{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T04:11:26Z","timestamp":1792987886655,"version":"4.5.0"},"reference-count":98,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001773","name":"University of New South Wales","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001773","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cervical cancer remains a major cause of morbidity and mortality among women in India, particularly among marginalized communities who face heightened vulnerability to Human papillomavirus (HPV)-related disease. As India prepares for the national rollout of HPV vaccination for girls aged 9\u201314 years, understanding community-level knowledge, attitudes, and acceptability is essential to ensuring equitable uptake. This study explored perceptions of HPV vaccination among marginalized populations across three diverse Indian settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A multi-site qualitative study was conducted between February and October 2023 in Delhi-NCR, Tripura, and Karnataka. Semi-structured interviews (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200989) and gender-specific focus group discussions (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912) were undertaken with tribal women, migrants and internally displaced women, women living with HIV, female sex workers, and men from tribal and migrant communities. Data were analyzed thematically using Braun and Clarke's framework.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Awareness of HPV vaccination was extremely low, with only 14 participants having heard of the vaccine, and only one male participant aware of it. While many participants expressed willingness to vaccinate themselves or their daughters, others held cautious or negative views rooted in concerns about side effects, fertility, moral beliefs, and confusion linked to the COVID-19 vaccination experience. Gendered decision-making norms shaped vaccine acceptance, with many women relying on husbands or senior family members for consent. Participants emphasized culturally grounded, community-based strategies for vaccine introduction, including locally tailored communication and engagement through trusted community actors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion<\/jats:title>\n                    <jats:p>This multi-site qualitative study highlights the interplay of limited knowledge, gendered power dynamics, stigma, and trust in shaping HPV vaccine acceptability among marginalized populations in India. To enhance vaccine knowledge and acceptability, tailored community engagement, culturally responsive communication, and inclusive decision-making processes are essential. As India advances towards national HPV vaccine rollout, addressing these factors will be critical for achieving equitable coverage and supporting cervical cancer elimination goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fgwh.2026.1791203","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:51:50Z","timestamp":1776837110000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Marginalized voices on HPV vaccination in India: exploring knowledge, attitudes, and acceptance"],"prefix":"10.3389","volume":"7","author":[{"given":"Uma","family":"Vasudevan","sequence":"first","affiliation":[{"name":"Department of Public Health, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham","place":["Kochi, India"]},{"name":"The George Institute for Global Health","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Kelly-Hanku","sequence":"additional","affiliation":[{"name":"Kirby Institute, The University of New South Wales (UNSW)","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Limbu","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Jops","sequence":"additional","affiliation":[{"name":"Kirby Institute, The University of New South Wales (UNSW)","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjitha S.","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education","place":["Manipal, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekta","family":"Gupta","sequence":"additional","affiliation":[{"name":"ICMR-National Institute of Cancer Prevention and Research","place":["Noida, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Eshwari","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education","place":["Manipal, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Singh","sequence":"additional","affiliation":[{"name":"ICMR-National Institute of Cancer Prevention and Research","place":["Noida, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Vallely","sequence":"additional","affiliation":[{"name":"Kirby Institute, The