HPV Knowledge, Anxiety and Vaccine Acceptance Among Adults in Saudi Arabia: A Cross-Sectional Study

Human Papillomavirus (HPV) causes various infections and serious health complications, including cancer. Vaccine hesitancy and anxiety continue to hinder its control. This study assessed HPV-related knowledge, infection anxiety, and vaccine hesitancy among the adult population in Saudi Arabia (including both citizens and non-Saudi residents), as well as exposure to skin and genital warts. A total of 2014 adults (≥ 18 years) completed an online survey covering demographics, HPV knowledge, and the modified Generalized Anxiety Disorder-7 (GAD-7) scale adapted to measure HPV-specific concerns. Skin warts were common, particularly among females aged 21-50 years, whereas genital warts were less frequent, peaking in the 21-40 age group. Anxiety was highest among participants aged 18-30 years. Notable knowledge gaps existed regarding HPV transmission and vaccine benefits. Younger participants showed better understanding, but males were less aware of vaccine availability. Healthcare professionals and medical students demonstrated superior knowledge. Multinomial logistic regression showed that gender was the only significant predictor of vaccine willingness (p < 0.001). Males were more likely than females to say "yes" (aOR = 1.409, p = 0.009) and "no" (aOR = 1.633, p < 0.001), indicating that females were disproportionately hesitant ("not sure"). A high school education (vs. a medical background) was associated with lower willingness (aOR = 0.631, p = 0.030). Overall, the findings emphasize the need for targeted educational campaigns to improve HPV awareness and promote vaccine acceptance.