Human papillomavirus (HPV) is a common sexually transmitted infection with low-risk types causing warts and high-risk types linked to cancers including cervical, anal, vulvar, vaginal, penile, and oropharyngeal cancers. Globally, cervical cancer ranks fourth for incidence and mortality among women. In Canada, HPV-related cancers and cervical cancer incidence remain an important public health concern, and Indigenous populations experience disproportionately higher rates of sexually transmitted infections and cervical cancer compared with non-Indigenous populations. Indigenous women in Canada have been reported to be at substantially higher risk of cervical cancer and related mortality.
The World Health Organization recommended HPV vaccination in 2006 to reduce HPV-related disease. Canada implemented school-based HPV vaccination beginning in 2007–2008 and programs have expanded to include gender-neutral immunization in many jurisdictions. Despite proven vaccine safety and efficacy and publicly funded programs in the Northwest Territories (NWT), uptake and awareness vary and Indigenous children nationally have lower HPV vaccine coverage than non-Indigenous children.
This project addressed a gap: prior to this work, no data existed assessing HPV or HPV vaccine awareness, utilization, and influencing factors specifically within Indigenous communities across NWT. The study aimed to quantify awareness and vaccine use and to explore reasons for non-vaccination and community-driven recommendations to improve uptake.
The study used a mixed-methods, cross-sectional design implemented in 11 Indigenous communities across NWT between 2022 and 2024. Communities varied by population size, remoteness, and infrastructure: larger communities (>1,000 residents) had hospital services and year-round road access, medium communities (300–1,000) had community health centers and year-round road access but no hospital, and smaller communities (<300) sometimes lacked all-season road connections and often had limited local health services.
Researchers applied a community-based participatory research model, emphasizing equal partnership with Indigenous communities, local engagement at all research stages, and use of trained local research assistants to administer semi-structured questionnaires. The approach aimed to foster trust and cultural appropriateness in data collection and interpretation.
Indigenous adults aged 18 years and older were invited to complete a semi-structured questionnaire administered by trained local research assistants. The analytic sample included 221 participants. Participant characteristics reported in the source article include 66.5% women and a mean age of 43.6 years (±13.9). The questionnaire collected information on awareness of HPV and the HPV vaccine, vaccination status for eligible younger participants, demographic variables such as age, gender, and educational attainment, and open-ended items used for qualitative thematic analysis.
Multiple logistic regression was used to evaluate associations between demographic factors (age, gender, education) and awareness of HPV and the HPV vaccine. Key quantitative findings reported in the source article:
Full numeric tables and additional model details are presented in the source article. If further specifics of the analytic models or subgroup counts are required, consult the original publication for the complete tables and statistical outputs.
A thematic analysis of open-ended responses identified limited awareness and insufficient information about HPV and the vaccine as primary barriers to vaccination in the participating communities. Participants expressed that knowledge gaps—particularly about the link between HPV and cancer—limited the perceived importance of vaccination. The qualitative data underscored community-level informational needs rather than explicit concerns about vaccine safety reported in the quantitative summary.
The source reports participants’ emphasis on increasing accessible, culturally appropriate information as a means to address low uptake. Specific illustrative quotes and deeper qualitative code structures are available within the full article.
Participants recommended targeted promotion activities to raise awareness about the association between HPV and cancer and to improve understanding of the vaccine’s role in prevention. Suggested strategies included enhanced educational efforts in schools and community settings and more visible, consistent public health messaging tailored to local contexts. The community-based research process itself supported recommendations that interventions be co-designed with Indigenous communities to ensure cultural relevance and acceptability.
The study concludes that limited awareness of HPV and the HPV vaccine likely contributes to low vaccination rates among Indigenous communities in NWT. Education emerged as a major correlate of awareness, while age and gender also predicted vaccine knowledge. The authors recommend tailored, targeted interventions—particularly education and community-driven promotion—to increase HPV vaccine utilization.
Data supporting the project contain potentially identifying or sensitive information and are not publicly available. Requests for access to de-identified data must be directed to the University of Alberta Research Ethics Office and will be considered in accordance with institutional and ethical guidelines and data-sharing agreements with the participating communities, as noted in the source article.
Funding for the project was provided by the Canadian Institutes of Health Research through specific grants named in the source. The authors declared no competing interests.
Note: Some procedural and analytic details (for example, full questionnaire items, complete regression coefficients, and full qualitative codebooks) are presented in the original article; those detailed tables and appendices should be consulted directly for in-depth review.