Evaluation of HPV awareness among parents of adolescent girls in Tunisia: a cross-sectional study

Abstract Cervical cancer remains a major public health problem, particularly in low- and middle-income countries, and persistent human papillomavirus (HPV) infection is its primary cause. In Tunisia, the HPV vaccine was introduced into the national immunization program for 12-year-old girls in April 2025; however, data on parental awareness and acceptance remain limited. This cross-sectional study aimed to assess parental knowledge of HPV and its vaccine and to identify factors influencing vaccination intentions. Between July and September 2025, 105 parents of adolescent girls completed a structured questionnaire assessing sociodemographic characteristics, HPV knowledge, vaccine awareness, and attitudes toward vaccination. Overall, 76.2% of participants had heard of HPV, and 63.8% correctly identified sexual contact as the primary mode of transmission. A total of 23.8% were unaware of the HPV vaccine. Regarding vaccination intention, 45.7% were undecided, 18.1% probably would not vaccinate, and 7.6% refused vaccination (25.7% combined reluctance/refusal), while 28.6% probably intended to vaccinate. Higher educational level was significantly associated with better HPV knowledge (p < 0.0001), whereas no demographic factors were significantly associated with vaccination intention. These findings indicate persistent knowledge gaps and substantial uncertainty regarding HPV vaccination shortly after national implementation. Targeted educational strategies and stronger involvement of healthcare professionals may be essential to improve vaccine uptake.