Cervical cancer remains a significant global public health challenge, claiming over 350,000 lives each year and ranking as the fourth leading cause of cancer-related deaths among women. This study aims to use the Theory of Planned Behavior (TPB) to examine acceptance of the HPV vaccine and associated factors among female students in higher primary schools. A cross-sectional study was conducted among female students in higher primary schools in Fitche Town, Ethiopia, involving 424 participants. Data were collected using a self-administered questionnaire that included sociodemographic characteristics, knowledge, and TPB-based variables. Statistical analysis was performed using SPSS version 26, with Poisson regression analysis to identify factors associated with the intention to accept the HPV vaccine. A total of 400 female students aged between 13 and 14 years were included in this analysis. About 265 (66.3%) of participants showed a positive attitude toward the HPV vaccine, while 245 (61.3%) expressed an intention to receive it within the next six months. Additionally, 227 (56.8%) reported favorable subjective norms, and 228 (57.0%) indicated positive perceived behavioral control regarding the vaccine. Factors influencing HPV vaccination intention included knowledge levels (aPR 0.82, CI 0.72-0.92), attitudes (aPR 1.09, CI 1.03-1.20), subjective norms (aPR 1.09, CI 1.01-1.17), and perceived behavioral control (aPR 1.87, CI 1.72-2.04). Generally, the intention to vaccinate against HPV was low compared to the WHO 2030 HPV vaccination goals. Therefore, achieving these targets will require collaborative efforts from the Ethiopian Ministry of Health, the Oromia Regional Health Bureau, and non-governmental organizations.

Tinsae Abeya Geleta is a PhD student at National Yang Ming Chiao Tung University (NYCU), Taiwan. He holds an MPH in Health Promotion and Health Behavior from Jimma University, Ethiopia. Tinsae has published 20 articles in reputable journals, utilizing diverse epidemiological study designs. He has also contributed as a qualitative and quantitative research consultant to an international project led by Wageningen University, the Netherlands.