University of New South Wales (UNSW)","place":["Sydney, NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preety R.","family":"Rajbangshi","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1002\/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F","article-title":"Human papillomavirus is a necessary cause of invasive cervical cancer worldwide","volume":"189","author":"Walboomers","year":"1999","journal-title":"J Pathol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1016\/S0140-6736(05)67069-9","article-title":"Worldwide distribution of human papillomavirus types in cytologically normal women in the international agency for research on cancer HPV prevalence surveys: a pooled analysis","volume":"366","author":"Clifford","year":"2005","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"S52","DOI":"10.1016\/j.vaccine.2006.05.031","article-title":"Chapter 6: epidemiology and transmission dynamics of genital HPV infection","volume":"24","author":"Burchell","year":"2006","journal-title":"Vaccine"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1086\/657321","article-title":"Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings","volume":"202","author":"Bruni","year":"2010","journal-title":"J Infect Dis"},{"key":"B5","year":""},{"key":"B6","doi-asserted-by":"publisher","first-page":"25151355251356646","DOI":"10.1177\/25151355251356646","article-title":"Cervical cancer trends, HPV vaccine utilization, and screening in low- and lower-middle-income countries: an updated review","volume":"13","author":"Hamid","year":"2025","journal-title":"Ther Adv Vaccines Immunother"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2058","DOI":"10.3892\/ol.2020.11754","article-title":"Cervical cancer in low and middle-income countries","volume":"20","author":"Hull","year":"2020","journal-title":"Oncol Lett"},{"key":"B8","doi-asserted-by":"publisher","first-page":"100549","DOI":"10.1016\/j.jvacx.2024.100549","article-title":"Human papilloma virus vaccination in the resource-limited settings of sub-saharan Africa: challenges and recommendations","volume":"20","author":"Murewanhema","year":"2024","journal-title":"Vaccine X"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3001","DOI":"10.1016\/j.vaccine.2007.01.013","article-title":"Developing an HPV vaccine to prevent cervical cancer and genital warts","volume":"25","author":"Bryan","year":"2007","journal-title":"Vaccine"},{"key":"B10","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s12325-011-0045-x","article-title":"The human papillomavirus (HPV) vaccine and cervical cancer: uptake and next steps","volume":"28","author":"Sheinfeld Gorin","year":"2011","journal-title":"Adv Ther"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2357","DOI":"10.22034\/APJCP.2018.19.9.2357","article-title":"HPV vaccination of girl child in India: intervention for primary prevention of cervical cancer","volume":"19","author":"Roy","year":"2018","journal-title":"Asian Pac J Cancer Prev"},{"key":"B12","year":""},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2021.07.024","article-title":"Human papillomavirus (HPV) vaccine introduction in Sikkim state: best practices from the first statewide multiple-age cohort HPV vaccine introduction in India\u20132018\u20132019","volume":"40","author":"Ahmed","year":"2021","journal-title":"Vaccine"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1321","DOI":"10.1016\/S1470-2045(23)00480-1","article-title":"Immunogenicity and safety of a new quadrivalent HPV vaccine in girls and boys aged 9-14 years versus an established quadrivalent HPV vaccine in women aged 15-26 years in India: a randomised, active-controlled, multicentre, phase 2\/3 trial","volume":"24","author":"Sharma","year":"2023","journal-title":"Lancet Oncol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"100780","DOI":"10.1016\/j.ctarc.2023.100780","article-title":"Human papilloma virus vaccines: a comprehensive narrative review","volume":"37","author":"Aggarwal","year":"2023","journal-title":"Cancer Treat Res Commun"},{"key":"B16","author":"Anand","year":""},{"key":"B17","doi-asserted-by":"publisher","first-page":"e0291990","DOI":"10.1371\/journal.pone.0291990","article-title":"Global perspectives of determinants influencing HPV vaccine introduction and scale-up in low- and middle-income countries","volume":"19","author":"Guillaume","year":"2024","journal-title":"PLoS One"},{"key":"B18","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1007\/s10147-014-0723-1","article-title":"Effect on HPV vaccination in Japan resulting from news report of adverse events and suspension of governmental recommendation for HPV vaccination","volume":"20","author":"Morimoto","year":"2015","journal-title":"Int