Determinants of HPV Vaccine Uptake in Women in the United States: A Scoping Review of Socioecological Influences.

The human papillomavirus (HPV) vaccine is a critical tool in cervical cancer prevention, yet uptake remains suboptimal in the United States. This scoping review examines the multilevel determinants influencing HPV vaccine uptake among women, identifying key barriers and facilitators to vaccination. Using the socioecological model (SEM), this review categorizes factors affecting vaccine uptake across individual, interpersonal, community, and societal levels, providing a structured framework for analyzing multilevel influences. Studies published in English between 2009 and 2023 were systematically reviewed, focusing on HPV vaccine uptake determinants among U.S. females aged 9 to 45, aligning with vaccination guidelines. Fifteen studies were included in the final analysis. However, studies including older adults (up to 80 years) were analyzed to explore vaccine awareness trends and decision-making beyond the routinely recommended age groups. Excluded were studies focusing solely on healthcare providers' perspectives, those conducted outside the United States, and non-English language publications. A comprehensive search of PsycINFO, CINAHL, and PubMed was conducted using relevant keywords to ensure a thorough literature review. Findings indicate that multiple interrelated factors, including misinformation, healthcare provider recommendations, socioeconomic status, insurance coverage, cultural beliefs, and geographic disparities, shape vaccine hesitancy. Key barriers include a lack of provider recommendations, financial constraints, and concerns about vaccine safety, while facilitators include strong provider communication and targeted educational interventions. Addressing these barriers through multilevel interventions such as provider training, policy reforms, and community-driven outreach will be essential for increasing HPV vaccine uptake and reducing cervical cancer disparities among underserved populations.