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Keywords = human papillomavirus vaccination program

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16 pages, 1116 KB  
Review
Impact of the COVID-19 Pandemic on HPV Vaccination in Low- and Middle-Income Countries: A Scoping Review
by Joyce Omondi, Robert Ambogo, Candy Ochieng, Marwa Farag and George Mutwiri
Vaccines 2026, 14(5), 432; https://doi.org/10.3390/vaccines14050432 - 12 May 2026
Viewed by 323
Abstract
Background: The COVID-19 pandemic caused disruptions in HPV vaccination and may have severely undermined global cervical cancer prevention, posing long-term risks to controlling cervical cancer and other HPV-related diseases. Objective: We conducted a scoping review to map and synthesize available evidence on how [...] Read more.
Background: The COVID-19 pandemic caused disruptions in HPV vaccination and may have severely undermined global cervical cancer prevention, posing long-term risks to controlling cervical cancer and other HPV-related diseases. Objective: We conducted a scoping review to map and synthesize available evidence on how the COVID-19 pandemic has affected human papillomavirus (HPV) vaccination programs in low- and middle-income countries (LMICs) focusing on changes in vaccine delivery and coverage, determinants of uptake, economic and programmatic consequences and vaccine hesitancy. Methods: Inclusion criteria were limited to studies published in the English language between January 2020 to May 2025, and followed JBI and Arksey & O’Malley’s scoping review guidelines. The review proceeded through three stages: database searches, gray literature and citation tracking and used a PRISMA-ScR checklist to guide narrative and tabular synthesis. Results: A total of 1063 records, 57 studies were included in the final analysis, and these were spread out across 37 low- and middle-income countries (LMICs) mainly in Africa, Asia, and Latin America. Our analysis revealed that HPV vaccination coverage declined substantially during the COVID-19 pandemic, with reductions of up to 90% reported across the included studies, in the context of school closures, workforce redeployment, and supply-chain disruptions. Recovery efforts also faced major barriers including vaccine hesitancy, misinformation about COVID-19 vaccines, and travel restrictions. Strategies like digital tools, mobile clinics, and community health workers showed promise alongside integrated school- and facility-based approaches, although there is limited evidence on cost-effectiveness and long-term sustainability of these strategies. Conclusions: HPV vaccination in LMICs was significantly disrupted by the COVID-19 pandemic due to unreliable vaccine supply chains, health-worker shortages, and challenges tied to school-based vaccine delivery. Although recovery methods show potential, longer observation periods are needed to determine their full effectiveness. Full article
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14 pages, 273 KB  
Article
Association of Oral Papivir/Pavirona® Supplementation with HPV DNA Clearance
by Betul Gungor Serin, Bilal Esat Temiz, Haticegul Tuncer, Muhammed Onur Atakul, Ali Can Gunes, Taylan Onat, Utku Akgor, Derman Basaran, Zafer Selcuk Tuncer and Murat Gultekin
Viruses 2026, 18(4), 455; https://doi.org/10.3390/v18040455 - 9 Apr 2026
Viewed by 827
Abstract
Background: Persistent cervical human papillomavirus (Human papillomavirus) infection remains a significant public health concern, as it is the primary etiological factor in the development of cervical cancer and its precursor lesions. While prophylactic vaccination and standard screening programs are cornerstones of prevention, a [...] Read more.
Background: Persistent cervical human papillomavirus (Human papillomavirus) infection remains a significant public health concern, as it is the primary etiological factor in the development of cervical cancer and its precursor lesions. While prophylactic vaccination and standard screening programs are cornerstones of prevention, a substantial proportion of women with established infection are managed conservatively, often with prolonged follow-up and associated psychological burden. Interest has therefore grown in supportive interventions that may facilitate viral clearance during routine clinical management. Methods: This retrospective cohort study included 239 women with confirmed cervical Human papillomavirus infection followed at a tertiary referral center between February 2023 and August 2025. Participants were classified into a treatment group receiving oral Papivir/Pavirona® twice daily for six months (n = 119) and a control group managed with routine clinical follow-up alone (n = 120). Human papillomavirus DNA testing and cervical cytology were evaluated at baseline and at 6 and 12 months. Results: Human papillomavirus clearance rates were significantly higher in the Papivir/Pavirona® group compared with controls at both 6 and 12 months. Cytological regression was also more frequent in the treatment group at both time points. In multivariate logistic regression analysis, Papivir/Pavirona® use emerged as the only independent predictor of both Human papillomavirus clearance and cytological regression, while demographic, reproductive, behavioral, and virological baseline characteristics were not significantly associated with outcomes. Conclusions: Papivir/Pavirona® supplementation was associated with increased Human papillomavirus clearance and cytological regression rates in women with cervical Human papillomavirus infection, suggesting a potential supportive role alongside standard clinical follow-up. Full article
16 pages, 3068 KB  
Communication
Towards Global HPV Eradication: Single-Dose HPV Vaccination vs. Pseudoscience
by Reona Shiro and Ikuo Tsunoda
Pathophysiology 2026, 33(2), 25; https://doi.org/10.3390/pathophysiology33020025 - 30 Mar 2026
Viewed by 1214
Abstract
Human papillomavirus (HPV) can cause cervical cancer. Global viral eradication relies on specific criteria, including a single host species and effective vaccines, a feat successfully achieved with smallpox and rinderpest. Although measles is also a candidate for elimination, its progress has been hindered [...] Read more.
