge gap was observed, as most respondents in the four regions could not link HPV to cervical cancer. Concerns about vaccine safety, particularly side effects (39.7%) and fertility issues (28.0%), were prevalent. Despite these concerns, over 75% of respondents expressed a willingness to vaccinate their children, though actual vaccine uptake was low (less than 25% across all regions). Cultural and religious beliefs were found to influence attitudes toward vaccination, with regional variations in the perceived impact of these factors. Although awareness of HPV is high in Sierra Leone, knowledge gaps and misconceptions about the vaccine’s safety and its link to cervical cancer persist. Communication strategies should focus on (a) educating the public about the connection between HPV and cervical cancer and (b) addressing misconceptions about vaccine safety, particularly regarding side effects and fertility. Healthcare workers remain a trusted source of information, but peer influence should also be leveraged to improve vaccine uptake. These findings highlight the need for targeted public health interventions to increase HPV vaccination coverage in Sierra Leone.