J Clin Oncol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1186\/s12889-018-6268-x","article-title":"Decline in HPV-vaccination uptake in Denmark \u2013 the association between HPV-related media coverage and HPV-vaccination","volume":"18","author":"Suppli","year":"2018","journal-title":"BMC Public Health"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1615","DOI":"10.1080\/21645515.2018.1564436","article-title":"HPV vaccination in a context of public mistrust and uncertainty: a systematic literature review of determinants of HPV vaccine hesitancy in Europe","volume":"15","author":"Karafillakis","year":"2019","journal-title":"Hum Vaccin Immunother"},{"key":"B21","doi-asserted-by":"publisher","first-page":"873","DOI":"10.37557\/gjphm.v5i2.217","article-title":"Cervical cancer and its screening: knowledge, practices of screening and vaccination among selected women healthcare professionals in hospitals of Kolkata, India","volume":"5","author":"Saha","year":"2023","journal-title":"Glob J Public Health Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"100171","DOI":"10.1016\/j.pvr.2019.100171","article-title":"HPV vaccination in Papua New Guinea to prevent cervical cancer in women: gender, sexual morality, outsiders and the de-feminization of the HPV vaccine","volume":"8","author":"Kelly-Hanku","year":"2019","journal-title":"Papillomavirus Res"},{"key":"B23","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1177\/0017896919856657","article-title":"Health communication messaging about HPV vaccine in Papua New Guinea","volume":"78","author":"Kelly-Hanku","year":"2019","journal-title":"Health Educ J"},{"key":"B24","doi-asserted-by":"publisher","first-page":"245","DOI":"10.3389\/fpubh.2015.00245","article-title":"Issues of unequal access to public health in India","volume":"3","author":"Barik","year":"2015","journal-title":"Front Public Health"},{"key":"B25","doi-asserted-by":"publisher","first-page":"100702","DOI":"10.1016\/j.jvacx.2025.100702","article-title":"Does behaviour matters the most in improving urban immunization coverage: exploring behavioural barriers in northern states of India","volume":"26","author":"Dhalaria","year":"2025","journal-title":"Vaccine X"},{"key":"B26","doi-asserted-by":"publisher","first-page":"966","DOI":"10.4269\/ajtmh.20-1650","article-title":"Challenges to human papillomavirus vaccine acceptability among women in south India: an exploratory study","volume":"105","author":"Shah","year":"2021","journal-title":"Am J Trop Med Hyg"},{"key":"B27","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/1742-4755-2-11","article-title":"A strategic assessment of cervical cancer prevention and treatment services in 3 districts of Uttar Pradesh, India","volume":"2","author":"Dabash","year":"2005","journal-title":"Reprod Health"},{"key":"B28","doi-asserted-by":"publisher","first-page":"e112861","DOI":"10.1371\/journal.pone.0112861","article-title":"Perception of human papillomavirus infection, cervical cancer and HPV vaccination in north Indian population","volume":"9","author":"Hussain","year":"2014","journal-title":"PLoS One"},{"key":"B29","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1007\/s13187-014-0745-4","article-title":"Knowledge and acceptability of human papillomavirus vaccination and cervical cancer screening among women in Karnataka, India","volume":"30","author":"Montgomery","year":"2015","journal-title":"J Cancer Educ"},{"key":"B30","doi-asserted-by":"publisher","first-page":"216","DOI":"10.4103\/jehp.jehp_156_19","article-title":"Challenges of health promotion and education strategies to prevent cervical cancer in India: a systematic review","volume":"8","author":"Thulaseedharan","year":"2019","journal-title":"J Educ Health Promot"},{"key":"B31","doi-asserted-by":"publisher","first-page":"100195","DOI":"10.1016\/j.lanwpc.2021.100195","article-title":"Knowledge, attitudes, beliefs, intentions and behaviours of Australian indigenous women from NSW in response to the national cervical screening program changes: a qualitative study","volume":"13","author":"Moxham","year":"2021","journal-title":"Lancet Reg Health West Pac"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1772","DOI":"10.3332\/ecancer.2024.1772","article-title":"Prevalence of human papilloma virus infection and risk of cervical intraepithelial neoplasia among female sex workers in Mumbai, India","volume":"18","author":"Pahwa","year":"2024","journal-title":"Ecancermedicalscience"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e161","DOI":"10.1016\/S2214-109X(20)30459-9","article-title":"Estimates of the global burden of cervical cancer associated with