Beyond infection status: a cross-sectional study of socioeconomic disparities, infection dynamics, and psychosocial burden among women with HPV in Luzhou, China

Abstract

Background: Human papillomavirus (HPV) infection entails oncologic risk as well as substantial psychosocial and quality-of-life (QoL) burden. data from Southwest China remain limited. This study aims to evaluate anxiety, depression, and quality of life among HPV-positive women in Luzhou, China. Methods: In this cross-sectional study, 441 HPV-positive women attending two tertiary hospitals (November 2023–September 2024) completed the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and a culturally adapted HPV Impact Profile (HIP). Clinically relevant anxiety and depression were defined as GAD-7 or PHQ-9 ≥ 5 (mild or greater). Multivariate binary logistic regression identified predictors; HIP construct validity was examined using confirmatory factor analysis (CFA). Results: The prevalence of anxiety and depression symptoms among HPV-positive women was 40.36% and 41.72%, respectively. The HIP demonstrated excellent internal consistency (Cronbach’s α = 0.946) and acceptable fit (CFI 0.927; RMSEA 0.079). Quality of life analysis indicated the highest domain burden was Worry & Concern (66.73 ± 34.33). Lower monthly income emerged as a protective factor for both anxiety and depression. Key risk predictors for both anxiety and depression included HPV16/18 infection (OR = 3.11; OR = 2.76, respectively), shorter infection duration (OR = 5.77; OR = 7.24, respectively), and higher HIP domain scores (all p < 0.01). Reduced gravidity (≤ 1 pregnancy: OR = 2.832) and parity (≤ 1 birth: OR = 3.889; 2–3 births: OR = 3.056) were identified as specific risk factors for depression. Current smoking showed an inverse association with both anxiety and depression (OR = 0.350; OR = 0.324, respectively), though this requires cautious interpretation. Regression analyses further identified specific psychosocial domains, such as emotional impact and self-image, as significant predictors for these mental health conditions. Conclusions: Substantial psychosocial and QoL burden accompanies HPV infection in Southwest China, concentrated in worry, emotional distress, body image, relational, and healthcare interaction domains. Early, genotype-informed, culturally adapted psychosocial screening and counseling are warranted.