📄 infectious diseases

Biopsychosocial determinants of HPV vaccine perception in university students of both sexes in Cucuta, Colombia, 2024: a cross-sectional study

This 2024 cross-sectional study of 750 university students in Cucuta, Colombia, reveals that while HPV vaccine perception is predominantly positive, it is significantly shaped by gender, university type, and general HPV knowledge, highlighting the need for gender-inclusive educational strategies that address non-cervical HPV-related diseases.

Original authors: ARIAS-SANCHEZ, A., Florez, M., Pereira, N., Caceres-Penaloza, D. Y., Dallos Rivera, L. S., Nunez-Villamizar, K. G., Beltran - Arroyave, C.

Published 2026-06-22

📖 4 min read☕ Coffee break read

CC BY 4.0

Original authors: ARIAS-SANCHEZ, A., Florez, M., Pereira, N., Caceres-Penaloza, D. Y., Dallos Rivera, L. S., Nunez-Villamizar, K. G., Beltran - Arroyave, C.

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ⚕️ This is an AI-generated explanation of a preprint that has not been peer-reviewed. It is not medical advice. Do not make health decisions based on this content. Read full disclaimer

Imagine the Human Papillomavirus (HPV) as a very common, invisible guest that shows up at almost every party of sexual activity. While most people know this guest exists, many don't realize it can cause trouble in many different rooms of the house, not just the bedroom. In fact, this virus can cause issues in the throat, the mouth, the anus, and the penis, as well as the cervix.

This study is like a big, friendly survey conducted in 2024 with 750 university students in Cúcuta, Colombia. The researchers wanted to know: Do these young adults understand the virus, and do they think the vaccine (a shield against it) is a good idea?

Here is what they found, broken down simply:

1. The "Cervix-Only" Blind Spot

For a long time, public health messages have been like a spotlight that only shines on women's health (specifically cervical cancer). Because of this, many people think the HPV vaccine is only for girls.

The Reality: The study found that while most students had heard of the virus, they were often blind to the fact that it affects men too.
The Analogy: Imagine if everyone thought a raincoat was only for people walking on the left side of the street. Even though the rain falls on everyone, the people on the right side don't think they need protection. The study showed that men knew significantly less about the virus and its dangers than women did.

2. The "Knowledge is Power" Rule

The researchers tested what actually makes a student feel good about getting the vaccine. They looked at age, money, where they went to school, and how much they knew.

The Winner: The single biggest factor was knowledge.
The Metaphor: Think of the vaccine perception as a car. Age, income, and school type are like the color of the car or the brand of the tires—they matter a little bit. But knowledge is the engine. If the engine is running (you understand the virus), the car moves forward (you have a positive view of the vaccine). If the engine is off (you don't know much), the car sits still, regardless of how nice the paint job is.
The Result: Students who knew more about the virus (not just the vaccine, but the virus itself) were much more likely to support vaccination.

3. The "Good News" and the "Bad News"

Good News: Overall, the students were pretty positive! About two-thirds (66.6%) thought the vaccine was a good idea. Most trusted it and were willing to recommend it to friends.
Bad News: There is a "knowledge gap." While 91% had heard of HPV, only about half knew it causes cervical cancer, and even fewer knew it causes penile cancer or warts. Specifically, men were much less likely to know that they could get sick from it.

4. Why the Gap Exists

The study suggests this gap exists because the "story" told to the public for years has been: "This is a girl's problem."

The Analogy: It's like a fire drill that only tells the women in the building where the exits are. The men assume the fire doesn't affect them, so they don't pay attention to the drill. The researchers found that until the story changes to include everyone, the men will remain less informed and less convinced.

The Bottom Line

The paper concludes that to fix the vaccination rates, we can't just run more ads or try to convince people with different school backgrounds. We need to change the story.

We need to stop shining the spotlight only on women and start showing the whole picture: that this virus affects everyone, and the vaccine protects everyone. If we teach students (especially men) that the virus is a universal guest that can cause trouble in many parts of the body, their trust in the vaccine will naturally go up.

In short: The vaccine is popular, but it's held back by a lack of understanding. Once people realize the virus is a "team sport" threat that affects both men and women, their support for the vaccine becomes much stronger.

