Awareness and attitudes of health and non-health faculty students at the University of Split, Croatia about human papillomavirus vaccination: a cross-sectional study

Awareness, vaccine-related behavior, and perceptions about the human papillomavirus (HPV) vary in certain higher education student populations in Croatia in the context of low HPV vaccination rates. These factors concerning HPV and vaccination in higher education students in diverse fields would inform public health officials about interventions to improve non-vaccination. We aimed to evaluate HPV and HPV vaccine knowledge, perceptions, and behavior of health and non-health students in Split, Croatia. In a cross-sectional survey, we purposively approached students at the University of Split enrolled in health-related and non-health-related programs from March to April 2024. We used a survey with 29 dichotomous (yes/no) and Likert-scale items in English. The survey requested sociodemographic characteristics (12 items), HPV awareness (8 items), and perceptions and attitude (4 items) and behavioral intentions toward HPV vaccination (3 items). We used Chi-square test to compare frequencies and binomial logistic regression in unadjusted and adjusted models to explore associations of sociodemographic variables (unadjusted models only) and knowledge, perception, and behavior variables, HPV vaccination status, intention to be vaccinated, and study program. Of the 463 students who participated in the survey, 256 (55%) were health studies students. Of these, 361 (78%) were female and 287 (62%) were first-year students. Two hundred and thirty-four (91.4%) health studies students compared to 178 (86.0%) non-health studies students were aware of the HPV vaccine, while high proportions of health (98.4%) and non-health (95.7%) students heard about HPV. Non-health studies students reported higher uncertainty about HPV as a cause of cancer (odds ratio [OR] 2.29, 95% CI 1.17–4.47) and anogenital cancer (4.03, 95% CI 2.17–7.50). Less than one-third ( n = 123/463, 27%) of the students self-reported being vaccinated against HPV. Not wanting to seek more information about the vaccine (OR 0.10, 95% CI 0.05–0.21) was associated with not intending to get vaccinated, similarly not knowing family or friends’ vaccination status was associated with self-reported non-vaccination (OR 0.26, 95% CI 0.16–0.42) and not intending to get vaccinated (OR 0.17, 95% CI 0.09–0.34). Although most students were not vaccinated, many students’ awareness was high about HPV and the HPV vaccine. To increase the vaccination rate in similar student populations, public health interventions could target knowledgeable students who may be reluctant to seek more information about the vaccine with early evidence-based interventions.