Human Papillomavirus Vaccine Hesitancy and Uptake Among Adolescent Girls Living with HIV in Sierra Leone

A Call for Integration of Cervical Cancer Services

Bibliographic Data

ID19469697
AuthorsDarlinda F Jiba (0000-0002-1595-4742, University of Sierra Leone, corresponding author), Patrick Turay (University of Makeni), Mamadu Baldeh (0000-0001-7772-1111, University of Sierra Leone), Matilda N Kamara (0009-0000-6950-5822, University of Sierra Leone), Saidu Kanu (University of Makeni), Lynda M L Farma-Grant (University of Sierra Leone), Umu Barrie (Sierra Leone Urban Research Centre), Waheed O Awonuga, Waheed Awonuga (University of Sierra Leone), Mary M Baio (University of Sierra Leone), Daniel Sesay (University of Sierra Leone), Diana Shehab (University of Sierra Leone), Rosaline Sinnah (University of Sierra Leone), Enanga Sonia Namanga (University of Sierra Leone), Phildys M D Johnson (University of Sierra Leone), Michael Tanu Brima (University of Sierra Leone), Solomon F F Sandy (University of Sierra Leone), Everett J Saccoi (University of Sierra Leone), Joseph B Kamara (University of Sierra Leone), Mohamed Smith (0000-0003-3004-2298, University of Sierra Leone), Musa Salieu Kamara (University of Sierra Leone), J Andrew Dykens (University of Illinois Urbana-Champaign), Sulaiman Lakoh (0000-0002-7639-0004, University of Sierra Leone)
Year2026
Volume30
Issue8
Pages2411-2421
Publication date2026-04-11
Open AccessYes
TypeARTICLE
VenueAIDS and Behavior (JOURNAL)
Journal identifiersISSN: 1090-7165 • E-ISSN: 1573-3254
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1007/s10461-026-05065-x
PMID41964808
OpenAlexW7153481609
LanguageEN
References cited29

Human papillomavirus (HPV) vaccination is critical for preventing cervical cancer among women living with HIV. Yet, uptake among adolescent girls needed to prevent cervical cancer remains understudied in low-income countries. This cross-sectional study examined HPV vaccination rates among adolescent girls (aged 10-18 years), sociodemographic predictors and perceptions related to HPV vaccination among their caregivers. A total of 249 caregivers of these adolescents, all attending antiretroviral therapy clinics in Sierra Leone, were included. This cross-sectional study assessed HPV vaccination rates among adolescent girls with HIV. We collected data using structured surveys and employed logistic regression models to identify factors associated with vaccine initiation (≥ 1 dose). Only 13.3% (n = 33/249) of adolescents had received the HPV vaccine, with significant disparities by age: older adolescents (18 years) had higher uptake (27.8%, 10/36) compared to younger peers (10-13 years) (5.3%, 5/94). Caregiver relationship strongly predicted vaccination: extended family caregivers had 1.84-fold higher odds of initiating vaccination than grandparents (adjusted OR = 1.84, 95% CI:1.09-3.12, p = 0.022). Misconceptions were prevalent: 16.8% (n = 41/243) of caregivers believed HPV vaccination promotes premarital sex, and 4.5% (n = 11/243) feared infertility, with none in the latter group vaccinating their child. Despite 80.7% (n = 196/243) expressing intent to vaccinate, only 6.6% (n = 13/196) had done so, highlighting a critical intention-action gap. Structural barriers, such as inconsistent access and cultural myths, likely mediate low uptake. These findings underscore the need for multifaceted interventions, including community-led education to dispel myths, integration of HPV vaccination into HIV care platforms, and targeted engagement of extended family decision-makers

Cervical cancer · Health communication · Health psychology · Human immunodeficiency virus (HIV) · Human papillomavirus · Human papillomavirus vaccine · Public health · Cervical Cancer and HPV Research · Family Support in Illness · Vaccine Coverage and Hesitancy

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