Human papillomavirus (HPV) can cause cervical cancer. Global viral eradication relies on specific criteria, including a single host species and effective vaccines, a feat successfully achieved with smallpox and rinderpest. Although measles is also a candidate for elimination, its progress has been hindered by vaccine hesitancy based on misinformation about vaccine safety. Similarly, HPV is an ideal candidate for eradication due to its strict human infectivity and the proven vaccine efficacy in reducing cancer rates and establishing herd immunity. We highlighted the growing global consensus on single-dose HPV vaccination to improve feasibility and compliance with comparable effectiveness and safety to three-dose vaccination. Supporting this, we demonstrated that mice receiving a single HPV vaccine produced anti-HPV antibodies without a prolonged pro-inflammatory cytokine profile. On the other hand, in Japan, a nine-year suspension of proactive government recommendations occurred due to alleged adverse events termed “HPV vaccination-associated neuro-immunopathic syndrome (HANS),” drastically reducing vaccination rates, despite rigorous international studies have confirmed the vaccine’s safety. Critical scientific evaluation demonstrated that HANS failed to meet the criteria for autoimmune diseases (Witebsky’s postulates); no evidence has been presented that HANS is a novel autoimmune disease. The claim of molecular mimicry between HPV L1 and human proteins was based solely on flawed computational analyses. Furthermore, the hypothesis implicating a pathogenic role for aluminum adjuvants was unsupported by experimental evidence; HANS animal models were flawed methodologically and unreproducible experimentally. In summary, we believe that implementing worldwide HPV vaccination strategies, including gender-neutral and single-dose programs, as well as denouncing pseudoscientific claims hold the potential to eliminate high-risk HPV types globally. Full article
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14 pages, 261 KB  
Article
Exploring Parental Hesitancy and Acceptance of HPV Vaccination in a Saudi Population
by Arwa Khaled, Khalid Orayj, Hend Talkhan, Retaj Ali, Altaf Alfifi, Shahad Bin Ghamia and Naglaa Bazan
Vaccines 2026, 14(3), 229; https://doi.org/10.3390/vaccines14030229 - 28 Feb 2026
Viewed by 1163
Abstract
Background: Human papillomavirus (HPV) vaccination is a major concern and highly effective strategy for preventing cervical cancer and other related diseases. Despite the inclusion of the HPV vaccine in the Saudi national immunization program and recent school-based initiatives, vaccine uptake remains suboptimal, mainly [...] Read more.
Background: Human papillomavirus (HPV) vaccination is a major concern and highly effective strategy for preventing cervical cancer and other related diseases. Despite the inclusion of the HPV vaccine in the Saudi national immunization program and recent school-based initiatives, vaccine uptake remains suboptimal, mainly due to the hesitancy of parents. Evidence regarding HPV vaccine hesitancy in the Aseer region of Saudi Arabia is limited. Objectives: This study aimed to assess the level of the HPV vaccine hesitancy, knowledge, attitude and barriers among parents in the Aseer region of Saudi Arabia using the World Health Organization (WHO) HPV Vaccine Hesitancy Scale (VAS). Methods: A cross-sectional study was conducted among parents residing in the Aseer region, Saudi Arabia. Data were collected using a structured questionnaire that included sociodemographic characteristics, knowledge, barriers and the validated nine-item WHO HPV Vaccine Hesitancy Scale. Data was expressed in numbers (%) for categorical variables and mean ± SD for continuous variables. Independent t-tests and one-way ANOVA were used for inferential statistics. Results: A total of 379 parents participated in the study. Overall, 49% of parents exhibited high HPV vaccine hesitancy. The most frequently reported barriers were safety concerns (82.6%), insufficient information (80.3%) and fear of side effects (79.4). Lower hesitancy scores were observed among parents aged ≥ 46 years than among those aged 18–25 years (p = 0.022), and respondents with postgraduate education were less hesitant than those with a high school education or less (p = 0.030). Parents whose children were fully vaccinated exhibited significantly lower hesitancy scores compared with those whose children were unvaccinated (p = 0.004). Conclusions: The HPV vaccine hesitancy among parents in the Aseer region is greatly influenced by the age of the parents, their educational level, and the child’s vaccination history. Higher hesitancy among younger parents, those with lower educational levels, and parents of unvaccinated children highlights priority groups for targeted interventions. Strengthening healthcare-provider recommendations and implementing culturally tailored, evidence-based communication strategies may improve HPV vaccine acceptance and support national cervical cancer prevention efforts in Saudi Arabia. Full article
(This article belongs to the Section Human Papillomavirus Vaccines)
16 pages, 907 KB  
Article
Acceptability of HPV Vaccination for Daughters: A University Hospital-Wide Questionnaire Survey
by Midori Yamaguchi, Akiko Sukegawa, Kenji Ohshige, Yukio Suzuki, Atsuko Furuno, Etsuko Miyagi and Taichi Mizushima
Vaccines 2026, 14(3), 218; https://doi.org/10.3390/vaccines14030218 - 27 Feb 2026
Viewed by 757
Abstract
Background/Objectives: Japan has experienced a marked decline in human papillomavirus (HPV) vaccination coverage, reaching less than 1%, after the government suspended its proactive recommendation in 2013, following media reports of symptoms alleged to be adverse events caused by the vaccine. Although the recommendation [...] Read more.
