Human Papillomavirus (HPV) Infections in Women: A Narrative Review of Prevalence, Testing, and Prevention in Rural Areas of the United States, with a Focus on Arkansas

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a well-established etiological agent in the development of cervical, vulvar, vaginal, anal, and oropharyngeal cancers, particularly among women. While national efforts in HPV vaccination and cervical cancer screening have led to measurable declines in HPV-related morbidity in urban and well-resourced regions, rural communities continue to experience persistent disparities. These disparities are especially evident in states like Arkansas, where women in rural areas face disproportionately high rates of HPV infection, cervical cancer incidence, and mortality. Contributing factors include structural deficiencies in healthcare access, economic challenges, limited availability of gynecologic and preventive care, cultural stigma surrounding HPV vaccination, and gaps in public health outreach. This narrative review synthesizes contemporary research and public health data to evaluate HPV prevalence, testing practices, and prevention efforts among rural women in the U.S., with a particular focus on Arkansas. It examines barriers that hinder early detection and immunization, and it explores scalable, evidence-based interventions such as self-sampling HPV tests, mobile screening units, and community-based education campaigns that could bridge these gaps. Expanding access to HPV testing and vaccination through targeted, locally informed strategies holds promise in mitigating cervical cancer disparities and advancing equitable reproductive health outcomes for rural populations.