Exploring awareness, attitudes and clinical practices of Ukrainian health professionals regarding human papillomavirus and vaccination: a qualitative study

Abstract

Introduction Cervical cancer, a preventable disease, remains a significant public health issue in Ukraine, characterised by low human papillomavirus (HPV) vaccination rates and systemic healthcare challenges exacerbated by the ongoing war. To improve the situation with HPV vaccination, understanding the perspective of healthcare professionals (HCPs) is crucial. Aim This study aimed to assess the knowledge, awareness and clinical practices of Ukrainian HCPs regarding HPV, HPV- related diseases and vaccination. It sought to identify their readiness to recommend vaccination, the barriers they face and the impact of the full- scale Russia–Ukrainian war on these aspects. Methods A qualitative exploratory study was conducted using the Knowledge, Attitude and Practice (KAP) framework. Data were collected through 12 focus group discussions, 10 in- depth semistructured interviews and short questionnaires with 60 HCPs (gynaecologists, paediatricians, general practitioners, nurses and key decision- makers) across four macroregions of Ukraine in July 2023. A descriptive thematic analysis was performed on the transcribed data. Results The study found support for HPV vaccination among HCPs, who recognise it as a critical cancer prevention tool. However, significant barriers impede its implementation. These include organisational challenges like the vaccine’s high cost and non- mandatory status, professional issues such as knowledge gaps and prevalent misconceptions (eg, belief in natural immunity, doubts about vaccine safety), particularly among non- gynaecological specialists, and low public awareness of the HPV–cancer link. The war has intensified these barriers by shifting priorities and disrupting services, yet it has also paradoxically increased vaccine awareness among Ukrainians who have been abroad. Conclusion The successful rollout of Ukraine’s national HPV vaccination programme requires a comprehensive strategy. Merely adding the vaccine to the schedule is insufficient. It must be accompanied by robust state funding to ensure it is free, a large- scale public information campaign to combat misinformation and raise awareness and targeted continuing medical education to close knowledge gaps and empower HCPs to recommend the vaccine confidently.