Background/Objectives: Japan has experienced a marked decline in human papillomavirus (HPV) vaccination coverage, reaching less than 1%, after the government suspended its proactive recommendation in 2013, following media reports of symptoms alleged to be adverse events caused by the vaccine. Although the recommendation was reinstated in 2022 after comprehensive safety reviews, vaccination rates have remained modest. We aimed to assess HPV vaccine acceptability and identify factors associated with acceptance among staff at a university hospital. Methods: We administered a web-based questionnaire in February 2024 to 2761 hospital employees, assessing demographic and professional characteristics, HPV-related knowledge, awareness about vaccine effectiveness, adverse events, and catch-up programs, as well as acceptability across four hypothetical scenarios reflecting publicly funded and self-funded vaccination programs. Logistic regression analyses were conducted to identify factors associated with acceptability. Results: Among 1132 respondents (response rate 41.0%), acceptability exceeded 75% in the publicly funded scenarios but was approximately 45% in the self-funded scenarios. In multivariable analyses of the publicly funded scenarios, younger age, being a medical professional, greater HPV vaccine knowledge levels, and awareness about HPV vaccine effectiveness or catch-up vaccination were positively associated with acceptability; awareness about adverse events showed negative associations. In the self-funded scenarios, women were less likely to accept vaccination, but greater knowledge levels and awareness of catch-up vaccination remained positively associated with acceptability. Conclusions: These findings suggest that strategies tailored to specific population characteristics are important for improving HPV vaccine acceptability. Full article
(This article belongs to the Special Issue Prevention of Human Papillomavirus (HPV) and Vaccination)
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63 pages, 861 KB  
Review
A Scoping Review of Influences on HPV Vaccine Uptake in the Rural US
by Sherri Sheinfeld Gorin, Rebecca Hyman, Courtney Olson, Elizabeth Amber Fournier, Kaitlyn Yang, Diana Hanko and HPV Review Working Group
Vaccines 2026, 14(2), 156; https://doi.org/10.3390/vaccines14020156 - 5 Feb 2026
Viewed by 1609
Abstract
The human papillomavirus (HPV) is the leading cause of cervical and oropharyngeal cancers. Vaccination can prevent over 90% of HPV-attributed cancers. Rural populations are less likely to initiate and complete HPV vaccinations than urban. The primary objective of this paper is to systematically [...] Read more.