HIV","volume":"9","author":"Stelzle","year":"2021","journal-title":"Lancet Glob Health"},{"key":"B34","first-page":"409","article-title":"Exploring the socio-economic impacts on sex workers: a comprehensive study in Cooch Behar, West Bengal","volume":"13","author":"Ganguly","year":"2025","journal-title":"IJCRT"},{"key":"B35","author":"Fauk","year":""},{"key":"B36","first-page":"155","article-title":"In women\u2019s eyes","volume":"19","author":"Orza","year":"2017","journal-title":"Health Hum Rights"},{"key":"B37","doi-asserted-by":"publisher","first-page":"2273","DOI":"10.1111\/jan.16010","article-title":"Stigmatizing and inaccessible: the perspectives of female sex workers on barriers to reproductive healthcare utilization \u2013 a scoping review","volume":"80","author":"Birger","year":"2024","journal-title":"J Adv Nurs"},{"key":"B38","doi-asserted-by":"publisher","first-page":"8889358","DOI":"10.1155\/2023\/8889358","article-title":"A critical review of social exclusion and inclusion among immigrant and refugee women","volume":"2023","author":"Crawford","year":"2023","journal-title":"Adv Public Health"},{"key":"B39","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1007\/s10615-019-00736-w","article-title":"\u201cThey kept away\u201d: social isolation of cisgender women living with HIV in Hyderabad, India","volume":"48","author":"Azhar","year":"2020","journal-title":"Clin Soc Work J"},{"key":"B40","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-64171-9_1","article-title":"Overview and evidence-based recommendations to address health and human rights inequities faced by sex workers","volume-title":"Sex Work, Health, and Human Rights: Global Inequities, Challenges, and Opportunities for Action [Internet]","author":"Goldenberg","year":"2021"},{"key":"B41","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1007\/s10865-023-00417-7","article-title":"Medical mistrust as a barrier to HIV prevention and care","volume":"46","author":"El-Krab","year":"2023","journal-title":"J Behav Med"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1177\/1049732313494854","article-title":"Structural barriers to receiving health care services for female sex workers in Russia","volume":"23","author":"King","year":"2013","journal-title":"Qual Health Res"},{"key":"B43","doi-asserted-by":"publisher","first-page":"cmaf048","DOI":"10.1093\/fampra\/cmaf048","article-title":"Health care experiences of female sex workers: a qualitative study","volume":"42","author":"K\u0131z\u0131lta\u015f","year":"2025","journal-title":"Fam Pract"},{"key":"B44","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1186\/s12939-016-0453-2","article-title":"Barriers to health service access among female migrant Ugandan sex workers in Guangzhou, China","volume":"15","author":"Davis","year":"2016","journal-title":"Int J Equity Health"},{"key":"B45","doi-asserted-by":"publisher","first-page":"e0291486","DOI":"10.1371\/journal.pone.0291486","article-title":"Barriers and facilitators of access to sexual and reproductive health services among migrant, internally displaced, asylum seeking and refugee women: a scoping review","volume":"18","author":"Sawadogo","year":"2023","journal-title":"PLoS One"},{"key":"B46","doi-asserted-by":"publisher","first-page":"155","DOI":"10.4103\/ijph.ijph_485_22","article-title":"Experiences of stigma and discrimination of women living with HIV\/AIDS in health-care settings of Kashmir","volume":"67","author":"Jan","year":"2023","journal-title":"Indian J Public Health"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1247","DOI":"10.7196\/SAMJ.2016.v106.i12.11224","article-title":"Awareness, perceived risk and practices related to cervical cancer and pap smear screening: a cross-sectional study among HIV-positive women attending an urban HIV clinic in Johannesburg, South Africa","volume":"106","author":"Mokhele","year":"2016","journal-title":"S Afr Med J"},{"key":"B48","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/s12913-022-07561-x","article-title":"\u201cMy condition is my secret\u201d: perspectives of HIV positive female sex workers on differentiated service delivery models in Kampala Uganda","volume":"22","author":"Atuhaire","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"B49","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1080\/09540121.2012.748872","article-title":"Female sex workers and access to social and health services in Catalonia: influence of region of origin and place of work","volume":"25","author":"Folch","year":"2013","journal-title":"AIDS Care"},{"key":"B50","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/s40615-018-0495-9","article-title":"Insiders\u2019 insight: discrimination