Technical Summary: Biopsychosocial Determinants of HPV Vaccine Perception in University Students in Cúcuta, Colombia (2024)

Problem Statement
Colombia has experienced a significant crisis in vaccine confidence following the 2014 El Carmen de Bolívar event, resulting in HPV vaccination coverage that remains below World Health Organization 2030 targets. While existing literature extensively covers female adolescents and cervical cancer, there is a comparative lack of evidence regarding HPV vaccine perception among university-age populations of both sexes. Furthermore, public health communication has historically framed the vaccine exclusively around cervical cancer, potentially obscuring the burden of HPV-attributable diseases in men (e.g., penile, anal, and oropharyngeal cancers) and creating a gendered perception gap. This study addresses the need to characterize the biopsychosocial determinants influencing HPV vaccine perception in a mixed-sex university population to inform gender-inclusive educational strategies.

Methodology
The researchers conducted a cross-sectional study with a mixed quantitative–qualitative approach in 2024 within the metropolitan area of Cúcuta, Norte de Santander.

Population and Sampling: The study included 750 actively enrolled undergraduate students (aged 18–60) from four universities: Universidad de Santander (UDES), Universidad Francisco de Paula Santander (UFPS), Universidad de Pamplona, and Universidad Libre. A convenience sampling strategy stratified by institution was employed.
Instrument: A structured online questionnaire was developed by adapting and triangulating items from validated instruments (including surveys from Puerto Rico, Ecuador, and Colombia). The instrument covered sociodemographics, HPV knowledge (transmission, prevention, clinical manifestations), and vaccine perception (trust, benefits, inconveniences, willingness to recommend).
Analysis: Data were analyzed using IBM SPSS Statistics. Descriptive statistics were used for frequencies and central tendencies. Inferential analysis employed Student's t-tests and one-way ANOVA to assess differences across groups (sex, age, university type, knowledge levels). Effect sizes (Cohen's d and partial eta-squared) and 95% confidence intervals were calculated to determine the magnitude of associations, with a significance threshold of p < 0.05.

Key Results

Demographics: The sample consisted of 54.2% women, with 61.3% under 20 years of age. 75.1% of respondents attended public universities.
HPV Knowledge: Overall knowledge was mixed: 39.2% high, 42.4% intermediate, and 18.4% low. Women demonstrated higher knowledge scores than men (mean 7.13 vs. 6.24). While 91.2% had heard of HPV and 82.5% recognized it affects both sexes, recognition of specific clinical manifestations was uneven (cervical cancer: 51.7%; penile cancer: 30.5%; anogenital warts in men: 34.0%).
Vaccine Knowledge: Specific knowledge regarding the vaccine schedule and target population was low in 77.1% of respondents, with men disproportionately represented in the low-knowledge category (85.9% vs. 69.5% for women).
Perception: Overall positive perception of the vaccine was 66.6%. This was slightly higher among women (68.8%), students aged 26 or older (70.1%), and students from private universities (68.1%).
Determinants: Inferential analysis identified three statistically significant biopsychosocial determinants of vaccine perception:
1. HPV Knowledge: The primary driver, explaining approximately 9.6% of the variance in perception (partial $\eta^2$ = 0.096).
2. Sex: A small-to-moderate effect (Cohen's d = −0.357), with women showing more positive perceptions.
3. Type of University: A small effect (Cohen's d = 0.189), likely operating indirectly through differences in knowledge levels.
  Factors such as age, socioeconomic stratum, age at sexual debut, and specific vaccine knowledge did not reach meaningful significance.

Contributions and Significance
The study contributes to the literature by shifting the focus from female-only cohorts to a mixed-sex university population, explicitly analyzing the "gendered cognitive structure" where men perceive the vaccine as primarily relevant to women. The authors claim that the study's primary significance lies in identifying HPV knowledge—specifically regarding the full spectrum of HPV-attributable diseases—as the dominant determinant of vaccine perception, rather than demographic factors alone.

The paper argues that the persistent gender gap in perception reflects historical messaging anchored in cervical cancer. Consequently, the authors conclude that public health strategies must move beyond promotional campaigns to comprehensive, gender-inclusive educational interventions. These interventions should explicitly visibilize non-cervical HPV-related cancers and address both sexes from a common evidence base to restore confidence and meet 2030 vaccination targets. The authors modestly note that while the findings are statistically significant, the effect sizes for sex and university type are modest compared to knowledge, and the cross-sectional design precludes causal inference.

1. The "Cervix-Only" Blind Spot

2. The "Knowledge is Power" Rule

3. The "Good News" and the "Bad News"

4. Why the Gap Exists

The Bottom Line

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