Factors influencing HPV vaccination behavior among Chinese women aged 18–45 years based on the information-motivation-behavioral skills model: a cross-sectional study

The human papillomavirus (HPV) vaccine can effectively prevent cervical cancer; however, the HPV immunization rates in China are inadequate. Current literature primarily focuses on adolescent HPV vaccination and neglects the vaccination behaviors and influencing factors in women aged 18–45 years, a high-risk cervical cancer population. This study aims to evaluate the current state of HPV vaccination among Chinese women aged 18–45 years and to comprehensively analyze its main influencing factors, using the Information-Motivation-Behavioral Skills (IMB) model. This cross-sectional survey included 653 women aged 18–45 years from Jingzhou City, Hubei Province, China, between January and March 2025, via convenience sampling. A self-designed questionnaire on HPV vaccination was employed to assess respondents' HPV vaccination behavior, as well as their associated knowledge, motivational factors, and behavioral skills. Furthermore, chi-square tests and independent-samples t-tests were performed to assess differences between vaccinated and unvaccinated groups. Moreover, hierarchical multiple logistic regression analysis was performed to identify characteristics correlated with HPV vaccination behavior. A total of 653 valid questionnaires were collected, and 265 respondents (40.6%) had received at least one dose of the HPV vaccine. Hierarchical multiple logistic regression analysis showed that women whose fathers held an associate degree or higher (OR = 2.116, P = 0.013), who received systematic medical education (OR = 1.681, P = 0.009), attained a postgraduate degree or higher (OR = 2.323, P = 0.042), had a monthly income of at least 2,000 yuan (OR = 1.872, P = 0.004), or were sexually active (OR = 1.837, P = 0.010) were significantly associated with HPV vaccination behavior. Regarding the IMB model dimensions, perceived severity (OR = 0.880, P < 0.001), perceived barriers (OR = 1.123, P < 0.001), social motivation (OR = 1.181, P < 0.001), and self-efficacy (OR = 1.060, P = 0.005) were also significantly correlated with vaccination behavior. The incorporation of the IMB model dimensions significantly improved the model's explanatory power (△Nagelkerke R 2 = 0.145). HPV vaccination coverage among adult women aged 18–45 years in China remains suboptimal. The study highlights the importance of strengthening HPV-related health education for this key population, reducing vaccination barriers, providing a supportive social environment, and increasing confidence in HPV vaccines to improve vaccination behavior.