Lived experiences, reproductive concerns, and unmet supportive care needs among reproductive-aged women with persistent HPV infection in China: a qualitative study

Persistent human papillomavirus (HPV) infection is a major risk factor for cervical precancerous lesions and cancer. Reproductiveaged women in China with persistent HPV infection experience substantial psychosocial distress, reproductive anxiety, and unmet care needs under unique cultural and healthcare contexts. However, high-quality qualitative evidence focusing on this population remains limited.

This study aimed to explore the lived experiences, reproductive concerns, and unmet supportive care needs of women aged 20–45 years with persistent HPV infection — persistent HPV infection is strictly defined as two or more consecutive positive HPV tests separated by an interval of ≥ 12 months — in China to inform patient-centered nursing interventions. A qualitative descriptive design was adopted. Purposive sampling was used to recruit women with persistent HPV infection (defined as two or more consecutive positive HPV tests over a 12-month period) from the gynecology outpatient department of a tertiary hospital in Chongqing, China.

Semi-structured, in-depth interviews were conducted December 2025 to March 2026, and data were analyzed thematically using Braun and Clarke’s six-phase framework. Twenty women participated (13 from urban areas and 7 from rural areas). Five core themes were identified: (1) Emotional distress and chronic uncertainty; (2) Reproductive health concerns and fertility-related conflicts; (3) Perceived stigma and relational strain; (4) Unmet information and supportive care needs; (5) Cultural and healthcare contextual challenges.

Participants reported intense anxiety about cancer progression, fears about conception and vertical transmission, high levels of disease stigma, insufficient personalized education, lack of psychological and peer support, and confusion regarding traditional Chinese medicine and online health information. Reproductive-aged women with persistent HPV infection receiving care at a Chongqing tertiary hospital described multifaceted psychological, reproductive, and social challenges shaped by local intergenerational fertility norms observed within this sample. Nursing interventions should prioritize tailored education, integrated reproductive counseling, psychological support, stigma reduction, and family-centered care.

These findings fill an evidence gap and provide practical guidance for optimizing supportive care in clinical nursing practice. This work was supported by the Nursing Backbone Project of the Second Affiliated Hospital of Chongqing Medical University (Grant No. HL2024-08), and the National Key Clinical Specialty (Clinical Nursing) Construction Project of China, and the authors sincerely thank the staff of the Department of Gynecology, The Second Affiliated Hospital of Chongqing Medical University, for their valuable assistance in data collection, and all participants for their valuable contributions to this study.

This study was supported by the Nursing Backbone Project of the Second Affiliated Hospital of Chongqing Medical University (Grant No. Department of Gynecology, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China Yan Shi, Zhimei Chen, Hailan He & Meichen Weng Nursing Department, The Second Affiliated Hospital of Chongqing Medical University, No. 74 Linjiang Road, Yuzhong District, Chongqing, 400010, China This study was approved by the Ethics Committee of the Second Affiliated Hospital of Chongqing Medical University (Approval No. 2025001), and it was conducted in accordance with the principles of the Declaration of Helsinki. All participants provided written informed consent before participating in the interviews.