Human papillomavirus vaccination readiness, uptake, and perceived barriers among university students in the Pearl River Delta Region: A cross-sectional study
Introduction: Human papillomavirus (HPV) vaccination prevents cervical cancer and other HPV-related diseases, yet uptake among Chinese university students is uneven.
Objective: We examined HPV vaccination readiness, uptake, and perceived barriers among university students in the Pearl River Delta.
Methods: We conducted a cross-sectional survey in May–June 2026. Outcomes were classified as no definite short-term intention, intention to vaccinate within six months, or vaccinated. We used multinomial and binary logistic regression, a 13-item knowledge score, and an 8-item barrier index.
Results: Of 429 students, 175 (40.8%) lacked definite short-term intention, 89 (20.7%) intended to vaccinate within six months, and 165 (38.5%) were vaccinated. Short-term intention was associated with sexual activity with (adjusted OR [aOR] = 4.14, 95% confidence interval [CI]: 2.20–7.79) or without (aOR = 3.06, 95% CI: 1.12–8.35) a regular partner and senior undergraduate/postgraduate status (aOR = 1.83, 95% CI: 1.01–3.31); being vaccinated was additionally associated with female sex (aOR = 4.17, 95% CI 2.41–7.19) and medical major (aOR = 3.58, 95% CI: 2.15–5.95). HPV knowledge was not independently associated with either outcome. Among the unvaccinated (n = 264), the leading barriers were insufficient vaccine information, safety concerns, appointment difficulty, and cost; the barrier index was not significantly associated with definite intention (aOR = 0.63, 95% CI: 0.39–1.03) and was composition-sensitive.
Conclusion: Intention and uptake had distinct correlates: intention was associated with sexual experience and grade level, and being vaccinated was additionally associated with female sex and medical major; knowledge showed no independent association. Interventions should offer practical guidance, gender-inclusive communication, and access support.
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