Beyond infection status: a cross-sectional study of socioeconomic disparities, infection dynamics, and psychosocial burden among women with HPV in Luzhou, China

Human papillomavirus (HPV) infection entails oncologic risk as well as substantial psychosocial and quality-of-life (QoL) burden. data from Southwest China remain limited. This study aims to evaluate anxiety, depression, and quality of life among HPV-positive women in Luzhou, China. In this cross-sectional study, 441 HPV-positive women attending two tertiary hospitals (November 2023–September 2024) completed the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and a culturally adapted HPV Impact Profile (HIP). Clinically relevant anxiety and depression were defined as GAD-7 or PHQ-9 ≥ 5 (mild or greater). Multivariate binary logistic regression identified predictors; HIP construct validity was examined using confirmatory factor analysis (CFA). The prevalence of anxiety and depression symptoms among HPV-positive women was 40.36% and 41.72%, respectively. The HIP demonstrated excellent internal consistency (Cronbach’s α = 0.946) and acceptable fit (CFI 0.927; RMSEA 0.079). Quality of life analysis indicated the highest domain burden was Worry & Concern (66.73 ± 34.33). Lower monthly income emerged as a protective factor for both anxiety and depression. Key risk predictors for both anxiety and depression included HPV16/18 infection (OR = 3.11; OR = 2.76, respectively), shorter infection duration (OR = 5.77; OR = 7.24, respectively), and higher HIP domain scores (all p < 0.01). Reduced gravidity (≤ 1 pregnancy: OR = 2.832) and parity (≤ 1 birth: OR = 3.889; 2–3 births: OR = 3.056) were identified as specific risk factors for depression. Current smoking showed an inverse association with both anxiety and depression (OR = 0.350; OR = 0.324, respectively), though this requires cautious interpretation. Regression analyses further identified specific psychosocial domains, such as emotional impact and self-image, as significant predictors for these mental health conditions. Substantial psychosocial and QoL burden accompanies HPV infection in Southwest China, concentrated in worry, emotional distress, body image, relational, and healthcare interaction domains. Early, genotype-informed, culturally adapted psychosocial screening and counseling are warranted.