Abstract / Summary
A high incidence of cervical cancer is evident in several low-income countries, particularly in the urban slums that harbor densely populated poor communities. Even though Human papillomavirus (HPV) vaccination is a key strategy for cervical cancer, the uptake remains low in these settings. This study assessed HPV vaccine uptake and barriers among adolescent girls and young women (AGYW) in the urban slums of Kampala, Uganda. We conducted a cross-sectional, concurrent mixed-methods study among 290 AGYW aged 15–24 years. Multistage sampling was used to recruit participants between August and October 2025. Quantitative data were collected using a semi-structured questionnaire and analyzed with descriptive statistics and logistic regression in Stata 16.0. Qualitative data from focus group discussions were analyzed using thematic analysis. Of 290 AGYW (mean age 19.76 years, SD = 3.00), 30.7% reported receiving the HPV vaccine, and only 19.0% had completed the two-dose schedule. The most commonly reported barriers to vaccination were lack of awareness, fear of side effects, and limited access to vaccination services. Proximity to a vaccination clinic (aOR 0.35; 95% Cl: 0.21–0.60) and healthcare worker counselling (aOR 0.19; 95% CI: 0.11–0.34) were each associated with significantly lower odds of remaining unvaccinated. Qualitative findings highlighted limited knowledge and misconceptions about HPV and the vaccine, parental influence on vaccination decisions, and health system barriers such as poor communication, inconsistent service availability, and negative healthcare experiences. Structural challenges, including distance to vaccination sites and transport limitations, further constrained access to HPV vaccination. HPV vaccine uptake among AGYW in Kampala’s urban slums remains low and was associated with low vaccine awareness, misconceptions, parental influence, and health system and structural barriers. Strengthening community sensitization, improving healthcare worker communication, and expanding community- and school-based delivery could improve equitable vaccine access and uptake, but further research is needed to assess the effectiveness of these strategies in this setting. Not applicable.