A structural equation modeling analysis of human papillomavirus preventive behaviors among women in Southwest Iran based on the health belief model

HPV contributes substantially to the global burden of cervical cancer and exhibits considerable genotypic diversity in southwestern Iran. Therefore, understanding the determinants of preventive behaviors is essential. Given the persistent gaps in awareness and uptake of preventive measures, this study employs the Health Belief Model and structural equation modeling to identify the psychological and demographic factors shaping women’s engagement in HPV preventive behaviors. A cross-sectional study was carried out among women attending four comprehensive health centers in Behbahan, southwest Iran (2024–2025). Demographic data and HBM-related constructs were assessed using a validated questionnaire. Confirmatory factor analysis and structural equation modeling were employed to evaluate measurement validity and examine predictors of HPV preventive behaviors. Among 820 women (mean age = 36.78 ± 8.95 years), perceived susceptibility, self-efficacy, and perceived barriers were significantly associated with HPV preventive behaviors. SEM showed excellent model fit (CFI = 0.96, RMSEA = 0.04) and identified significant effects of perceived susceptibility (β = 0.34, p < 0.001), self-efficacy (β = 0.31, p < 0.001), and perceived barriers (β = − 0.28, p < 0.001) on preventive behaviors. The findings highlight that psychological factors, particularly perceived susceptibility, self-efficacy, and perceived barriers, are significantly associated with women’s engagement in HPV preventive behaviors. Interventions addressing these factors may be associated with improved preventive practices in southwestern Iran.