Uptake of a single dose human papillomavirus vaccine among adolescent girls aged 13-19 years in Wakiso Dstrict, Uganda

Abstract

Introduction: Cervical cancer remains a major public health challenge in Uganda, and Human Papillomavirus (HPV) vaccination is a key preventive measure. Despite national vaccination programs, coverage among adolescents remains suboptimal. This study assessed the uptake and factors associated with uptake of single-dose HPV vaccination among adolescent girls aged 13-19 years in Wakiso District. Methods: A mixed-methods cross-sectional study was conducted with 597 adolescent records extracted from African Medical and Behavioral Sciences Organization (AMBSO) Population Health Surveillance (APHS) and 58 participants through focus group discussions and key informant interviews, including adolescents, parents, health workers, Head teachers, and Village Health Teams (VHTs). Quantitative analysis included descriptive statistics and regression model using STATA 14.0 and qualitative data were thematically analyzed using NVivo version 15; QSR International, 2021. Results: The overall uptake of at least one dose of the HPV vaccine was 33.3%. Uptake was higher among Protestants (44.8%) than Catholics (33.3%), and among rural residents (47.3%) compared to urban residents (27.2%). Younger adolescents aged 13–15 years (42.9%) were more likely to have been vaccinated than those aged 16–19 years (27.8%). In multivariable modified Poisson regression, significant predictors of HPV vaccine uptake were Protestant religion (Adjusted PR = 1.36, 95% CI: 1.04–1.77, p=0.022), rural residence (Adjusted PR = 1.81, 95% CI: 1.46–2.24, p=0.001), and younger age (Adjusted PR = 0.63, 95% CI: 0.50–0.81, p=0.001). Facilitators included community outreach programs, peer encouragement, school-based vaccination program, and trust in health workers. Key barriers, were limited awareness (90.5%) and misinformation. Conclusion: Single-dose HPV vaccine uptake among adolescent girls aged 13-19years in Wakiso District remains low, largely due to inadequate awareness and sociocultural misconceptions. Strengthening community education, parental engagement, school-health facility programs, and continuous outreach is critical for improving coverage and advancing Uganda’s cervical cancer prevention goals. Keywords: HPV vaccine, adolescent girls, uptake, cervical cancer prevention.