Knowledge, attitude, and associated factors toward human papillomavirus vaccination among female secondary school students in Nifas Silk Lafto Sub-City, Addis Ababa, Ethiopia: Multicenter cross-sectional study

Background: Human papillomavirus (HPV) infection is among the most common sexually transmitted infections worldwide and a leading cause of cervical cancer, which claims the life of one woman every minute globally. HPV vaccination is a proven, effective strategy to prevent cervical cancer. Despite vaccine availability, few studies have assessed awareness and perceptions among female secondary school students, a key target group for early vaccination. Addressing this gap is essential for designing interventions to improve vaccine acceptance and coverage. Objectives: This study aimed to assess knowledge and attitudes toward the HPV vaccine and identify associated factors among female secondary school students in Nifas Silk Lafto Sub-City, Addis Ababa, Ethiopia. Methods: Institutional-based cross-sectional study was conducted from May 10 to 20, 2023, in Nifas Silk Lafto Sub-City. Stratified sampling was used to select study participants. A total of 635 students were selected using a simple random sampling technique. Data were collected using structured self-administered questionnaires. The data were entered into EpiData version 4.6 and analyzed with SPSS version 25. Descriptive statistics (such as frequency, percentage, and means) were used to summarize the data, while binary and multivariable logistic regression analyses were performed to identify factors associated with the outcome variables. Adjusted odds ratios with 95% confidence intervals (CI) and p-value