against indigenous peoples through the eyes of health care professionals","volume":"6","author":"Wylie","year":"2019","journal-title":"J Racial Ethn Health Disparities"},{"key":"B51","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.puhe.2016.12.023","article-title":"Delhi\u2019s health system exceptionalism: inadequate progress for a global capital city","volume":"145","author":"Gusmano","year":"2017","journal-title":"Public Health"},{"key":"B52","year":""},{"key":"B53","year":""},{"key":"B54","author":"Kurian","year":""},{"key":"B55","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.21275\/SR231115122619","article-title":"Demography: a case study of Mangalore city","volume":"12","author":"Ingalgi","year":"2023","journal-title":"IJSR"},{"key":"B56","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1111\/jog.14168","article-title":"Screening and management of preinvasive lesions of the cervix: Good clinical practice recommendations from the Federation of Obstetrics and Gynaecologic Societies of India (FOGSI)","volume":"46","author":"Bhatla","year":"2020","journal-title":"J Obstet Gynaecol Res"},{"key":"B57","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"B58","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"B59","doi-asserted-by":"publisher","first-page":"793","DOI":"10.31557\/APJCP.2024.25.3.793","article-title":"Evidence of knowledge, attitude, and practice regarding human papilloma virus vaccination at the community level in India: a systematic review and meta-analysis","volume":"25","author":"Pal","year":"2024","journal-title":"Asian Pac J Cancer Prev"},{"key":"B60","doi-asserted-by":"publisher","first-page":"4307","DOI":"10.31557\/APJCP.2022.23.12.4307","article-title":"Awareness about human papillomavirus vaccine and its uptake among women from north India: evidence from a cross-sectional study","volume":"23","author":"Rehman","year":"2022","journal-title":"Asian Pac J Cancer Prev"},{"key":"B61","doi-asserted-by":"publisher","first-page":"1656","DOI":"10.1080\/21645515.2019.1565260","article-title":"Knowledge, attitudes and factors associated with acceptability of human papillomavirus vaccination among undergraduate medical, dental and nursing students in south India","volume":"15","author":"Shetty","year":"2019","journal-title":"Hum Vaccin Immunother"},{"key":"B62","doi-asserted-by":"publisher","first-page":"e90912","DOI":"10.1371\/journal.pone.0090912","article-title":"Knowledge and awareness of HPV vaccine and acceptability to vaccinate in sub-saharan Africa: a systematic review","volume":"9","author":"Perlman","year":"2014","journal-title":"PLoS One"},{"key":"B63","doi-asserted-by":"publisher","first-page":"8287","DOI":"10.7314\/apjcp.2014.15.19.8287","article-title":"Knowledge and awareness of human papillomavirus (HPV), cervical cancer and HPV vaccine among women in two distinct Nepali communities","volume":"15","author":"Johnson","year":"2014","journal-title":"Asian Pac J Cancer Prev"},{"key":"B64","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1007\/s10900-018-0540-y","article-title":"Poor knowledge of human papilloma virus and vaccination among respondents from three Nigerian states","volume":"43","author":"Eni","year":"2018","journal-title":"J Community Health"},{"key":"B65","doi-asserted-by":"publisher","first-page":"2883","DOI":"10.1080\/17441692.2021.1985580","article-title":"Latinx fathers report low awareness and knowledge of the human papillomavirus vaccine, but high willingness to vaccinate their children if recommended by a healthcare provider: a qualitative study","volume":"17","author":"Lindsay","year":"2022","journal-title":"Glob Public Health"},{"key":"B66","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1186\/1471-2458-13-696","article-title":"HPV and cervical cancer related knowledge, awareness and testing behaviors in a community sample of female sex workers in China","volume":"13","author":"Hong","year":"2013","journal-title":"BMC Public Health"},{"key":"B67","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1177\/0956462414563626","article-title":"Human papillomavirus knowledge, vaccine acceptance, and vaccine series completion among female entertainment and sex workers in Phnom Penh, Cambodia: the young women\u2019s health study","volume":"26","author":"Wadhera","year":"2015","journal-title":"Int J STD AIDS"},{"key":"B68","doi-asserted-by":"publisher","first-page":"127064","DOI":"10.1016\/j.vaccine.2025.127064","article-title":"\u201cIf I know about it of course I would give my son and daughter\u201d, barriers to and enablers of accessing human papillomavirus vaccination among women from refugee and asylum-seeking backgrounds resettling