A nationwide survey on knowledge, attitude and practice regarding human papillomavirus (HPV), HPV-related disease and HPV vaccine among young adults in China.

BACKGROUND

Human papillomavirus (HPV) is a common sexually transmitted infection with a substantial disease burden in China. Despite the importance of vaccinating young adults, coverage remains suboptimal. This study aims to assess the knowledge, attitude, and practice (KAP) towards HPV, HPV-related disease, and HPV vaccine among young adults in China.

METHODS

A nationwide cross-sectional survey was conducted between July and August 2024, enrolling 1000 young adults aged 18-30 years through stratified sampling across seven administrative regions. Participants completed a structured electronic questionnaire assessing socio-demographics and KAP regarding HPV, HPV-related disease, and HPV vaccination. Descriptive analyses summarized KAP, and regression models identified associated factors.

RESULTS

Overall, 70.4% of participants had heard of HPV and 75.2% had heard of HPV vaccine. The mean knowledge score was 5.3/10 for HPV and related diseases and 8.2/12 for HPV vaccine. Multivariable analysis demonstrated that higher knowledge levels were significantly associated with more favorable attitudes and stronger willingness to vaccinate in both sexes. There was a substantial gap between self-reported vaccination willingness (36.0% of males, 71.4% of females) and actual uptake (5.0% of males, 22.2% of females). Key barriers included insufficient knowledge about HPV vaccine, the absence of vaccinated individuals within participants' social networks, and safety concerns.

CONCLUSION

KAP regarding HPV and vaccination have improved among young adults in China but still lag behind developed countries. Despite increased knowledge and vaccination willingness, a substantial gap persisted between intention and actual uptake. This requires not only strengthening HPV knowledge, reducing safety concerns, advocating universal vaccination strategies, and enhancing on-campus education, but also implementing systemic policy reforms to translate willingness into action, with the ultimate goal to reduce HPV-related disease burden.