Understanding HPV Mitigation Content in Highly Engaged YouTube Videos: A Mixed-Method Topic Modeling and Sentiment Analysis of Videos and Related Comments Study.

As the most common sexually transmitted infection and leading cause of several cancers, the human papillomavirus (HPV) warrants careful attention in how it is portrayed and discussed on social media platforms such as YouTube. This study examines highly commented YouTube videos about HPV to analyze how different content creators frame health information and behaviors, and how audiences respond. We applied the Health Belief Model to evaluate how different creators portrayed health information, performed sentiment analysis to assess comments' emotions, and conducted topic modeling to identify key themes emerging from the comments. Medical professionals contributed most of the videos (n = 15, 75%) and were protagonists (n = 15, 75%). However, those videos received lower viewer engagement and fewer positive interactions. The most frequently mentioned health behavior was vaccination (n = 12, 60%), followed by medical screening (n = 10, 50%), treatment (n = 8, 40%), consulting healthcare providers (n = 6, 30%), practicing safe sex (n = 5, 25%), and lifestyle change (n = 3, 15%). Constructs of perceived severity, perceived susceptibility to HPV, and perceived benefits of health behaviors were present in over 80% of videos, whereas self-efficacy was mentioned in only 45%. Topic modeling of comments identified four major themes: knowledge (43.36%), screening and treatment (27.67%), vaccination (16.58%), and alternative treatment (12.38%). These findings highlight that medical professionals were the primary creators and figures in HPV-related YouTube communication. Health behaviors received limited emphasis. Comments revealed notable disagreement and skepticism toward recommended health behaviors and frequent promotion of alternative treatments, highlighting the need for more engaging, trust-building, and behaviorally focused HPV communication on social media.