HPV Vaccination Predictors Among College Students.

Abstract

College students remain at increased risk for acquiring human papillomavirus (HPV), yet HPV vaccination coverage remains suboptimal despite the availability of a safe and effective vaccine. This study examined predictors of HPV vaccination and HPV- and HPV vaccine-related knowledge, beliefs, and hesitancy among undergraduate students at a southern United States university. An online cross-sectional survey was administered to undergraduate students aged 18-26 years in November 2024. Descriptive statistics summarized participant characteristics, vaccination status, and HPV-related measures. Multinomial logistic regression models were used to examine factors associated with HPV vaccination status while estimating adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Among 1,127 respondents (mean age, 20.1 years), most were female (74.1%), White (74.9%), and insured (90.4%). Overall, 48.4% reported receiving at least one dose of the HPV vaccine, with only 21.7% completion. More than 30% were unsure of their HPV vaccination status. HPV knowledge, HPV vaccine knowledge and beliefs, and vaccine hesitancy were all independently associated with vaccination status (all p < 0.001). Participants with stronger positive HPV vaccine beliefs and lower vaccine hesitancy had significantly greater odds of reporting HPV vaccination. In secondary analyses, both provider and parental recommendation were significantly associated with younger age at initiation. HPV vaccination initiation and completion remain low among college students, with substantial gaps in knowledge, awareness, and confidence. College campuses represent an important setting for interventions that improve HPV-related knowledge, strengthen vaccine confidence, increase awareness of personal vaccination status, and promote vaccination to reduce future HPV-associated cancers.