Strengthened HPV vaccination among adolescents living with HIV, – Findings of a Pilot QI project in Kampala Metropolitan, Uganda
10 affiliations
- 1East Africa Centre for Vaccines and Immunization (ECAVI), Kampala, Uganda
- 2Department of Paediatrics & Child Health, Moi University, Eldoret, Kenya
- 3Department of Paediatrics & Child Health, Makerere University, Kampala, Uganda
- 4Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- 5Department of Paediatrics and Child Health, Mulago National Referral Hospital, Kampala, Uganda
- 6Department of Virology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- 7South African Vaccination and Immunisation Centre (SAVIC), Sefako Makgatho Health Sciences University, Pretoria, South Africa
- 8Department of Microbiology, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- 9Mildmay Uganda (MUg), Kampala, Uganda
- 10Joint Clinical Research Centre (JCRC), Kampala, Uganda
Abstract
Introduction: Recent reports from Kampala indicate low uptake and completion of the human papillomavirus (HPV) vaccine among adolescents, especially amongst those living with HIV. However, the drivers of this low uptake are poorly understood. This study aimed to determine the current HPV vaccine coverage; assess the knowledge, attitude and practices influencing HPV vaccine uptake among adolescent girls living with HIV; and pilot an HPV vaccination program while documenting lessons learned and experiences at two urban HIV treatment centres the Joint Clinical Research Centre (JCRC) and Mildmay Uganda in Kampala, Uganda. Methods: This was a descriptive cross-sectional mixed methods study employing both qualitative and quantitative data collection methods, carried out between 03/12/2024–30/08/2025, among adolescent girls living with HIV in Kampala, Uganda. A total of 371 were enrolled, of which 182 from JCRC and 189 from Mild May Uganda. At enrolment, 11 adolescents declined consent to participate. Quantitative data on knowledge of HPV and HPV vaccination was collected through interviews, with any additional demographic data being obtained from medical records at the treatment centres. Qualitative data included four focused group discussions (FGDs) of adolescent girls and 32 key informant interviews (KIIs) with focal health workers (Paediatricians, nurses, counsellors) at the two centres were conducted. Results: Overall, 138/371 (37%) of the adolescents reported having heard about the HPV vaccine, while 233/371 (63%) had not. At enrolment, only 51 out of 371 (14%) participants had initiated vaccination. Among those who initiated vaccination, 51% had received only the first dose. By the end of the study, 342/371 (92%) of adolescents had completed the recommended two doses of the HPV vaccine. This study focused on increasing vaccine uptake amongst the HIV positive adolescents at the two centres. Most adolescents with a good level of knowledge about HPV or those attending school reported to have initiated vaccination. Identified barriers to vaccine uptake included inadequate knowledge about HPV and the benefits of vaccination; limited availability of HPV vaccines, and the absence of routine HPV immunisation programs within HIV treatment centres or programs specifically targeting adolescents living with HIV. Conclusion: In these two urban HIV care and treatment centres, vaccination against HPV among eligible adolescents is way lower than recommended 90 percent. Adolescent girls living with HIV demonstrated low levels of knowledge about the HPV vaccine and poor access to vaccination services, despite being receptive to vaccination. This study showed that HPV vaccine uptake can be substantially improved within HIV care and treatment centers by reducing barriers to HPV vaccination uptake when the vaccines are made readily available and accessible, either in existing HIV care and treatment centres or in the new integrated care centres in areas where government programs have moved to implement HIV care integration into mainstream medical services.
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BibTeX
@article{malande2026strengthened,
title = {{Strengthened HPV vaccination among adolescents living with HIV, – Findings of a Pilot QI project in Kampala Metropolitan, Uganda}},
author = {Oliver Ombeva Malande and Munube Deogratias and Julia Jerono Songok and Sekinah Hassan and Varsetile Varster Nkwinika and Andrew Munyalo Musyoki and Doreen Sekibombo and Diana Antonia and Rachel Nakatugga Afaayo and Sam Njunwamukama and Mutunga Nzoka and Sabrina Bakeera Kitaka},
journal = {PLOS One},
year = {2026},
month = aug,
doi = {10.1371/journal.pone.0356686},
url = {https://doi.org/10.1371/journal.pone.0356686},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Strengthened HPV vaccination among adolescents living with HIV, – Findings of a Pilot QI project in Kampala Metropolitan, Uganda
AU - Oliver Ombeva Malande
AU - Munube Deogratias
AU - Julia Jerono Songok
AU - Sekinah Hassan
AU - Varsetile Varster Nkwinika
AU - Andrew Munyalo Musyoki
AU - Doreen Sekibombo
AU - Diana Antonia
AU - Rachel Nakatugga Afaayo
AU - Sam Njunwamukama
AU - Mutunga Nzoka
AU - Sabrina Bakeera Kitaka
PY - 2026
DA - 2026/08/31
JO - PLOS One
DO - 10.1371/journal.pone.0356686
UR - https://doi.org/10.1371/journal.pone.0356686
AB - Introduction: Recent reports from Kampala indicate low uptake and completion of the human papillomavirus (HPV) vaccine among adolescents, especially amongst those living with HIV. However, the drivers of this low uptake are poorly understood. This study aimed to determine the current HPV vaccine coverage; assess the knowledge, attitude and practices influencing HPV vaccine uptake among adolescent girls living with HIV; and pilot an HPV vaccination program while documenting lessons learned and experiences at two urban HIV treatment centres the Joint Clinical Research Centre (JCRC) and Mildmay Uganda in Kampala, Uganda. Methods: This was a descriptive cross-sectional mixed methods study employing both qualitative and quantitative data collection methods, carried out between 03/12/2024–30/08/2025, among adolescent girls living with HIV in Kampala, Uganda. A total of 371 were enrolled, of which 182 from JCRC and 189 from Mild May Uganda. At enrolment, 11 adolescents declined consent to participate. Quantitative data on knowledge of HPV and HPV vaccination was collected through interviews, with any additional demographic data being obtained from medical records at the treatment centres. Qualitative data included four focused group discussions (FGDs) of adolescent girls and 32 key informant interviews (KIIs) with focal health workers (Paediatricians, nurses, counsellors) at the two centres were conducted. Results: Overall, 138/371 (37%) of the adolescents reported having heard about the HPV vaccine, while 233/371 (63%) had not. At enrolment, only 51 out of 371 (14%) participants had initiated vaccination. Among those who initiated vaccination, 51% had received only the first dose. By the end of the study, 342/371 (92%) of adolescents had completed the recommended two doses of the HPV vaccine. This study focused on increasing vaccine uptake amongst the HIV positive adolescents at the two centres. Most adolescents with a good level of knowledge about HPV or those attending school reported to have initiated vaccination. Identified barriers to vaccine uptake included inadequate knowledge about HPV and the benefits of vaccination; limited availability of HPV vaccines, and the absence of routine HPV immunisation programs within HIV treatment centres or programs specifically targeting adolescents living with HIV. Conclusion: In these two urban HIV care and treatment centres, vaccination against HPV among eligible adolescents is way lower than recommended 90 percent. Adolescent girls living with HIV demonstrated low levels of knowledge about the HPV vaccine and poor access to vaccination services, despite being receptive to vaccination. This study showed that HPV vaccine uptake can be substantially improved within HIV care and treatment centers by reducing barriers to HPV vaccination uptake when the vaccines are made readily available and accessible, either in existing HIV care and treatment centres or in the new integrated care centres in areas where government programs have moved to implement HIV care integration into mainstream medical services.
SN - 1932-6203
ER -