Awareness and determinants of HPV vaccination intentions among female university students in Guangzhou, China: a cross-sectional study

Background This study aims to investigate HPV vaccine awareness and determinants among female university students in China—a key group for cervical cancer prevention. Methods A cross-sectional study was conducted among 1434 female college students from four universities in Guangzhou in 2024 using non-probability sampling method. Data were collected via structured questionnaires that assessed HPV knowledge and vaccination attitudes. Descriptive statistics, chi-square tests, and multivariate logistic regression analysis were performed using SPSSAU and SPSS 25.0 to identify significant predictors of vaccination intention. Results Among 1,434 participants, 85.6% were aware of HPV, 93.3% aware of the HPV vaccine, and 87.1% willing to be vaccinated. Sexual transmission was recognized by 74.0% of participants, 42.7% were cognizant of the optimal timing for vaccination (before sexual debut), and 87.1% exhibited willingness or had a history of vaccination. Key predictors of vaccination intent were identified as worry about cervical cancer (OR=1.84, 95%CI=1.45–2.28), knowledge of transmission routes (OR=1.20, 95%CI=1.03–1.40), and belief in vaccine efficacy (OR=3.25, 95%CI=2.06–3.90). Among hesitant respondents (n=185), safety (47.1%) and cost (29.4%) were cited as the main concerns. Conclusions Though awareness is high (93.3%), knowledge gaps remain. These findings highlight the urgent need for targeted public health interventions to improve vaccination rates and address vaccine hesitancy among female university students in China, which has significant implications for cervical cancer prevention not only in China but also in other low- and middle-income countries (LMICs) with similar challenges.