The human papillomavirus (HPV) is the leading cause of cervical and oropharyngeal cancers. Vaccination can prevent over 90% of HPV-attributed cancers. Rural populations are less likely to initiate and complete HPV vaccinations than urban. The primary objective of this paper is to systematically examine the multilevel (child/youth, parent/caregiver, physician/team, healthcare organization, community, and policy) influences on HPV vaccine uptake in the rural US population. As a secondary aim, we seek to identify gaps in the research that could contribute to the development of more precise intervention approaches in this population. The study adds to the limited number of recent reviews on rural HPV vaccine uptake in the US. Method: We conducted a systematic search of published empirical studies over 13 years (2010–2023), resulting in 1657 publications. The following databases were searched: Medline (OVID), Embase, CINAHL, PsychInfo, Cochrane, Sociological Abstracts, and Scopus using pre-specified inclusion criteria. Two reviewers independently coded 101 full texts; discrepancies were resolved by a third reviewer. The primary outcome was HPV vaccine uptake. Results: Adolescents themselves were the most common foci of change. Barriers to rural HPV uptake included limited; vaccine awareness, access to vaccines for children vaccination sites, and primary care recommendations. Conclusions: Tailored interventions to rural parents/caregivers could increase uptake of the vaccine. Provider training increases HPV vaccine recommendations; programs should also be targeted to rural school nurses, pharmacists, and dental care providers. Linking primary care practices and public health dissemination strategies are key. Full article
(This article belongs to the Special Issue Acceptance and Hesitancy in Vaccine Uptake: 2nd Edition)
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18 pages, 2292 KB  
Article
The Epidemiology of Human Papillomavirus (HPV) Infections in Poland in the Light of the Nationwide HPV Vaccination Program for Children Aged 12–13 and Updated HPV DNA Detection Guidelines
by Mateusz Sztuka, Agnieszka Jeleń, Adrian Krygier, Dagmara Szmajda-Krygier and Ewa Balcerczak
Int. J. Mol. Sci. 2026, 27(3), 1434; https://doi.org/10.3390/ijms27031434 - 31 Jan 2026
Viewed by 1001
Abstract
Many countries have introduced HPV screening and vaccination programs to reduce the burden of cervical cancer. In Poland, before 2023, HPV vaccination was available only on an individual, non-universal basis, using all types of vaccines, while in 2023, a nationwide vaccination program for [...] Read more.
Many countries have introduced HPV screening and vaccination programs to reduce the burden of cervical cancer. In Poland, before 2023, HPV vaccination was available only on an individual, non-universal basis, using all types of vaccines, while in 2023, a nationwide vaccination program for boys and girls aged 12–13 years was introduced alongside updated screening guidelines. This retrospective study analyzed 2296 HPV-positive test results obtained from adult patients in Poland, including demographic data, HPV genotypes distribution, infection intensity, and cytological findings. HPV genotyping was performed using the Anyplex™ II HPV28 assay. HR-HPV genotypes accounted for 64.53% of all detected infections, with the highest prevalence observed in individuals aged 26–35 years of both sexes. HPV-18 was significantly more frequently in women (p = 0.0430), whereas HPV-53 predominated in men (p = 0.0030). Men more often presented low-intensity infections, while women showed higher viral load. Multigenotypic infections occurred in 46.5% of cases, particularly among younger patients (p < 0.001), and were significantly associated with LSIL changes in cytology. The HSIL type correlated most strongly with HPV-16 (p < 0.001). These findings confirm the high burden of HR-HPV infections in the Polish adult population and provide an essential epidemiological baseline for evaluating the impact of universal HPV vaccination and updated screening strategies. Full article
(This article belongs to the Special Issue Current Advance in Infectious and Inflammatory Diseases)
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17 pages, 551 KB  
Review
Research Trends and Gaps in Human Papillomavirus Vaccination Intention in South Korea: A Scoping Review
by Jiyeon Bark, Haejin Kim and Soyoung Seo
Healthcare 2026, 14(3), 355; https://doi.org/10.3390/healthcare14030355 - 30 Jan 2026
Cited by 1 | Viewed by 611
Abstract
Background/Objectives: Human papillomavirus (HPV) is a major cause of cervical, penile, anal, and oropharyngeal cancers. HPV vaccination is the most effective public health strategy for its prevention. Understanding the factors influencing vaccination intentions is critical for developing effective public health policies and improving [...] Read more.
Background/Objectives: Human papillomavirus (HPV) is a major cause of cervical, penile, anal, and oropharyngeal cancers. HPV vaccination is the most effective public health strategy for its prevention. Understanding the factors influencing vaccination intentions is critical for developing effective public health policies and improving population-level vaccine uptake. Therefore, in this scoping review, we aimed to examine HPV vaccination research conducted in Korea, identify common trends and gaps in study populations and influencing factors, and provide evidence-based recommendations for public health policies. Methods: We systematically searched four Korean databases—Research Information Sharing Service (RISS), DBpia, Korean Studies Information Service System (KISS), and National Digital Science Library (NDSL)—for studies published from their respective inception dates to January 2025, using “human papillomavirus,” “HPV,” “vaccination,” and “intention” as keywords. Thirty-six studies were ultimately included. Study characteristics, populations, theoretical frameworks, and key variables were extracted and analyzed using descriptive statistics and content analysis. Results: Of the included studies, 61.1% and 38.9% targeted vaccination-eligible individuals (adolescents and adults) and parents/guardians, respectively, with 50% focusing exclusively on women. The major factors influencing HPV vaccination intention were attitude (47.2%), subjective norms (38.9%), and perceived behavioral control (30.9%). Attitude and knowledge were critical for vaccination-eligible individuals (Direct group), whereas subjective norms were key for parents/guardians (Indirect group). Conclusions: Korean HPV vaccination intention research has predominantly focused on women and parents, with insufficient attention to adolescents and men. Public health strategies must employ multilevel interventions tailored to each group’s decision-making structures, including school-based programs for adolescents, gender-inclusive policies for men, and community-based approaches to address social norms among parents. These findings provide evidence for policy development aligned with the WHO cervical cancer elimination goals. Full article
(This article belongs to the Section Public Health and Preventive Medicine)
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10 pages, 414 KB  
Article
Association Between Human Papillomavirus Vaccination and the Risk of Cervical Cancer and Precancerous Lesions in Israel: A Retrospective Cohort Study
by Gabriel Chodick and Myriam Strassberg
J. Clin. Med. 2026, 15(3), 995; https://doi.org/10.3390/jcm15030995 - 26 Jan 2026
Viewed by 835
Abstract
Background: Human papillomavirus (HPV) infection is the necessary cause of almost all cervical cancers. HPV vaccination programs have been implemented worldwide, yet real-world evidence on vaccine effectiveness against invasive cervical cancer remains limited. Methods: We conducted a retrospective cohort study using [...] Read more.
