Association Between the Information Environment, Knowledge, Perceived Lack of Information, and Uptake of the HPV Vaccine in Female and Male Undergraduate Students in Belgrade, Serbia

The aim of this study was to assess the association between the use of and trust in sources of information, knowledge about human papillomavirus (HPV) and vaccines against it, perceived lack of information, and the decision to receive the HPV vaccine in undergraduate students in Belgrade. The sample of this cross-sectional study included students aged 18 to 27 who received the second dose of the HPV vaccine or used other services of the general medicine department at the Institute for Students' Health of Belgrade during the period June-July 2024. The research instrument was a questionnaire consisting of socio-demographic data, information environment (sources of information, trust in sources of information, as well as questions related to perceived lack of information), knowledge about HPV and HPV vaccines, and vaccination status. Participants filled out an online questionnaire created on the RedCap platform of the Faculty of Medicine, University of Belgrade, which they accessed via a QR code. Hierarchical logistic regression was used to assess the association between vaccine status and socio-demographic characteristics, use and trust in information sources, knowledge, and perceived lack of information. Of the 603 participants who filled out the questionnaire completely, 78.6% were vaccinated against HPV. Key factors associated with vaccine uptake were female gender (OR = 2.33, <i>p</i> < 0.05), use of scientific literature (OR = 1.40, <i>p</i> < 0.05) and family as a source of information (OR = 1.37, <i>p</i> < 0.01), less frequent use of regional TV channels (OR = 0.76, <i>p</i> < 0.05), higher level of knowledge (OR = 1.43, <i>p</i> < 0.01), and lower perceived lack of information (OR = 0.50, <i>p</i> < 0.01). These variables explained 41% of variability in vaccine uptake in the multivariate hierarchical logistic regression model. Exposure to and trust in sources of information were significantly associated with knowledge about HPV and HPV vaccination, as well as with the perceived lack of information regarding HPV vaccination, and were the most significant determinants of the decision to accept HPV vaccine in the student population.