Abstract

Background: Human papillomavirus (HPV) vaccine has been proven a safe, necessary, and effective measure against HPV infection. However, HPV vaccine uptake remains limited among university students in China. This study investigated HPV vaccine intent among university freshmen in the largest university town in China. Methods: A cross-sectional online survey was conducted among unvaccinated female and male freshmen attending seven universities in Songjiang University Town, Shanghai, during 2024–2025. The questionnaire collected sociodemographic characteristics, HPV and HPV-vaccine-related knowledge, awareness, and vaccine intent. Factors associated with HPV vaccine intent were determined. Results: A total of 3397 valid questionnaires were collected, including female (60.02%) and male (39.98%) university freshmen. Overall, 76.12% were aware of HPV, 80.98% were aware of the HPV vaccine, and 84.31% expressed vaccine intent, with significantly higher rates among females than males (each p < 0.001). Socioeconomics, knowledge, awareness, sexual behavior, and HPV testing history were significantly associated with vaccine intent (each p < 0.05). The most common reason for no intent was perceived low risk of HPV-related diseases (40.53%). The most expected improvement measures were regulatory confirmation of vaccine safety and effectiveness (37.71%) and healthcare professionals’ recommendations (37.71%), with no gender difference (each p > 0.05). Notably, 4.00% refused HPV vaccination, regardless of improvement measures. Additionally, most respondents preferred financial supporting policies, regardless of gender or vaccine intent (each p > 0.05). Conclusions: University freshmen showed the disparity between high awareness/intent and low knowledge. Financial considerations may influence HPV vaccination decisions. Thus, improving knowledge, particularly among males, and providing financial support may enhance HPV vaccine intent.

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