Predicting Human Papillomavirus Infection in Women Based on Sexual Assertiveness, Body Image Shame, and Impulsiveness

Niloofar  Harati; Nahid Hossein  Abbasi; Zahra Marzban  Raad

doi:10.18502/ijph.v54i9.19868

Niloofar Harati Department of Psychology and Educational Sciences, ST.C, Islamic Azad University, Tehran, Iran
Nahid Hossein Abbasi Department of Nursing and Midwifery, Ahv. C., Islamic Azad University, Ahvaz, Iran
Zahra Marzban Raad Department of Gynecology Surgery, Iran University, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v54i9.19868

Keywords: Human papillomavirus; Sexual assertiveness; Body image shame; Impulsiveness

Abstract

Background: Human papillomavirus (HPV) is among the most prevalent sexually transmitted infections worldwide. Understanding the psychological contributors to HPV infection is crucial for informing preventive strategies. We examined whether sexual assertiveness, body image shame, and impulsiveness predict HPV infection in women.

Methods: In this cross-sectional, predictive correlational study, 119 women aged 18 to 45 who underwent HPV testing in gynecology and oncology clinics in early 2024 were recruited via convenience sampling. Data were gathered using a demographic questionnaire and three standardized instruments: the Hurlbert Index of Sexual Assertiveness (HISA), the Body Image Shame Scale (BISS), and the Barratt Impulsiveness Scale (BIS). Logistic regression analysis was conducted using SPSS version 27.

Results: The participants had a mean age of 33.98 years, with 47.89% being single and 52.1% married. Among all participants, 40.3% tested positive for HPV. Body image shame and impulsiveness emerged as significant predictors of HPV infection risk (P < 0.001). External body image shame was identified as the most impactful subscale of body image shame, while cognitive impulsivity showed the strongest influence among the components of impulsiveness. However, the findings revealed no significant association between low sexual assertiveness and the risk of HPV infection (P > 0.05).

Conclusion: These findings highlight the role of psychological factors, especially body image shame and impulsiveness, in HPV risk. Integrating related interventions into public health measures like vaccination and screening may improve their effectiveness and enhance women’s sexual health outcomes.