Investigation of Youth Attitudes and Opinions Regarding HPV: A Systematic Review.
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Background: Human papillomavirus (HPV) has been identified as the causative agent of cervical cancer and other cancers of the genital area, head and neck, on a worldwide scale. Despite the proven effectiveness of the vaccine in preventing HPV-related diseases, vaccination uptake remains low in many countries. It is crucial to understand how adolescents and young adults perceive HPV and its vaccine in order to design effective public health strategies and targeted awareness campaigns. Aim: This systematic review examined the attitudes, perceptions, and opinions of young people regarding HPV and HPV vaccination, with the goal of identifying factors that shape vaccine acceptance. Methods: A systematic literature search of PubMed and Scopus identified 293 articles published between January 2014 and February 2025. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Eligible studies included primary qualitative and analytical cross-sectional research published in English that explored views on HPV and vaccination among individuals aged 15-24 years. Due to substantial heterogeneity in study design and outcome measures, findings were synthesized narratively and no meta-analysis was performed. The methodological quality and risk of bias of the included studies were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists (2017) for qualitative and analytical cross-sectional designs. Results: Ten studies met the eligibility criteria, representing 15,776 young people across six countries. The included studies comprised eight cross-sectional surveys and two qualitative studies. Across these studies, knowledge and awareness of HPV and its vaccine were generally moderate, while vaccination coverage remained low. The highest awareness levels were reported in the United States (95.3% for HPV; 90.6% for the vaccine), whereas lower levels were noted in Brazil, Greece, and Italy. Influential factors associated with vaccine acceptance included parental attitudes, healthcare-provider recommendations, cultural norms, and the presence of misinformation. Conclusions: The level of awareness regarding HPV among adolescents and young adults in the included countries is moderate, yet the vaccination coverage remains low across the included countries. The provision of targeted educational interventions, in conjunction with the consistent guidance and training provided by healthcare professionals, is of considerable importance in order to increase vaccination rates. Findings should be interpreted in light of heterogeneity across studies and reliance on self-reported outcomes. Future research should adopt a mixed-methods approach to more effectively address the social, cultural and informational influences shaping young people's perceptions, and to develop more effective communication strategies that promote HPV vaccination.