Latent profiles of HPV vaccine-related health beliefs and their associations with vaccination intention among college students: a global health perspective

Purpose Human papillomavirus (HPV) vaccination is an effective strategy for preventing cervical cancer and other HPV-related diseases, yet uptake among young adults remains suboptimal. College students may hold heterogeneous vaccine-related beliefs that are not fully captured by variable-centered analyses. This study aimed to identify latent profiles of HPV vaccine-related health beliefs among Chinese college students and examine their associations with HPV vaccine knowledge, social support and perceived service accessibility, e-health literacy, vaccination intention, and uptake. Methods A cross-sectional survey was conducted among 2,755 Chinese college students recruited from five universities across Shandong and Guangdong provinces. HPV vaccine-related health beliefs were measured across five Health Belief Model dimensions: perceived susceptibility, perceived severity, perceived barriers, perceived benefits, and self-efficacy. The Information-Motivation-Behavioral Skills model guided the selection of HPV vaccine knowledge, social support and perceived service accessibility, and e-health literacy as correlates. Latent profile analysis was used to identify belief-based subgroups. Between-profile differences were examined using t -tests and chi-square tests, with effect sizes reported. Logistic regression was used to identify factors associated with membership in the more favorable profile. Results Two profiles were identified: a high-barrier/moderate-benefit profile (74.0%) and a high-benefit/low-barrier profile (26.0%). Compared with the high-barrier/moderate-benefit profile, the high-benefit/low-barrier profile had higher HPV vaccine knowledge (6.54 vs. 4.61), social support and perceived service accessibility (3.55 vs. 3.26), e-health literacy (4.00 vs. 3.51), vaccination intention (3.96 vs. 3.43), and vaccination uptake (24.6% vs. 15.3%; all p < 0.001). Female sex, active information seeking, higher HPV vaccine knowledge, and higher e-health literacy were associated with greater odds of belonging to the high-benefit/low-barrier profile. E-health literacy showed the strongest adjusted association. Conclusion Chinese college students showed distinct HPV vaccine-related health belief profiles. Most students recognized some benefits of HPV vaccination but reported substantial barriers. HPV vaccine knowledge, active information seeking, and e-health literacy were associated with more favorable belief profiles and may be considered potential targets for future health education interventions. Given the cross-sectional design, causal relationships cannot be inferred.