Human papillomavirus (HPV) vaccination uptake (initiation and completion): factors associated with uptake of the human papillomavirus (HPV) vaccine among young people living with HIV in Uganda.

Limitations

The study used cross-sectional design from a single ART clinic in one district, so findings may not be generalizable to all HIV-positive youth in Uganda. The study does not explain the reasons why participants failed to complete vaccination or explore the quality of school education provided.

Abstract

Introduction The prevalence of human papillomavirus (HPV) infection and related illnesses is disproportionately high in women and young people living with HIV. Vaccination against high-risk HPV types has the potential to reduce HPV- associated disease burden dramatically. However, HPV vaccine uptake has been variable and suboptimal in most countries, including Uganda, with low levels of both initiation and completion of the HPV doses. The purpose of this research was to identify determinants of HPV vaccine uptake and completion among young girls living with HIV. Methods A cross-sectional study was conducted among 274 adolescents and young people living with HIV who were selected from an antiretroviral therapy (ART) clinic in a district Hospital ART clinic, Uganda. Data were collected between February and June 2024. The data were collected using a structured questionnaire examining HPV vaccine uptake (initiation and completion). Bivariate and multivariate analyses were conducted to assess factors associated with HPV vaccine uptake using SPSS version 21 software. Results This study involved 274 participants, with a mean age of 20.3 years ranging from 15-24 years. The proportion who initiated HPV vaccination in this study was 68.2% (187/274), and HPV vaccine dose completion (2 doses and more) was 24.1% (66/274). The uptake of HPV vaccination was significantly associated with age 15 to 19 years (AOR 2.9, 95% CI 1.352-6.1 P = 0.006), having been taught about HPV vaccine and cervical cancer at school (AOR 8.7 95% CI 2.8-24.7, P = < 0.001), living within a distance of less than 5 km from the health facility (AOR 5.9, 95% CI 2.2-16.1, P = < 0.001), and availability of HPV vaccines at the health facility (AOR 5.2, 95% CI 1.9-14.5, P = < 0.001). The completion of HPV vaccination was significantly associated with age 20 to 24 years (AOR 1.9, 95% CI 1.057-3.499, P = 0.032). Conclusion The initiation and completion of HPV vaccination among HIV- positive girls are both crucial for preventing HPV related diseases and cancers. In this study, the completion rate is very low. Vaccination against human papillomavirus (HPV) must be prioritised in the HIV-positive youth population. The findings suggest a need for targeted policies to improve vaccine uptake among HIV-positive youth, including better education, healthcare provider engagement, and system support for follow-up care. This will guide targeted interventions in achieving the WHO's target of 90% immunising all adolescent girls by 2030.