中国女大学生人乳头瘤病毒疫苗接种率及影响因素的Meta分析

陶廷素; 金辉; 倪亚娟

doi:10.16462/j.cnki.zhjbkz.2025.06.014

中国女大学生人乳头瘤病毒疫苗接种率及影响因素的Meta分析

doi: 10.16462/j.cnki.zhjbkz.2025.06.014

东南大学公共卫生学院流行病与卫生统计学系，东南大学公共卫生学院环境医学工程教育部重点实验室，南京 210009

基金项目:

江苏省社会发展项目 BE2021739

新型冠状病毒感染肺炎中医药应急专项 2021ZYLCYJ05

详细信息

通讯作者:
金辉，E-mail: jinhui_hld@163.com

中图分类号: R181.3;R186
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出版历程
- 收稿日期: 2025-01-06
- 修回日期: 2025-04-26
- 网络出版日期: 2025-07-07
- 刊出日期: 2025-06-10

Human papillomavirus vaccination rate and influencing factors among female university students in China: a Meta-analysis

Department of Epidemiology and Health Statistics, Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China

Funds:

Social Development Project of Jiangsu Province BE2021739

Traditional Chinese Medicine Emergency Treatment for Novel Coronavirus Pneumonia 2021ZYLCYJ05

More Information

Corresponding author: JIN Hui, E-mail: jinhui_hld@163.com

摘要

摘要: 目的了解中国女大学生人乳头瘤病毒(human papillomavirus, HPV)疫苗接种率及影响因素。方法检索2016年以后女大学生HPV疫苗接种相关文献。使用Stata 17.0软件进行Meta分析。结果共纳入24项研究，总样本量为40 320人。Meta分析显示，中国女大学生HPV疫苗接种率为7.56%(95% CI：5.27%~10.21%)。影响因素包括城市户籍(OR=2.50, 95% CI：1.79~3.49)、母亲大专及以上学历(OR=1.59, 95% CI：1.13~2.24)、父亲大专及以上学历(OR=1.56, 95% CI：1.16~2.11)、性行为(OR=1.63, 95% CI：1.38~1.92)、知晓HPV疫苗(OR=4.72, 95% CI：3.26~6.28)及对HPV疫苗认知良好(OR=3.96, 95% CI：1.77~8.87)。结论中国女大学生HPV疫苗接种率较低，对HPV疫苗的认知是疫苗接种的重要因素。应加强宣传和教育，提高女大学生对HPV疫苗的认知，以推进HPV疫苗的普及和应用。
- 人乳头瘤病毒疫苗 /
- 接种率 /
- 女大学生
Abstract: Objective This study aimed to investigate the human papillomavirus (HPV) vaccination rate and its influencing factors among female university students in China. Methods We used Stata 17.0 software to conduct a Meta-analysis of articles published since 2016 on HPV vaccination among female university students. Results Twenty-four studies with a total sample size of 40 320 individuals were included. The HPV vaccination rate was 7.56% (95% CI: 5.27%-10.21%). The influencing factors included household registration in an urban area (OR=2.50, 95% CI: 1.79-3.49), mother with a college degree or above (OR=1.59, 95% CI: 1.13-2.24), father with a college degree or above (OR=1.56, 95% CI: 1.16-2.11), sexual behavior (OR=1.63, 95% CI: 1.38-1.92), HPV vaccine awareness (OR=4.72, 95% CI: 3.26-6.28), and good knowledge of HPV vaccine (OR=3.96, 95% CI: 1.77-8.87). Conclusions The HPV vaccination rate is low among female university students in China. Knowledge of HPV vaccine is an important factor influencing vaccination. Publicity and education should be strengthened to raise awareness of the HPV vaccine among female college students, promoting its widespread application.
- Human papillomavirus vaccine /
- Vaccination /
- Female college students

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图 1 文献筛选流程

Figure 1. Flow diagram of study selection

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图 2 HPV疫苗接种率的森林图

HPV：人乳头瘤病毒; I²: 异质性指数。

Figure 2. Forest plot of HPV vaccination rate

HPV: human papillomavirus; I²: I-squared statistic.

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图 3 HPV疫苗接种率的漏斗图

HPV：人乳头瘤病毒。

Figure 3. Funnel plot of HPV vaccination rate

HPV: human papillomavirus.

