Pregnancy health literacy and willingness for HPV Testing among pregnant women in Lahore, Pakistan

Abstract

Human papillomavirus (HPV) infection is a primary risk factor for cervical cancer development. In low-resource settings, HPV screening uptake is often limited by health literacy barriers. This study examined how health literacy affects willingness to undergo HPV screening (as a cervical cancer prevention method) among 384 pregnant women (aged 15-45) in Lahore, Pakistan using cross sectional data. We assessed health literacy using Kharazi's validated questionnaire, with evaluation done across four dimensions: health information comprehension, critical evaluation, informed decision-making, and practical application. We assessed the HPV screening willingness using a WHO's instrument, with evaluation done across two dimensions: an awareness and an attitude and willingness section. Data were analyzed using SPSS version 26 through simple and multiple linear regression models. The results from the simple linear analysis showed that health literacy had a significant positive effect on women’s willingness to undergo HPV testing (β=0.811, 95% CI=0.753,0.875, p=0.001). From the multiple linear regression analysis, the different dimension of health literacy had significant positive effect on willingness to undergo HPV testing, with the health information comprehension dimension having the strongest positive effect (β=0.724, 95% CI=0.676, 0.801, p=0.001). These findings suggest that enhancing pregnancy health literacy could improve HPV screening acceptance. The results have important implications for designing cervical cancer prevention programs in high-risk populations through antenatal care services.