Knowledge, trust, and multidimensional perceptions of human papillomavirus vaccination among women attending a single primary care centre in Astana, Kazakhstan: a cross-sectional study

Background Kazakhstan reintroduced human papillomavirus (HPV) vaccination in 2024, making public confidence and communication important. This study described HPV knowledge and trust in information sources and exploratorily examined vaccine-perception structure and correlates among women attending primary care in Astana. Methods A cross-sectional electronic survey was conducted from 17 January to 28 February 2026 among 221 adult women recruited through convenience sampling. HPV knowledge, source-specific trust, and 16 perception items were assessed. Exploratory psychometric analysis used polychoric correlations, parallel analysis, and principal-axis factor analysis with oblimin rotation to derive preliminary composite measures. Spearman correlations and robust multivariable linear models examined safety concern and perceived effectiveness. A secondary logistic model examined refusal or intention to refuse HPV vaccination for a daughter. Results Mean HPV knowledge was 4.95 ± 3.84 of 12. A five-item safety concern measure (mean 2.34 ± 0.97; α = 0.868; ω = 0.901) and a three-item perceived effectiveness measure (mean 3.20 ± 1.24; α = 0.922; ω = 0.948) were derived. Knowledge correlated negatively with safety concern ( ρ = −0.284, p < 0.001) and positively with perceived effectiveness ( ρ = 0.393, p < 0.001). Safety concern was associated with COVID-19 controversy spillover (B = 0.190, 95% CI 0.043−0.337), earlier-programme distrust (B = 0.197, 95% CI 0.047−0.347), and preference for natural immunity (B = 0.137, 95% CI 0.040−0.234). Higher knowledge (B = 0.061, 95% CI 0.010−0.111) and professional/scientific trust (B = 0.297, 95% CI 0.114−0.480) were associated with greater perceived effectiveness. Forty-nine participants (22.2%) reported refusal or intention to refuse vaccination for a daughter; knowing someone believed to have become seriously ill after vaccination was associated with this response (aOR 7.42, 95% CI 2.60−21.16). Conclusion HPV vaccine perceptions were multidimensional. Knowledge and professional-scientific trust were linked mainly to perceived effectiveness, whereas safety concerns were more strongly related to vaccine narratives. Communication strategies should combine factual education with transparent safety dialogue and clinician communication.