This study compared the willingness to receive human papillomavirus (HPV) vaccination and the influencing factors between male and female university students who had never been vaccinated against HPV in China. University students were recruited from seven universities in China. A self‐administered questionnaire was used to collect information about demographic characteristics, willingness to HPV vaccination, and possible influencing factors including demographics, knowledge, and attitude toward HPV vaccination. The χ² test was used to test the difference between males and females' knowledge and attitudes to HPV vaccination. Multivariate logistic regression was employed to detect the factors associated with willingness to HPV vaccination. A total of 7335 university students participated in the survey (3570 males and 3765 females). Over 70% of the participants had previously received sex education and knowledge. The average age of sexual debut was 17.5 years old. More male students reported acceptance of premarital sex than female students did (χ² = 708.458, p < 0.001). Female students had better knowledge and attitudes to HPV in general, while male students perceived a higher chance of being infected by HPV compared with female students (χ² = 6.047, p = 0.014). The level of knowledge (male: adjusted odds ratio [AOR] = 1.935, 95% confidence interval [CI]:1.516–2.470; female: AOR = 1.227, 95% CI: 1.055–1.428) and receiving sex education (male: AOR = 1.414, 95% CI: 1.109–1.804; female: AOR = 1.289, 95% CI: 1.064–1.562) were indicators of the HPV vaccination willingness for both genders. For male students, those who had ever inoculated optional self‐paid vaccines were more likely to receive the HPV vaccine than those who had not (AOR = 1.567, 95% CI: 1.242–1.977). Female students were more willing to be vaccinated against HPV, if they had higher living expenses (AOR = 1.395 and 3.717, 95% CI: 1.071–1.426 and 1.776–7.752), relatives or friends had certain cancer (AOR = 1.290, 95% CI: 1.095–1.518), ever had sexual experiences (AOR = 2.628, 95% CI: 1.788–3.863), and had ever consulted on HPV vaccination issues (AOR = 1.612, 95% CI: 1.367–1.901). In China, more active education should be provided to improve university students' knowledge and attitudes on HPV and HPV vaccination. Including HPV vaccine uptake for both males and females at recommended ages in National Immunization Program would be the most cost‐effective way to prevent HPV infection.

Summary: Background: Symptoms of psychiatric, neurological, and physical illnesses with post-COVID syndrome could increase suicidal ideation (SI) and behavior in Corona Virus Disease 2019 (COVID-19) survivors. However, information on the level of SI among COVID-19 survivors in China is still limited. Aim: To assess the prevalence and risk factors of SI among COVID-19 survivors in Wuhan, China. Design: The cross-sectional study was carried out among former COVID-19 patients in Jianghan District (Wuhan, China) from June 10 to July 25, 2021. Methods: SI, fatigue, stigma, sleep disorder, resilience, peace of mind, and social support of the participants were measured by the SI-related item, Fatigue Scale (FS-14), short version of COVID-19 Stigma Scale, Pittsburgh Sleep Quality Index (PSQI), The Peace of Mind Scale (PoM), The Resilience Style Questionnaire (RSQ) and two single separate items for measuring social support. Logistic regression was utilized to identify associated factors of SI. Mediation analysis was performed to assess the potential mechanisms between psychological factors and SI. Results: A total of 1,297 participants were included in this study. 6.7% of them reported SI. Marriage (AOR = 0.389, P = 0.003) and peace of mind (AOR = 0.854, P < 0.001) were negatively associated with SI. History of psychological or emotional counseling before COVID-19 infection (AOR = 1.889, P = 0.049), fatigue (AOR = 1.110, P = 0.007), higher self-reported COVID-19 related stigma (AOR = 1.054, P = 0.003) and sleep disorder (AOR = 1.112, P = 0.001) were positively associated with SI. Conclusions: Consideration should be taken into account to develop appropriate alleviating measures such as mindfulness-based cognitive therapy to reduce the rates of SI among COVID-19 survivors and improve their resilience to cope with the personal impact of the COVID-19 pandemic.

