Survey Finds Gaps in US Adult Awareness of HPV, Mpox STI Vaccine Prevention

A nationally representative Annenberg Public Policy Center (APPC) survey suggests US adults generally understand how sexually transmitted infections (STIs) are spread, but many remain uncertain about which infections are vaccine-preventable—an issue with direct implications for HPV and monkeypox (mpox) prevention counseling in primary care, pediatrics, adolescent medicine, obstetrics and gynecology, and infectious diseases settings.¹

“Public understanding improves when accurate health information reaches people clearly and consistently,” Ken Winneg, PhD, APPC’s managing director of survey research, said in the release.¹ “But these findings show continuing gaps in awareness about diseases which can be sexually transmitted such as HPV, mpox, and Zika.”

The survey, conducted April 14-28, 2026, included 1639 US adults from a nationally representative probability-based panel. APPC reported a margin of sampling error of ±3.5 percentage points at the 95% confidence level. Nearly half of respondents, 47%, said they or someone they know had ever been diagnosed with an STI; among those respondents, 72% reported knowing 2 or more people with an STI.¹

The findings arrive amid persistently high STI burden in the US. CDC provisional surveillance data cited by APPC indicate more than 2.2 million reported cases of chlamydia, gonorrhea, and syphilis in 2024. Although total cases of these 3 infections declined from 2022 to 2024, rates remained 13% higher than a decade earlier. Syphilis remains a particular concern: APPC cited CDC provisional data showing more than 190 000 reported syphilis cases in 2024 and a national rate of 55.9 cases per 100 000 population. Congenital syphilis increased for the 12th consecutive year, with nearly 4000 reported cases in 2024.²

Overall awareness of common sexual transmission routes was high. Respondents identified vaginal sex, anal sex, genital-to-genital contact, and oral sex as STI transmission routes at rates of 97%, 94%, 91%, and 89%, respectively. However, misconceptions persisted. Forty-nine percent selected kissing as a route of transmission, and 20% selected sitting on a toilet after someone with an STI sat on it, despite CDC guidance cited by APPC that toilet seats are not a route of transmission for several STIs, including HIV, syphilis, and genital herpes.¹

Knowledge varied substantially by infection. Most respondents recognized genital herpes, gonorrhea, syphilis, chlamydia, and HIV as sexually transmissible. Awareness was lower for HPV, mpox, and Zika. Seventy-five percent identified HPV as sexually transmitted, a 6-percentage-point increase from 2024. Only 35% knew mpox can be sexually transmitted, and 13% knew Zika virus can be sexually transmitted, although Zika is primarily mosquito-borne.¹

The most clinically actionable gap involved vaccines. Sixty-eight percent of respondents correctly said an HPV vaccine exists, while 42% knew a vaccine exists for mpox. For infections without vaccines, uncertainty or incorrect beliefs were common: 54% were unsure or incorrectly thought a genital herpes vaccine exists, 58% for gonorrhea, 61% for syphilis, 60% for chlamydia, 52% for HIV, and 81% for Zika.¹

For clinicians, these results underscore the continuing need to distinguish vaccine-preventable STIs from infections prevented primarily through screening, condoms, treatment, partner services, and behavioral risk reduction. HPV vaccination is recommended by CDC and can prevent more than 90% of HPV-related cancers, according to CDC materials cited by APPC.³ Mpox vaccination is recommended for groups at increased risk and may help prevent infection when given before exposure or mitigate illness if administered soon after exposure.⁴

The survey also identified mixed public understanding of STI outcomes and treatment. APPC reported that 93% knew STIs can spread without symptoms, 87% rejected the idea that only people with many sexual partners get STIs, and 80% knew STIs can be passed from a pregnant person to an infant. At the same time, only 45% knew most people in the United States with HIV do not develop AIDS.¹

Laura A. Gibson, an APPC research analyst, noted the dual signal around HPV education. “HPV vaccination is important for preventing cancers caused by HPV,” Gibson said. “The increase in awareness that HPV is sexually transmitted is a positive development, but it is concerning to see a similar increase in the incorrect belief that the HPV vaccine leads teens to engage in risky sexual behavior.”¹

As a survey, the findings describe knowledge and beliefs rather than clinical outcomes, and self-reported responses may not reflect behavior in health care settings. The data also do not identify which counseling strategies would most effectively close knowledge gaps. Still, the results point to practical next steps: routine, age-appropriate HPV vaccine counseling; targeted mpox vaccine discussions for eligible patients; reinforcement that syphilis has no vaccine but is preventable and treatable; and clear correction of misconceptions about transmission.

References

1. Annenberg Public Policy Center. A new Annenberg survey finds gap in public knowledge about vaccines for sexually transmitted infections. News release. Published May 21, 2026. Accessed June 3, 2026. https://www.annenbergpublicpolicycenter.org/survey-highlights-persistent-uncertainty-on-sti-vaccines/
2. Centers for Disease Control and Prevention. STI statistics. Accessed June 3, 2026. https://www.cdc.gov/sti-statistics/annual/index.html
3. Centers for Disease Control and Prevention. HPV vaccine. Accessed June 3, 2026. https://www.cdc.gov/hpv/vaccines/index.html
4. Centers for Disease Control and Prevention. Mpox vaccination. Accessed June 3, 2026. https://www.cdc.gov/monkeypox/vaccines/index.html