Background: Human papillomavirus (HPV) infection is the necessary cause of almost all cervical cancers. HPV vaccination programs have been implemented worldwide, yet real-world evidence on vaccine effectiveness against invasive cervical cancer remains limited. Methods: We conducted a retrospective cohort study using synthetically generated data from a large health provider in Israel, including women who underwent a first Papanicolaou (Pap) test during 2014–2015. Their HPV-vaccination status before an index Pap test was obtained from computerized records. Incident cervical cancer and high-grade cervical pathology (cervical cancer, cervical intraepithelial neoplasia [CIN] 1–3, and carcinoma in situ) occurrence were examined through 2022. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models and fitted with propensity score weighting. Results: The cohort included 98,102 women, of whom 9198 (9.4%) were vaccinated against HPV before an index Pap test. While HPV-vaccinated women had a higher risk of cervical pathology compared with unvaccinated women, among women vaccinated before age 18, HPV vaccination was associated with a substantially lower, though not statistically significant, risk of cervical cancer (HR 0.28, 95% CI: 0.07–1.20, p = 0.087). Conclusions: In this large cohort, HPV vaccination was correlated with a higher risk of cervical pathology, likely reflecting residual confounding factors from sexual behavior and differential baseline risks of HPV infection. In contrast, vaccination during adolescence showed a marked trend toward a reduced risk of cervical cancer, consistent with international evidence that early vaccination, prior to HPV exposure, is the most effective preventative treatment. Full article
(This article belongs to the Section Epidemiology & Public Health)
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21 pages, 1619 KB  
Review
Cholesterol Metabolism: An Ally in the Development and Progression of Cervical Cancer
by Imelda Martínez-Ramírez, J. Omar Muñoz-Bello, Adriana Contreras-Paredes, Elías Parra-Hernández, Adela Carrillo-García and Marcela Lizano
Int. J. Mol. Sci. 2026, 27(2), 591; https://doi.org/10.3390/ijms27020591 - 6 Jan 2026
Viewed by 1743
Abstract
Despite screening programs and vaccination campaigns, cervical cancer (CC) remains a health problem worldwide. The involvement of the E6 and E7 oncoproteins of Human Papillomavirus (HPV) is crucial for the development and progression of this type of cancer. Metabolic reprogramming by cancer cells [...] Read more.
Despite screening programs and vaccination campaigns, cervical cancer (CC) remains a health problem worldwide. The involvement of the E6 and E7 oncoproteins of Human Papillomavirus (HPV) is crucial for the development and progression of this type of cancer. Metabolic reprogramming by cancer cells has gained relevance in the last decade due to its ability to promote cell growth, survival, invasion, metastasis, and resistance to therapy. In this review, we focus on alterations in cholesterol metabolism that significantly influence the development and progression of CC, as well as the clinical outcome of patients. Furthermore, evidence from comprehensive omics studies suggesting that E6 and E7 are involved in the exacerbation of elements related to cholesterol metabolism is analyzed. Preclinical and clinical studies are also discussed that demonstrate that cholesterol metabolism is a potential therapeutic target, highlighting its impact on reducing tumor growth, altering the tumor microenvironment, and improving antitumor immunity. Full article
(This article belongs to the Special Issue Molecular Insights and Treatments for Gynecological Cancers)
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15 pages, 890 KB  
Article
Ureaplasma Species and Human Papillomavirus Coinfection and Associated Factors Among South African Adolescent Girls and Young Women
by Sinazo Kondlo and Zizipho Z. A. Mbulawa
Microbiol. Res. 2026, 17(1), 3; https://doi.org/10.3390/microbiolres17010003 - 23 Dec 2025
Viewed by 1325
Abstract
Ureaplasma species are associated with various reproductive health issues, while human papillomavirus (HPV) is associated with cervical, vaginal and vulvar cancers. Data on the association between Ureaplasma species and HPV are limited in South Africa. This study investigated the prevalence of Ureaplasma urealyticum [...] Read more.
