The intention and influencing factors of human papillomavirus vaccination among female students in the secondary vocational schools in East China: a cross-sectional study

This study aimed to explore the intention and influencing factors toward HPV vaccination among female students in secondary vocational schools in East China. A cross-sectional study was conducted among 500 female students aged 16-20 years from four secondary vocational schools in East China from September to December 2023. The information, including HPV and HPV vaccine-related knowledge questionnaire, family characteristics, attitudes toward premarital sex, information sources, and HPV vaccination or appointment status, was collected through an online questionnaire survey. According to the vaccination or appointment status, 421 participants who met the inclusion criteria were divided into two groups. The relationship between different factors and HPV vaccination intention was assessed using univariate and multivariate logistic analyses. Out of 421 participants, 286 (67.9%) were in the nonappointment group, while 135 (32.1%) were in the appointment/vaccination group. There was no significant difference in HPV and HPV vaccine-related knowledge scores and attitudes toward premarital sex between the two groups (p > 0.05). The factors such as grade level, family characteristics (including family's residence, parents' highest education level, monthly living expenses, and only child), and information sources showed significant differences between the two groups (p < 0.05). After multivariate logistic regression analysis (analyzing one characteristic at a time and adjusting all other characteristics as confounders), factors such as higher grades (grade 3 [odds ratio, OR = 0.39; 95% confidence interval, CI: 0.22-0.68], grade 4 [OR = 0.03; 95% CI: 0.02-0.07]), family's residence in urban areas (OR = 1.94; 95% CI: 1.1-3.41), monthly living expenses ≥2000 yuan (OR = 2.19; 95% CI: 1.08-4.47), only child (OR = 2; 95% CI: 1.2-3.36), and information sources from family or friends (OR = 2.34; 95% CI: 1.18-4.62), were independent influencing factors of HPV vaccination intention (all p < 0.05). The HPV vaccination policy of the local government significantly impacts accination intention. Meanwhile, family factors are independent influencing factors on HPV vaccination intention. When promoting HPV vaccination, secondary vocational schools in East China should focus on senior female students from rural areas, low-income families, and families with multiple children.