Human Papillomavirus (HPV) and HPV Vaccine Awareness Among U.S. Adults With Depression and Anxiety: A Nationally Representative Analysis Using Health Information National Trends Survey (HINTS) Data

Background Depression and anxiety are highly prevalent in the U.S. and can hinder engagement in preventive health services. Individuals affected by these conditions may have reduced motivation and lower health literacy, increasing their vulnerability to missed preventive-care opportunities such as vaccination. Awareness of human papillomavirus (HPV) and the HPV vaccine is crucial for cancer prevention but remains underexplored among adults with mental-health conditions. Methods We analyzed data from the Health Information National Trends Survey (HINTS) 5, Cycles 1-4 (2017-2020), to assess HPV and HPV-vaccine awareness among U.S. adults aged 18-44 with self-reported depression and/or anxiety. Weighted descriptive statistics, chi-square (χ²) tests, and multivariable logistic-regression models were used to assess awareness and associated sociodemographic and health-related factors. The primary aim was to estimate the prevalence of HPV and HPV-vaccine awareness, while the secondary aim was to identify associated sociodemographic and health-related predictors. Awareness was defined using binary ("yes"/"no") responses to HINTS items, and mental-health exposure was defined as self-reported physician-diagnosed depression and/or anxiety. Results The analytic sample included 1,105 adults, most of whom were female (n = 709; 64.1%), aged 18-34 years (n = 623; 56.4%), White (n = 753; 68.2%), and urban residents (n = 956; 86.5%). Approximately one-third (n = 372; 33.5%) held a college degree, and n = 384 (34.8%) reported annual income ≥ $75,000. Overall, 944 (85.4%) were aware of HPV, and 839 (75.9%) were aware of the HPV vaccine. Higher educational attainment (χ² = 46.7, p < 0.001) and female sex (χ² = 6.88, p = 0.009) were associated with greater awareness, whereas Hispanic ethnicity (χ² = 9.4, p = 0.024) and male sex were linked to lower awareness. Participants with two or more comorbidities showed higher HPV awareness (χ² = 6.11, p = 0.047) but not vaccine awareness (χ² = 2.34, p = 0.311). Conclusions While overall awareness of HPV is high, disparities persist by sex, education, and ethnicity among adults with depression and/or anxiety. Integrating culturally tailored and literacy-appropriate HPV education into mental-health and primary-care settings may promote equitable vaccine awareness and uptake.