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表 1 纳入研究基本特征

Table 1. Characteristics of included studies

纳入研究 Included study	地区 Region	调查年份 Survey year	抽样方法 Sampling method	样本量 Sample size	接种率 Vaccination rate/%	影响因素 Influencing factor	质量评分/分 Quality score/score
张肖肖等(2021)^[10] Zhang XX, et al(2021)^[10]	全国范围 Nationwide	2019	多阶段随机 Multi-stage random	3 007	2.96	③⑦	6
贾鑫华等(2019)^[11] Jia XH, et al(2019)^[11]	江西 Jiangxi	2018	单纯随机 Simple random	2 091	3.30	―	6
石晶等(2023)^[12] Shi J, et al(2023)^[12]	北京 Beijing	2019	整群抽样 Cluster sampling	825	2.91	―	4
何小桃等(2022)^[13] He XT, et al(2022)^[13]	广西 Guangxi	2022	便利抽样 Convenience sampling	628	4.14	―	5
赖江宜等(2019)^[6] Lai JY, et al(2019)^[6]	浙江 Zhejiang	2019	分层抽样 Stratified sampling	220	3.60	③	5
冯澜等(2021)^[14] Feng L, et al(2021)^[14]	广西 Guangxi	2020	便利抽样 Convenience sampling	337	21.66	―	8
胡淑怡等(2022)^[7] Hu SY, et al(2022)^[7]	上海 Shanghai	2020	整群抽样 Cluster sampling	1 992	8.38	①②③④⑤⑧	6
李君等(2021)^[15] Li J, et al(2021)^[15]	全国范围 Nationwide	2019	分层抽样 Stratified sampling	2 295	10.35	①②	8
范伟超等(2022)^[16] Fan WC, et al(2022)^[16]	广东 Guangdong	2020	便利抽样 Convenience sampling	587	14.82	―	8
邓景景等(2021)^[17] Deng JJ, et al(2021)^[17]	江苏 Jiangsu	2019	分层抽样 Stratified sampling	2 169	7.98	⑥	5
刘敏等(2021)^[18] Liu M, et al(2021)^[18]	山东 Shangdong	2020	分层抽样 Stratified sampling	408	21.32	―	8
陈慧等(2021)^[19] Chen H, et al(2021)^[19]	四川 Sichuan	2020	便利抽样 Convenience sampling	462	3.46	―	6
肖玲等(2022)^[20] Xiao L, et al(2022)^[20]	湖北 Hubei	2021	分层抽样 Stratified sampling	6 459	13.30	―	8
陈虹君等(2023)^[21] Chen HJ, et al(2023)^[21]	新疆 Xinjiang	2022	便利抽样 Convenience sampling	1 164	11.77	②③④⑤⑥⑦	4
郑浩等(2021)^[22] Zheng H, et al (2021)^[22]	浙江 Zhejiang	2021	分层抽样 Stratified sampling	1 092	3.29	―	5
张希等(2021)^[23] Zhang X, et al(2021)^[23]	山西、四川 Shanxi, Sichuan	2020	便利抽样 Convenience sampling	975	2.15	―	7
Liu YN, et al(2020)^[3]	北京 Beijing	2018	单纯随机 Simple random	453	9.49	―	8
You DY, et al(2020)^[2]	全国范围 Nationwide	2019	便利抽样 Convenience sampling	4 220	10.97	①②③④⑤⑧	5
Deng C, et al(2021)^[24]	全国范围 Nationwide	2019	便利抽样 Convenience sampling	755	3.58	―	7
Liu YN, et al(2021)^[8]	北京 Beijing	2018	便利抽样 Convenience sampling	589	8.66	③⑥⑧	7
Ma Y, et al(2021)^[1]	广东 Guangdong	2018	分层抽样 Stratified sampling	3 832	3.50	①⑥⑦⑧	6
Si MY, et al(2021)^[25]	全国范围 Nationwide	2020	便利抽样 Convenience sampling	3 867	2.64	―	7
Huang Y, et al(2022)^[26]	全国范围 Nationwide	2022	分层抽样 Stratified sampling	1 438	34.21	―	7
Wang H, et al(2022)^[27]	河南 Henan	2020	便利抽样 Convenience sampling	455	1.32	―	7
注：①户籍地; ②民族; ③专业; ④父亲学历; ⑤母亲学历; ⑥性行为; ⑦知晓HPV疫苗; ⑧HPV疫苗认知良好; “―”，无法获取。 Note：① Household registration; ② Nationality; ③ Major; ④ Father′s education; ⑤ Mother′s education; ⑥ Sexual behavior; ⑦ Awareness of HPV vaccine; ⑧ Good knowledge of HPV vaccine; "―"，unavailable.