This study is intended to assess the prevalence of depression and anxiety in individuals who had recovered from COVID-19 and been discharged from hospital (RD hereafter) in Wuhan, China, and to explore the factors associated with these mental disorders. Participants of this study were the RD who were infected at the beginning of the outbreak from 13 communities in Jianghan District of Wuhan City, Hubei Province, China by convenience sampling in mid-2021. The Generalized Anxiety Disorder Questionnaire, the Patient Health Questionnaire, the Short Version of COVID-19 Stigma Scale, the Peace of Mind Scale, the Resilience Style Questionnaire, and the Perceived Social Support Questionnaire were used to collect relevant information of the participants. Descriptive analyses, Pearson correlation analysis, and logistic regression analysis were used to describe and analyze the data and to examine the factors associated with the mental health status of this population. In total, we recruited 1601 participants from 3059 COVID-19 patients, and 1541 participants completed the questionnaire survey, with a response rate of 96.25%. Finally, 1297 participants met the inclusion and exclusion criteria in this study, of whom 28.8% and 37.9% reported mild to severe levels of anxiety and depression symptoms. Perceived better mental health status during hospitalization, higher frequency of alcohol use per week, peace of mind, higher education level, and resilience were negatively associated with anxiety, while stigma and history of psychological or emotional counseling before infection was positively associated with anxiety. More severe clinical classification of COVID-19 and stigma (AOR = 1.057, P<0.001) were both positively associated with depression, while perceived better mental health status during hospitalization (AOR = 0.564, P<0.001), higher frequency of alcohol use per week (AOR = 0.462, P = 0.004), peace of mind (AOR = 0.857, P<0.001), and social support (AOR = 0.972, P = 0.034) were negatively associated with depression. Tailored interventions on reducing stigma, enhancing mindfulness and social support should be taken into account to alleviate anxiety and depression among RD.

Background: Although patients recovered from COVID-19 already have immunity gained from natural infection, they are still at risk of reinfection due to the emergence of new variants of COVID-19 and the diminishing of naturally acquired immunity over time. Vaccination is associated with efficacious protection against COVID-19 infection and could boost infection-acquired immunity; however, various COVID-19 survivors have not been vaccinated due to vaccine hesitancy.Objective: The aim of this study was to investigate COVID-19 vaccine hesitancy and related factors among COVID-19 survivors.Methods: A cross-sectional questionnaire survey was conducted among patients who recovered from COVID-19 infection in Wuhan, China, between June 10 and July 25, 2021. The questionnaire included sociodemographic information, items on COVID-19 infection, the COVID-19 vaccine hesitancy scale based on the 3Cs (complacency, convenience, and confidence) model, trust in vaccine manufacturers and health facilities, and reasons for the decision to accept COVID-19 vaccination. Multivariate logistic regression analysis was used to assess the factors influencing COVID-19 vaccine hesitancy.Results: Among the 1422 participants, 538 (37.8%) were not vaccinated against COVID-19. The COVID-19–recovered patients who self-reported having a current unhealthy status expressed more hesitancy about the COVID-19 vaccine than those who perceived themselves to be healthy (odds ratio [OR] 0.45, 95% CI 0.28-0.71). Compared to the asymptomatic patients, patients with mild symptoms were more likely to receive a COVID-19 vaccine (OR 1.67, 95% CI 1.02-2.82). Regarding the 3Cs model, high complacency (P=.005) and low convenience (P=.004) were significant negative factors for COVID-19 vaccination. Trust in vaccine manufacturers and health facilities was a significant positive factor for COVID-19 vaccination (OR 1.14, 95% CI 1.09-1.19). “Self-needs” was the main reason for patients to receive the COVID-19 vaccine, whereas “already have antibodies and do not need vaccination” was the main reason for patients to not receive the COVID-19 vaccine.Conclusions: Among the three major factors of vaccine hesitancy, complacency proved to be the most notable among COVID-19–recovered patients. Therefore, educational campaigns can focus on raising the awareness of risk of infection and the benefits of vaccination to reduce complacency toward vaccination among this population. In particular, for individuals who have recovered from COVID-19, improving factors related to convenience such as transportation, the environment of vaccination, and providing door-to-door service was also deemed necessary to facilitate their vaccination. In addition, addressing the concerns about vaccination of COVID-19–recovered patients could foster trust and promote their uptake of vaccination.