HPV prevention awareness, vaccination willingness, and vaccine-related perceptions among middle-school girls in three Arab countries: an exploratory online survey.

BACKGROUND: Cervical cancer is largely preventable through human papillomavirus (HPV) vaccination, screening, and timely treatment; however, adolescent HPV literacy remains inconsistent. Egypt, Saudi Arabia, and the United Arab Emirates have different publicly documented HPV-vaccination and cervical-screening contexts. This study explored HPV and cervical cancer prevention awareness, selected Health Belief Model-informed beliefs, vaccination willingness, and vaccine-related perceptions among middle-school girls in these countries. METHODS: An exploratory online cross-sectional survey was conducted among 300 students, with equal quota-like groups of 100 per country recruited through non-probability snowball sampling. Analyses were primarily descriptive; one complete-case exploratory logistic model examined factors associated with willingness to accept free HPV vaccination. RESULTS: Overall, 89/300 participants (29.7%) had heard of HPV, 103/300 (34.3%) had heard of cervical cancer, and 49/300 (16.3%) were aware of cervical screening. School nurses were the most frequently reported HPV information source among source-item respondents (47/90; 52.2%). HPV-vaccine awareness was reported by 131/298 participants (44.0%), previous vaccination by 106/300 (35.3%), and willingness to accept free vaccination by 197/300 (65.7%). Responses to five negatively worded vaccine-perception items were predominantly neutral or reflected disagreement rather than consistent endorsement of distrust. The exploratory model generated several inverse associations with willingness, but these estimates are sample-specific and hypothesis-generating. CONCLUSION: Prevention awareness was limited despite relatively high stated willingness to accept free vaccination. The findings support culturally adapted, school-linked education and representative studies using validated measures, parent-linked information, and verified vaccination records.