Ureaplasma species are associated with various reproductive health issues, while human papillomavirus (HPV) is associated with cervical, vaginal and vulvar cancers. Data on the association between Ureaplasma species and HPV are limited in South Africa. This study investigated the prevalence of Ureaplasma urealyticum (U. urealyticum), Ureaplasma parvum (U. parvum), and HPV coinfection and their associated factors, among adolescent girls and young women (AGYW) in the Eastern Cape Province, South Africa. A total of 214 participants were retrospectively recruited, and secondary data on HPV, U. urealyticum, U. parvum, demographics, and sexual behavior were used. HPV was detected using the Roche Linear Array HPV Genotyping Test, while U. urealyticum and U. parvum were detected using Allplex™ sexually transmitted infection (STI) essential Assay. Statistical analyses were performed using GraphPad Prism Version 8.0.1.244. The prevalence of U. urealyticum was 43.9% (94/214) and increased significantly with age (p = 0.036, R2 = 0.8497); while U. parvum prevalence was 68.7% (147/214) and was not influenced by age. Having four to six lifetime sexual partners (PR: 1.77, 95% CI: 1.04–3.00, p = 0.043) was associated with increased risk of U. urealyticum. A proportion of 36.3% (77/212) had HPV-U. urealyticum coinfection and its risk was increased among those with 3–6 lifetime sexual partners (PR: 1.59, 95% CI: 1.10–2.53, p = 0.017), 2–4 new partners past three months (PR: 2.14, 95% CI: 1.19–2.42, p = 0.021); vaginal sexual intercourse frequency past 1-month (2–3 vaginal intercourse: PR: 1.54, 95% CI: 1.06–2.53, p = 0.037; 4–10 vaginal intercourse: PR: 1.91, 95% CI: 1.83–1.91, p = 0.005) and alcohol consumption (PR: 1.85, 95% CI: 1.20–3.28, p = 0.004). U. urealyticum positives had a significantly higher risk of HPV types targeted by Cervarix® HPV vaccine than negatives (PR: 2.56, 95% CI: 1.23–5.37, p = 0.013), Gardasil®4 (PR: 2.16, 95% CI: 1.25–3.75, p = 0.006) and Gardasil®9 (PR: 1.70, 95% CI: 1.25–2.32, p = 0.001). AGYW of Eastern Cape Province, South Africa had high prevalence of U. urealyticum-HPV and U. parvum-HPV coinfections. Ureaplasma species coinfection was associated with HPV prevalence and distribution of genotypes. The U. urealyticum prevalence and its coinfection with HPV were associated with sexual behavior. Data from this study could contribute to the design of sexual health and STI interventions and could serve as a baseline for future epidemiological studies, which include ongoing surveillance of HPV genotype prevalence to evaluate the impact and effectiveness of HPV vaccination programs in the population. Full article
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16 pages, 593 KB  
Review
Perception and Acceptance of HPV Vaccination Among Women Treated for Cervical Intraepithelial Neoplasia: An Evidence-Based Narrative Review
by Vasilios Lygizos, Rafaela Panagopoulou, Vasilios Pergialiotis, Eleni Sivylla Bikouvaraki, Sofoklis Stavros, Periklis Panagopoulos and Chrysi Christodoulaki
J. Clin. Med. 2025, 14(24), 8859; https://doi.org/10.3390/jcm14248859 - 15 Dec 2025
Viewed by 1013
Abstract
High-risk human papillomavirus (HPV), including types 16–18, is the established cause of cervical intraepithelial neoplasia (CIN) and invasive carcinoma of the cervix. While preventive vaccination is highly effective in preventing infection from becoming reconstituted following treatment of existing disease, its use among cervical [...] Read more.
