The role of socioeconomic status in HPV-related knowledge, attitude, vaccination willingness and preference among college males

Following the approval of HPV vaccines for males in China, male college students as a key target population, have shown suboptimal knowledge, attitudes, and practices (KAP) regarding HPV vaccination. Understanding inequalities within the population is essential for targeted interventions. This study examined socioeconomic status (SES) -related disparities in HPV-related KAP and vaccine preferences. A nationwide, multi-center cross-sectional survey of male college students aged 18–30 years was conducted. An SES index was constructed using six indicators of income, education, and occupational prestige, and participants were categorized into low, middle, and high SES groups. Differences in HPV-related knowledge, attitudes, and vaccination willingness were assessed. A discrete choice experiment (DCE) with six attributes (effectiveness, duration, safety, manufacturer, valence, and cost) was used to evaluate preferences and estimate marginal willingness to pay (MWTP). Odds ratio (OR) and 95% confidence interval (CI) were calculated. Among 25,188 participants, higher SES was associated with better knowledge, more favorable attitudes, and greater willingness to vaccinate. Willingness to pay increased with SES. Participants preferred vaccines with higher effectiveness, longer duration, better safety, and higher valence. Effectiveness (OR = 3.01, 95% CI 2.96–3.06) and safety (OR = 1.94, 95% CI 1.92–1.96) were the most influential attributes. Socioeconomic gradients were evident, with stronger preferences among higher-SES groups. SES-related inequalities in HPV-related KAP and vaccine preferences were evident, supporting the need for targeted and equitable vaccination strategies.