in Melbourne, Australia - a qualitative study","volume":"53","author":"Davidson","year":"2025","journal-title":"Vaccine"},{"key":"B69","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s13187-015-0943-8","article-title":"HPV vaccine awareness and knowledge among women living with HIV","volume":"31","author":"Wigfall","year":"2016","journal-title":"J Cancer Educ"},{"key":"B70","doi-asserted-by":"publisher","first-page":"10","DOI":"10.51168\/sjhrafrica.v5i12.1463","article-title":"HPV awareness and vaccination \u2013 are men and women equally aware? \u2013 A survey among college students of Jamshedpur","volume":"5","author":"Kar","year":"2024","journal-title":"Stud J Health Res Afr"},{"key":"B71","doi-asserted-by":"publisher","first-page":"2713","DOI":"10.1080\/21645515.2017.1363133","article-title":"Approaching a decade since HPV vaccine licensure: racial and gender disparities in knowledge and awareness of HPV and HPV vaccine","volume":"13","author":"Adjei Boakye","year":"2017","journal-title":"Hum Vaccin Immunother"},{"key":"B72","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1007\/s13187-024-02516-8","article-title":"Gender differences in the awareness of human papillomavirus infection and vaccination","volume":"39","author":"Heimbecker","year":"2024","journal-title":"J Cancer Educ"},{"key":"B73","year":""},{"key":"B74","year":""},{"key":"B75","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.3390\/vaccines13101003","article-title":"Understanding vaccine hesitancy: insights and improvement strategies drawn from a multi-study review","volume":"13","author":"Brumbaugh","year":"2025","journal-title":"Vaccines"},{"key":"B76","doi-asserted-by":"publisher","first-page":"393","DOI":"10.47391\/JPMA.11061","article-title":"Vaccine hesitancy of adolescents and their parents in a possible future pandemic based on their COVID-19 experience","volume":"75","author":"Ayaz","year":"2025","journal-title":"J Pak Med Assoc"},{"key":"B77","doi-asserted-by":"publisher","first-page":"2796","DOI":"10.1186\/s12889-024-20324-z","article-title":"Vaccine hesitancy in context of COVID-19 in east Africa: systematic review and meta-analysis","volume":"24","author":"Alie","year":"2024","journal-title":"BMC Public Health"},{"key":"B78","doi-asserted-by":"publisher","first-page":"976","DOI":"10.3390\/vaccines12090976","article-title":"Attitudes toward adolescent HPV vaccination after the COVID-19 pandemic: a national survey of mothers","volume":"12","author":"Glauberman","year":"2024","journal-title":"Vaccines"},{"key":"B79","doi-asserted-by":"publisher","first-page":"e0269944","DOI":"10.1371\/journal.pone.0269944","article-title":"Beliefs, barriers and hesitancy towards the COVID-19 vaccine among Bangladeshi residents: findings from a cross-sectional study","volume":"17","author":"Hossain","year":"2022","journal-title":"PLoS One"},{"key":"B80","doi-asserted-by":"publisher","first-page":"2241351","DOI":"10.1080\/07853890.2023.2241351","article-title":"COVID-19 vaccination reported side effects and hesitancy among the Syrian population: a cross-sectional study","volume":"55","author":"Najjar","year":"2023","journal-title":"Ann Med"},{"key":"B81","doi-asserted-by":"publisher","first-page":"1465","DOI":"10.1080\/10410236.2022.2035943","article-title":"COVID-19 vaccine hesitancy in three Latin American countries: reasons given for not becoming vaccinated in Colombia, Ecuador, and Venezuela","volume":"37","author":"Bates","year":"2022","journal-title":"Health Commun"},{"key":"B82","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1080\/20477724.2021.2011580","article-title":"Vaccine hesitancy among communities in ten countries in Asia, Africa, and South America during the COVID-19 pandemic","volume":"116","author":"Harapan","year":"2022","journal-title":"Pathog Glob Health"},{"key":"B83","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1111\/phn.13134","article-title":"Vaccination hesitancy: to be vaccinated, or not to be vaccinated, that is the question in the era of COVID-19","volume":"40","author":"Perrone","year":"2023","journal-title":"Public Health Nurs"},{"key":"B84","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1007\/s00228-022-03412-0","article-title":"Imprecision in adverse event reports following immunization against HPV in Japan and COVID-19 in the USA, UK, and Japan-and the effects of vaccine hesitancy and government policy","volume":"79","author":"Inokuma","year":"2023","journal-title":"Eur J Clin Pharmacol"},{"key":"B85","doi-asserted-by":"publisher","first-page":"1462722","DOI":"10.3389\/fpubh.2024.1462722","article-title":"Understanding cultural perceptions of sexuality in China and their influence