HPV Infection Prevalence, Vaccination-Related Knowledge, Attitudes, and Barriers Among Women Aged 30-64 in Shenzhen, China: A Cross-Sectional Study

Vaccines (Basel). 2025 May 25;13(6):561. doi: 10.3390/vaccines13060561.

Abstract

Background: the distribution of human papillomavirus (HPV) infection, vaccination rates, and awareness levels varies across China. Methods: this study examined HPV infection prevalence, vaccine uptake, and barriers among 2440 women aged 30-64 in Shenzhen, China, using partial least squares structural equation modeling (PLS-SEM) to analyze associated factors. Results: The overall HPV prevalence was 14.2% (347/2440), with HPV52 being the most common type, followed by HPV58 and HPV53. Factors significantly associated with HPV infection included more sexual partners, genital tract infections, manual labor, and single marital status (p < 0.05), whereas higher education demonstrated a protective association (p < 0.05). The HPV vaccination rate was 41.8% in ages 30-45. There were direct effect indicators of younger age, fewer pregnancies, and premenopausal status (p < 0.05) on HPV vaccine uptake, whereas inversely associated factors included divorce/widowed, lower household income, irregular menstruation, more deliveries, no contraception, and lack of HPV knowledge. Among 828 unvaccinated individuals, 47.9% of those aged 46-64 were willing if the age restrictions were expanded, with the main barrier being a lack of vaccine knowledge (40.7%). Willingness was significantly associated with younger age and healthcare occupation (p < 0.05), but negatively with eastern Shenzhen residence, lower household income, no HPV disease awareness, abnormal leucorrhea, lack of HPV knowledge, and belief against post-vaccination screening (p < 0.05). Conclusions: Socioeconomic disparities in HPV infection and vaccination rates in Shenzhen highlight intervention priorities. The impact of HPV knowledge underscores the need for effective health communication. The vaccination willingness and infection status among women aged 45+ provide supporting evidence for expanding HPV vaccination to older age groups.

Keywords: HPV prevalence; HPV vaccination uptake; related factors; willingness to receive HPV vaccine.