A Cross-Sectional Study of Knowledge, Attitudes, and Perceptions toward HPV Vaccination Among Undergraduate Students Studying in Sarawak, Malaysia

Lim, Melissa Siaw Han; Tan, Shirley Siang Ning; Bujang, Mohamad Adam; Shandra, Jordan Ferguson Anak; Nor Azman, Nurain Nazwa Binti; Mohd Razali, Siti Naura Insyirah Binti; Tan, Mee Fong; Wan Maharuddin, Izzati Binti; Ismail, Adam Malik Bin; Rashid, Rahmah Binti; Tiong, Xun Ting; Voon, Pei Jye

doi:10.31557/APJCP.2026.27.9.3365

A Cross-Sectional Study of Knowledge, Attitudes, and Perceptions toward HPV Vaccination Among Undergraduate Students Studying in Sarawak, Malaysia

Document Type : Research Articles

Authors

¹ Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia.

² Clinical Research Centre, Institute for Clinical Research, National Institutes of Health, Sarawak General Hospital, Ministry of Health, Malaysia.

³ Department of Pharmacy, Sarawak General Hospital, Ministry of Health, Malaysia.

⁴ Department of Radiotherapy, Oncology and Palliative Care, Sarawak General Hospital, Ministry of Health, Malaysia.

⁵ Department of Pathology, Sarawak General Hospital, Ministry of Health, Malaysia.

⁶ Family Health Development Division, Department of Public Health, Sarawak State Health Department, Ministry of Health, Malaysia.

10.31557/APJCP.2026.27.9.3365

Abstract

Background: Cervical cancer remains a significant public health problem, particularly in low- and middle-income countries, and is mainly caused by persistent infection with high-risk human papillomavirus (HPV). Despite Malaysia’s national HPV vaccination program, gaps in knowledge, misconceptions, and suboptimal vaccine uptake persist even among university students. Objective: This study aimed to assess HPV-related knowledge, attitudes and perceptions toward HPV vaccination among undergraduate students studying in Sarawak, and to identify sociodemographic factors associated with knowledge levels. Results: A total of 382 undergraduate students participated, of whom 55% were unvaccinated against HPV. Overall, HPV knowledge was moderate, with students from health faculties demonstrating higher HPV knowledge compared with those from non-health faculties ([aOR] = 2.0, 95% CI: 1.1-3.5; p = 0.016); Indian participants had significantly higher odds of high HPV-related knowledge compared with Malay participants (adjOR = 2.7, 95% CI: 1.0–7.0; p = 0.043). Vaccinated students have significantly higher HPV-related knowledge compared with unvaccinated students (adjOR = 1.9, 95% CI: 1.2-3.0; p=0.007). Attitudes toward HPV vaccination were generally positive, although concerns regarding cost, safety, and social stigma remained. Conclusion: Undergraduate students demonstrated moderate knowledge and positive attitudes toward HPV vaccination; however, notable knowledge gaps and misconceptions persist, particularly among non-health students and those who were unvaccinated. Targeted educational strategies and improved access to reliable information are essential to strengthen HPV prevention efforts.

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