# Awareness of HPV, HPV vaccine and associated factors among male junior high school students in Zhejiang Province, China

## TL;DR

This study finds low awareness of HPV and its vaccine among junior high school boys in Zhejiang, China, and identifies factors like urban residence and health education that could improve understanding.

## Contribution

The study is one of the first to assess HPV and vaccine awareness among male junior high school students in China, a previously under-researched group.

## Key findings

- Only 24.7% of male students were aware of HPV, and 30.7% were aware of the HPV vaccine.
- Urban residence, cervical cancer awareness, and school-based health education were strongly associated with higher HPV and vaccine awareness.
- Targeted school health programs are recommended to improve HPV vaccine uptake among this population.

## Abstract

With HPV vaccines for males recently approved in China (2025), this study assessed awareness of HPV and HPV vaccine among junior high school boys in Eastern China, a population underrepresented in research.

A cross-sectional study was conducted in Zhejiang Province in 2023 using multistage cluster sampling. Three cities were purposively selected; within each city, one urban district and one rural county were randomly chosen. A total of six junior high schools (one from each selected district/county) participated in the study, with students randomly sampled from each grade level. Participants completed an anonymous online questionnaire. Univariate and multivariate logistic regression analyses were performed to identify factors associated with awareness of HPV and the HPV vaccine among male junior high school students.

Among 1,786 male participants, awareness rates for HPV and the HPV vaccine were 24.7 and 30.7%, respectively. Multivariate analysis revealed factors significantly associated with HPV awareness: urban residence (aOR = 2.20, 95% CI: 1.57–3.08), knowing someone affected by cancer (aOR = 1.40, 95% CI: 1.02–1.92), cervical cancer awareness (aOR = 5.04, 95% CI: 3.48–7.28), HPV vaccine awareness (aOR = 21.31, 95% CI: 15.35–29.60), and concern for partner’s cervical cancer risk (aOR = 1.75, 95% CI: 1.23–2.49). Factors significantly associated with HPV vaccine awareness included: knowing someone affected by cancer (aOR = 1.58, 95% CI: 1.18–2.13), cervical cancer awareness (aOR = 2.43, 95% CI: 1.78–3.33), HPV awareness (aOR = 19.84, 95% CI: 14.39–27.36), concern for partner’s cervical cancer risk (aOR = 1.47, 95% CI: 1.47–2.91), perceiving being less likely to be infected with HPV (aOR = 1.48, 95% CI: 1.06–2.06), and having received school-based health education on HPV/vaccine (aOR = 2.27, 95% CI: 1.67–3.08).

Awareness of HPV and HPV vaccine among junior high school boys in Zhejiang province is low. Targeted interventions, particularly school health programs emphasizing HPV and vaccine knowledge, male HPV risks, the benefits of vaccination, and partner protection, are crucial to improve vaccine uptake in this population.