Invisible burden: Women's gendered health labor in promoting male HPV vaccination in China

The expansion of human papillomavirus (HPV) vaccination to males represents an important shift in public health in China. However, promotion of male HPV vaccination may involve female partners as information seekers, communicators, and facilitators, raising questions about the gendered distribution of health-related responsibility. Drawing on survey data from 402 Chinese women, this study examines how media exposure and Health Belief Model (HBM) constructs are associated with women's intention to promote male HPV vaccination. Structural equation modeling showed that media exposure was positively associated with both self-efficacy (β = 0.228, p < .001) and perceived barriers (β = 0.295, p < .001). Perceived benefits (β = 0.402, p < .001) and self-efficacy (β = 0.219, p < .001) were the strongest positive predictors of vaccination promotion intention, whereas perceived barriers were not significantly associated with intention (β = -0.073, p = .087). These findings suggest that women's partner-directed vaccination promotion may be shaped by both cognitive evaluations and gendered caregiving expectations. The study extends HBM research by applying it to other-oriented vaccination promotion within intimate relationships and provides indirect evidence consistent with the invisible health labor framework. Public health communication and vaccination policy should address men directly and reduce reliance on women's unpaid health promotion work.