Abstract: Objective To assess the cognition, vaccination willingness and behavior of human papillomavirus (HPV) vaccine among adult women in Shenzhen, and to identify influencing factors. Methods A multi-stage sampling method was employed to recruit women aged 18-<46 years from 20 communities in Shenzhen. A structured questionnaire was administered to collect data on sociodemographic characteristics, HPV knowledge, and vaccination status. Multinomial logistic regression was used to analyze factors associated with vaccination willingness and behavior. Results Among 1 140 participants (mean age: 30.9 years), 47.1% (537/1 140) held a college degree or higher. Awareness rates were 80.0% (912/1 140) for HPV and 96.6% (1 101/1 140) for HPV vaccines. Overall, 77.2% (880/1 140) demonstrated adequate HPV-related knowledge. Regarding vaccination stages: 40.9%(466/1 140) were in action stage, 44.7%(510/1 140) were in the intention stage and 14.4%(164/1 140) were in the no-intention stage. Comparison between the action and intention stage showed that women aged ≥26 years (26-<36: OR=2.149; 36-<46: OR=2.349), college-educated(OR=2.152), HPV-aware(OR=2.533) and knowledge-qualified (OR=2.027) were more likely to be in action, while those working in service/industries workers (OR=0.565), and unemployed individuals (OR=0.420) were more likely to be in the intention stage (all P<0.05). Comparison between the intention and no-intention stage showed that women aged 36-<46 years (OR=2.503) were more likely to be in the no-intention stage, while women with household incomes of 5 000-10 000 CNY/month (OR=0.616), HPV vaccine-aware (OR=0.354) and knowledge-qualified(OR=0.294) were more likely to be in the intention stage(all P<0.05). Conclusions Adult women in Shenzhen exhibit high cognition of HPV vaccines, with high vaccination rate and willingness. And the willingness and behavior are associated with age, education level, household income, HPV knowledge, and vaccine awareness.

Key words: Human papillomavirus vaccine, Cognition, Vaccination willingness, Vaccination behavior, Influencing factor