<b>Medical students’ perspective on HPV vaccination in India: Knowledge, acceptability, barriers, and opportunities</b>

Background: Human papillomavirus (HPV) is a leading cause of cervical cancer and other malignancies. Despite the availability of effective vaccines, uptake remains suboptimal, particularly in low- and middle-income countries like India. Medical students, as future healthcare providers, play a crucial role in shaping vaccination practices. Objectives: This study explores the knowledge, attitudes, and acceptance of the HPV vaccine among medical students in a tertiary care teaching hospital in Bangalore, India. Methods: A cross-sectional, questionnaire-based study was conducted from April to May 2024, involving 400 medical students aged 18-25 years. A 40-item semi-structured survey assessed demographic characteristics, general attitudes toward vaccines, knowledge of HPV infection, cervical cancer screening, HPV vaccination and attitude towards HPV vaccine. Knowledge scores were categorized as high (≥13) or low (<13). Statistical analysis was performed using SPSS version 20.0, applying chi-square tests and logistic regression models. Results: Among participants, clinical-year students demonstrated significantly higher knowledge scores (p<0.001) and greater vaccine acceptance (83.9%) compared to non-clinical students (57.9%). Although 78.8% intended to receive the vaccine, only 12% were vaccinated. Females exhibited higher vaccine acceptability (OR: 3.525; p<0.001). The most common barriers to vaccination were high cost (53.1%), lack of knowledge, and social stigma. Conclusions: While overall awareness of HPV was moderate, significant knowledge gaps persisted regarding HPV vaccine indications, schedule, and effectiveness. Clinical exposure positively influenced vaccine acceptance. Targeted educational interventions and cost-effective vaccine distribution strategies are essential to improving HPV vaccine uptake among medical students, ultimately shaping future public health policies in India.