Evaluating knowledge and awareness of cervical cancer, human papillomavirus and human papillomavirus vaccination among women in East London, South Africa

Abstract

Background: Cervical cancer poses a major health risk for women in low- and middle-income countries, with persistent human papillomavirus (HPV) types 16 and 18 as leading causes. In South Africa, screening rates are low, and awareness and vaccine uptake remain insufficient despite a national immunisation programme since 2014.
Aim: This study evaluated women’s knowledge and awareness of cervical cancer, HPV and HPV vaccination at three healthcare levels in East London, South Africa, and examined demographic factors and differences between settings.
Setting: The study was conducted at five public health facilities in East London, Eastern Cape Province, South Africa.
Methods: An analytical cross-sectional study was conducted. Three hundred and five female participants completed questionnaires on cervical cancer, HPV and vaccination. Data were analysed with STATA 17; knowledge was scored and classified from ‘very poor’ to ‘excellent’, and statistical tests determined associations.
Results: The median knowledge score was 28.6%. Awareness rates were as follows: cervical cancer (48.5%), HPV (25.9%) and HPV vaccination (29.2%). Community health centre attendees had the lowest scores. Only 6.2% had ‘excellent’ knowledge, and 52% had ‘poor’ or ‘very poor’ knowledge. Higher education and hospital-based care correlated with better scores (p < 0.001). Vaccine uptake among eligible female relatives was only 12%.
Conclusion: Knowledge and awareness of cervical cancer, HPV and vaccination are low, especially in primary care. Pap smear usage is high, but understanding remains limited. Improved community education and provider involvement are needed to boost awareness and vaccine acceptance if South Africa is to meet the World Health Organization cervical cancer targets by 2030.
Contribution: This study provides current evidence on HPV-related knowledge gaps among women in the Eastern Cape and highlights the need for targeted interventions within primary health care settings.