on human papillomavirus vaccine hesitancy","volume":"12","author":"Jin","year":"2024","journal-title":"Front Public Health"},{"key":"B86","doi-asserted-by":"publisher","first-page":"100279","DOI":"10.1016\/j.apjon.2023.100279","article-title":"Factors affecting HPV vaccine uptake among ethnic minority adolescent girls: a systematic review and meta-analysis","volume":"10","author":"Chan","year":"2023","journal-title":"Asia Pac J Oncol Nurs"},{"key":"B87","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1186\/s12939-019-1052-9","article-title":"Social and cultural construction processes involved in HPV vaccine hesitancy among Chinese women: a qualitative study","volume":"18","author":"Siu","year":"2019","journal-title":"Int J Equity Health"},{"key":"B88","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1177\/1010539509331590","article-title":"Women\u2019s autonomy in decision making for health care in south Asia","volume":"21","author":"Senarath","year":"2009","journal-title":"Asia Pac J Public Health"},{"key":"B89","doi-asserted-by":"publisher","first-page":"191","DOI":"10.2147\/IJWH.S105483","article-title":"Women\u2019s autonomy in health care decision-making in developing countries: a synthesis of the literature","volume":"8","author":"Osamor","year":"2016","journal-title":"Int J Womens Health"},{"key":"B90","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.ssresearch.2015.05.013","article-title":"Seclusion, decision-making power, and gender disparities in adult health: examining hypertension in India","volume":"53","author":"Stroope","year":"2015","journal-title":"Soc Sci Res"},{"key":"B91","doi-asserted-by":"publisher","first-page":"611","DOI":"10.3390\/vaccines12060611","article-title":"Clinician communication training to increase human papillomavirus vaccination uptake: a systematic review and meta-analysis","volume":"12","author":"Chandeying","year":"2024","journal-title":"Vaccines"},{"key":"B92","doi-asserted-by":"publisher","first-page":"623","DOI":"10.2471\/BLT.11.097253","article-title":"Achieving high coverage in Rwanda\u2019s national human papillomavirus vaccination programme","volume":"90","author":"Binagwaho","year":"2012","journal-title":"Bull World Health Org"},{"key":"B93","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1055\/s-0043-1764220","article-title":"Cervical cancer HPV vaccination and Bhutan","volume":"12","author":"Hingmire","year":"2023","journal-title":"South Asian J Cancer"},{"key":"B94","doi-asserted-by":"publisher","first-page":"3420","DOI":"10.1016\/j.vaccine.2015.11.076","article-title":"Successive introduction of four new vaccines in Rwanda: high coverage and rapid scale up of Rwanda\u2019s expanded immunization program from 2009 to 2013","volume":"34","author":"Gatera","year":"2016","journal-title":"Vaccine"},{"key":"B95","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1093\/jncimonographs\/lgae041","article-title":"Impact of single-dose HPV vaccination on HPV 16 and 18 prevalence in South African adolescent girls with and without HIV","volume":"2024","author":"Delany-Moretlwe","year":"2024","journal-title":"J Natl Cancer Inst Monogr"},{"key":"B96","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.vaccine.2017.11.038","article-title":"HPV vaccination strategies targeting hard-to-reach populations: out-of-school girls in LMICs","volume":"36","author":"Bonner","year":"2018","journal-title":"Vaccine"},{"key":"B97","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s40615-014-0050-2","article-title":"Human papillomavirus vaccine knowledge and attitudes, preventative health behaviors, and medical mistrust among a racially and ethnically diverse sample of college women","volume":"2","author":"Kolar","year":"2015","journal-title":"J Racial Ethn Health Disparities"},{"key":"B98","doi-asserted-by":"publisher","first-page":"48","DOI":"10.4274\/jtgga.galenos.2022.2022-6-6","article-title":"Barriers to the HPV vaccination program in the eastern Mediterranean region: a narrative review","volume":"24","author":"Hakimi","year":"2023","journal-title":"J Turk Ger Gynecol Assoc"}],"container-title":["Frontiers in Global Women's Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2026.1791203\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T05:51:57Z","timestamp":1776837117000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fgwh.2026.1791203\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":98,"alternative-id":["10.3389\/fgwh.2026.1791203"],"URL":"https:\/\/doi.org\/10.3389\/fgwh.2026.1791203","relation":{},"ISSN":["2673-5059"],"issn-type":[{"value":"2673-5059","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]},"article-number":"1791203"}}