Digital Health Misinformation and HPV Vaccine Awareness Among U.S. Adults: A National HINTS Analysis

Background Human papillomavirus (HPV) vaccination is an effective cancer prevention strategy, yet HPV vaccine awareness remains uneven across sociodemographic groups. In the current digital information environment, awareness may be shaped not only by access to health information but also by exposure to false or misleading health information, difficulty evaluating information accuracy, and echo-chamber dynamics on social media. Objective This study examined associations between perceived exposure to false or misleading health information on social media, difficulty determining whether social media health information is true or false, perceived echo-chamber exposure, and HPV vaccine awareness among U.S. adults. Methods We analyzed nationally representative Health Information National Trends Survey data using survey-weighted descriptive statistics and logistic regression models. The analytic sample included 2,371 respondents, representing a weighted population of 49.2 million U.S. adults. The outcome was HPV vaccine awareness. Primary predictors included perceived exposure to false or misleading health information on social media, difficulty determining whether social media health information was true or false, and perceived same-view health network exposure on social media. Models adjusted for age, sex, race/ethnicity, education, household income, rurality, and Census division. Results Overall, 60.37% of respondents reported HPV vaccine awareness. Most respondents reported encountering false or misleading health information on social media, with 45.57% reporting "some" and 32.83% reporting "a lot." In unadjusted models, greater perceived exposure to false or misleading health information was associated with higher odds of HPV vaccine awareness. After adjustment, respondents reporting "some" false or misleading health information had significantly higher odds of HPV vaccine awareness compared with those reporting none (AOR=2.40, 95% CI: 1.06-5.43), while the association for "a lot" was marginal (AOR=2.29, 95% CI: 0.97-5.38). Difficulty identifying true versus false social media health information and perceived echo-chamber exposure were associated with HPV vaccine awareness in unadjusted models but were attenuated after adjustment. HPV vaccine awareness was substantially higher among females and respondents with higher educational attainment, and lower among Hispanic, non-Hispanic Asian, and non-Hispanic other respondents compared with non-Hispanic White respondents. Conclusions HPV vaccine awareness is associated with both digital health information exposure and persistent sociodemographic inequities. Greater perceived exposure to misleading health information may reflect broader engagement with health-related content on social media, where accurate and inaccurate information coexist. Public health communication strategies should address misinformation vulnerability while expanding accurate, culturally responsive HPV vaccine messaging across digital platforms.