High-risk human papillomavirus (HPV), including types 16–18, is the established cause of cervical intraepithelial neoplasia (CIN) and invasive carcinoma of the cervix. While preventive vaccination is highly effective in preventing infection from becoming reconstituted following treatment of existing disease, its use among cervical intraepithelial neoplasia (CIN)-positive females has remained sporadic. The following review provides an update on the current state of evidence about the acceptance, awareness, or perception of HPV vaccination by women following a diagnosis or treatment of CIN. Methods: A narrative synthesis of literature from the publication period of 2010 to 2025 was performed on PubMed, Scopus, and Google Scholar. Surveys that quantified literature on post-CIN vaccination attitudes, risk perceptions, or behavioral factors were considered. Results: Acceptance levels varied from 20–95% across all continents. The highest acceptance levels (≥80%) among the populations belong to the European and Oceanian groups, followed by moderate acceptance among the North Americans (60–80%), which was influenced by financial costs, misconceptions, and sociocultural stigmas. Several systemic-level features in Europe and Oceania have been shown to be consistently associated across these regions with high acceptance rates. These features include public funding of HPV vaccine delivery universally in these regions and reminder and recall systems established in their electronic health records. In these two regions, provider recommendation demonstrates particular significance because there is follow-up care after treatment of CIN. In these regions, mass awareness about HPV conducted in conjunction with their cervical screening programs increases baseline knowledge and favorability towards HPV vaccination. The lowest levels (20–70%) of awareness of HPV diseases and vaccination programs among Asians and Africans can be attributed to obstacles that include misconceptions about fertility concerns. In the case of Asia, there are various socially ingrained stigma factors that contribute to the poor awareness and acceptance levels. These factors include the possibility of being perceived as promiscuous, embarrassment linked to STI conditions, as well as the possibility of rejection from partners and in-laws. In particular regions, there might be stigmas attached to HPV vaccination that cause tension within married women who perceive the vaccine as an indicator of being unfaithful. Also, distrust from the general community has been driven by past incidents, including the halting of proactive HPV vaccine recommendations in Japan in 2013. Moreover, there are numerous myths concerning infertility and menstruation linked to poor vaccine acceptance. The key determinant of acceptance levels was physician endorsement, lack of knowledge of the association of HPV-CIN, or the belief that there is no need for vaccination after treatment. Conclusion: The acceptance of HPV vaccination among women following CIN is influenced by educational level, the structure of the healthcare system, and sociocultural factors. Incorporating evidence-based cervical vaccination counseling into follow-up care after biopsy could help increase its acceptance and prevent recurrent high-grade lesions. Full article
(This article belongs to the Special Issue Advances in Gynecological Diseases (Second Edition))
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14 pages, 2995 KB  
Article
Initial Coverage and Regional Disparities of the National HPV Vaccination Program in Poland: A Cross-Sectional Analysis
by Patryk Poniewierza, Marcin Śniadecki, Oliwia Musielak, Afsheen Raza, Yousra Safari, Olga Piątek-Dalewska, Martyna Danielkiewicz, Alicja Mazur, Zofia Amerek, Saqib Raza Khan and Dariusz Grzegorz Wydra
Healthcare 2025, 13(24), 3281; https://doi.org/10.3390/healthcare13243281 - 14 Dec 2025
Cited by 1 | Viewed by 1197
Abstract
Background/Objectives: Cervical cancer is the second most common gynecological cancer worldwide, preventable through screening initiatives and vaccinations against its causative agent, anogenital human papillomavirus (HPV). This study aimed at measuring the coverage and uptake of the national HPV vaccination program launched in [...] Read more.
Background/Objectives: Cervical cancer is the second most common gynecological cancer worldwide, preventable through screening initiatives and vaccinations against its causative agent, anogenital human papillomavirus (HPV). This study aimed at measuring the coverage and uptake of the national HPV vaccination program launched in 2023 and implemented throughout Poland. Methods: This cross-sectional, observational study analyzed population data of adolescents in 11–13-year-old groups vaccinated in individual voivodeships (provinces) of Poland as provided by the National Health Fund and the Central Statistical Office. A p-value of <0.05 was considered statistically significant. Results: The rate of HPV vaccination participation under the population program was 8.67%. In the analyzed age groups, in both sexes, no statistically significant correlation was observed between the population size at a given age and population coverage or participation in HPV vaccination. However, a positive relationship in vaccination coverage was observed in individuals previously vaccinated with one dose in subsequent age groups, indicating a continued willingness to receive vaccination with further doses. No statistically significant difference in population coverage changes across voivodeships was found between the number of doses within the urban population share vs. rural population share. Conclusions: Our results show that, at 1.5 years of implementation of the national HPV vaccination program, the coverage and uptake of the program is considerably insufficient. The intensive corrective actions indicated are required to pave this program forward towards optimum results. Full article
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19 pages, 1439 KB  
Article
Awareness, Cultural Beliefs, and Health-Seeking Behavior of Females in Cancer Screening: A Pilot Study in Rural South Africa
by Olufunmilayo Olukemi Akapo, Mojisola Clara Hosu and Mirabel Kah-Keh Nanjoh
Epidemiologia 2025, 6(4), 90; https://doi.org/10.3390/epidemiologia6040090 - 10 Dec 2025
Viewed by 1126
Abstract
Background/Objectives: Cervical cancer is one of the most common cancers among women of reproductive age, with 80% of the cases occurring in developing countries. Cervical cancer is largely preventable by effective screening programs. This study assessed the knowledge, attitudes, cultural beliefs, and screening [...] Read more.
