Knowledge, Attitudes, and Practices of Secondary School Students Regarding HPV and HPV-Related Cancer Prevention in Urubamba, Cusco, Peru

Abstract

Human papillomavirus (HPV) is a major cause of preventable cancers and remains a significant public health concern in low-resource settings where adolescents have limited access to preventive services such as vaccination. In rural Peru, little is known about adolescents’ knowledge, attitudes, and practices (KAP) surrounding HPV, despite being the primary age group targeted for vaccination. This study assessed HPV-related KAP among secondary school students in Urubamba, Cusco, and examined how these domains varied by sociodemographic characteristics, resource access, and prior HPV awareness. A cross-sectional survey of 120 students aged 12–18 years from one public and one private school was conducted using a KAP instrument. Knowledge scores (0–38), attitude scores (0–11), practice score (0-1), and total KAP scores (0–50) were summarized descriptively and compared across demographic groups using non-parametric and chi-square tests. Knowledge levels were moderate (median 19/38) but showed major gaps in understanding non-vaginal transmission routes and non-cervical cancers. Attitudes were mixed (median 5/11) with limited confidence in vaccine safety. Only one-third (33%) of students had been vaccinated. Vaccination prevalence was higher among girls (53% vs. 20%). Students at the private school and those with greater resource and medical access demonstrated higher KAP. Prior HPV awareness was strongly associated with higher KAP. These findings reveal gaps in HPV awareness and vaccination in rural Andean adolescents and highlight the need for school-based education, stronger parental engagement, and improved access to vaccination services.