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表 2 HPV疫苗接种率的亚组分析和Meta回归分析

Table 2. Subgroup and Meta-regression analyses of HPV vaccination rate

亚组 Subgroup	研究数量 Number of study	接种率 Vaccination rate/% (95% CI)	异质性Heterogeneity		β值 value	P值 value
亚组 Subgroup	研究数量 Number of study	接种率 Vaccination rate/% (95% CI)	I²/%	P值value	β值 value	P值 value
地区Region
东部Eastern	10	7.61(5.07~10.62)	96.75	＜0.001	①
中西部Central and western	8	6.40(2.90~11.13)	98.61	＜0.001	-0.688	0.091
全国范围Nationwide	6	9.07(3.33~17.24)	99.57	＜0.001	-0.306	0.539
调查年份Survey year
2018	4	5.73(3.42~8.58)	94.14	＜0.001	①
2019	7	5.84(3.24~9.14)	98.00	＜0.001	0.081	0.871
2020	8	7.76(3.81~12.95)	98.28	＜0.001	0.148	0.748
2021	2	11.48(10.77~12.21)	99.53	＜0.001	-0.234	0.713
2022	3	14.73(2.30~35.17)	99.52	＜0.001	1.519	0.008
年龄组/岁Age group/ years
≤22	4	4.61(1.43~9.42)	97.03	＜0.001	―	―
>22	2	18.25(15.68~20.97)	79.09	＜0.001	―	―
年级Grade
大一~大二First and second year	8	4.38(2.33~7.03)	97.26	＜0.001	―	―
大三及以上Third year and above	4	10.45(4.54~18.38)	97.84	＜0.001	―	―
抽样方法Sampling method
随机Random	13	8.35(4.96~12.52)	99.16	＜0.001	-0.231	0.584
非随机Nonrandom	11	6.66(3.85~10.16)	98.05	＜0.001	①
样本量Sample size
≤1 000	12	6.85(3.83~10.64)	96.76	＜0.001	①
＞1 000	12	8.27(5.01~12.26)	99.32	＜0.001	0.542	0.188
质量评分/分Quality score/score
≤7	18	5.60(3.40~8.32)	98.81	＜0.001	①
＞7	6	7.56(5.27~10.21)	98.85	＜0.001	1.612	< 0.001
注：HPV，人乳头瘤病毒; I², 异质性指数。 ①作为参考水平; “―”，数据无法获取，因为提供年龄及年级具体信息的研究较少，数据缺失较多，所以无法纳入多因素的Meta回归分析，只能进行亚组分析。 Note: HPV, human papillomavirus; I², I-squared statistic. ① Reference level; "―"，data cannot be obtained, due to the lack of research providing specific information on age and grade level, there are many missing data, so it is not possible to include multiple factor Meta regression analysis, and only subgroup analysis can be conducted.

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表 3 HPV疫苗接种影响因素分析

Table 3. Analysis of factors influencing HPV vaccination

影响因素Influencing factor	研究数量 Number of study	异质性 Heterogeneity		OR值value (95% CI)	P值 value
影响因素Influencing factor	研究数量 Number of study	I²/%	P值value	OR值value (95% CI)	P值 value
城市Urban	4	75.52	0.007	2.50(1.79~3.49)	＜0.001
汉族Han ethnic	4	83.76	＜0.001	1.10(0.65~1.86)	0.719
医学专业Medical	6	20.67	0.278	1.13(0.97~1.31)	0.118
父亲学历(大专及以上) Father′s education level (college or above)	3	63.27	0.066	1.56(1.16~2.11)	0.004
母亲学历(大专及以上) Mother′s education level (college or above)	3	69.03	0.040	1.59(1.13~2.24)	0.008
性行为Sexual behavior	4	44.97	0.142	1.63(1.38~1.92)	＜0.001
知晓HPV疫苗Awareness of HPV vaccine	3	64.85	0.058	4.72(3.26~6.82)	＜0.001
HPV疫苗认知良好Good knowledge of HPV vaccine	4	92.74	＜0.001	3.96(1.77~8.87)	0.001
注：HPV，人乳头瘤病毒; I², 异质性指数。 Note：HPV, human papillomavirus; I², I-squared statistic.

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