Background/Objectives: Cervical cancer is one of the most common cancers among women of reproductive age, with 80% of the cases occurring in developing countries. Cervical cancer is largely preventable by effective screening programs. This study assessed the knowledge, attitudes, cultural beliefs, and screening practices related to cervical cancer among women in the rural community of Lutubeni, Eastern Cape Province. Methods: A descriptive cross-sectional study was conducted among 95 women aged 25 years or older attending Lutubeni Clinic. Data was collected using a structured, validated questionnaire covering demographics, reproductive health, knowledge of cervical cancer, attitudes, cultural perceptions, and screening practices. Statistical analysis involved descriptive summaries, chi-square tests, and binary logistic regression. Results: Most participants exhibited poor knowledge of cervical cancer symptoms (47.4%) and risk factors (61.1%), with only 3.2% demonstrating good overall knowledge. Vaginal bleeding (60.0%) and foul-smelling discharge (50.5%) were the most recognized symptoms. Only 40.0% were aware of human papillomavirus (HPV) vaccination. While 87.4% knew about cervical cancer screening, only 55.8% had ever been screened. Of these, 43.2% had screened only once, primarily at the clinic (33.7%), mostly initiated by health professionals (41.1%). Positive attitudes toward screening were observed in 52.6%, while 88.4% held cultural beliefs that hindered open discussion about sexual health. Statistically significant factors associated with screening uptake included educational level (p = 0.047), knowledge of symptoms (p = 0.04), risk factors (p < 0.0001), prevention (p < 0.0001), treatment (p = 0.001), and attitudes (p < 0.0001). Independent predictors of poor screening practice were holding an associate degree (OR = 0.04, p = 0.042), having good preventive knowledge (OR = 0.02, p = 0.012), and having negative attitudes (OR = 36.22, p = 0.005). Conclusions: High awareness alone does not guarantee participation in cervical cancer screening in rural South Africa. Interventions must address cultural barriers, stigma, and negative perceptions while strengthening health education that links HPV vaccination with screening awareness. The unexpected association between associate degree attainment and poor screening underscores the complexity of behavioral determinants and warrants further investigation in larger cohorts. Full article
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Article
A Novel Method for Predicting Oncogenic Types of Human Papillomavirus
by Songül Çeçen Kaynak and Hilal Arslan
Diagnostics 2025, 15(23), 3014; https://doi.org/10.3390/diagnostics15233014 - 27 Nov 2025
Viewed by 1195
Abstract
Background and Objectives: Human Papillomavirus (HPV) is a leading cause of cervical and other anogenital cancers, with over 200 known genotypes classified into high-risk, probable high-risk, and low-risk groups. While conventional diagnostic and classification approaches often rely on sequence alignment, phylogenetic relationships, or [...] Read more.
Background and Objectives: Human Papillomavirus (HPV) is a leading cause of cervical and other anogenital cancers, with over 200 known genotypes classified into high-risk, probable high-risk, and low-risk groups. While conventional diagnostic and classification approaches often rely on sequence alignment, phylogenetic relationships, or protein structure analyses, these methods are limited in scalability, cost efficiency, and generalizability to emerging HPV types. This study aims to develop a novel, machine learning-based framework for classifying HPV genotypes by oncogenic risk using genome-derived numerical features. A key objective is to introduce TATA-box, CAAT-box, and CpG-island-based features to HPV risk prediction for the first time. Methods: We constructed a comprehensive feature set that integrates regulatory sequence motifs (TATA-box, CAAT-box, CpG islands) with dinucleotide and trinucleotide (k-mer) composition derived from full HPV genomes. Multiple machine learning algorithms were implemented to evaluate classification performance across all risk categories. Model accuracy, precision, recall, and F1-score were calculated to assess the effectiveness and robustness of the proposed feature set. Results: The proposed method achieves an average precision of 0.95, a recall of 0.95, an F1-score of 0.95, and an accuracy of 97.47%. The experimental findings indicate that the proposed method not only attains high classification accuracy across all HPV risk groups but also surpasses existing models in generalizability by utilizing genomic data and novel biologically informed features. Conclusions: This study introduces regulatory motif-based numerical features to HPV classification for the first time and demonstrates that integrating these with k-mer descriptors yields a highly accurate and scalable machine learning model. Unlike previous studies, which often focus on specific HPV genes or a limited subset of types, our method is scalable, robust, and capable of classifying known and emerging HPV types with high reliability. This highlights its potential for real-world deployment in large-scale epidemiological screening and vaccine development programs. Full article
(This article belongs to the Special Issue A New Era in Diagnosis: From Biomarkers to Artificial Intelligence)
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