Background: To determine the association between university student political party alignment and HPV vaccination rates, HPV knowledge, and risk factors.

Methods: A survey was emailed in April 2024 to 28,095 students enrolled at the University of Iowa. Surveys were entered online and downloaded into a REDCap database for analysis.

Results: The majority (54%) of 1,380 respondents were aligned with the Democratic party, 16% Republican Party, 2.4% Libertarian Party, 23% Independent, and 4.9% other parties. The percentage of female respondents was higher in students aligned with the Democratic voters (81%) compared with Republican (71%) and Independent (68%) voters. The overall HPV vaccination rate for respondents was 82% with HPV vaccination rates highest among females 88% vs 73% males, Democrats 88% vs 75% Republican, 76% Independent and 87% Health Science students. Median age at first HPV vaccine dose was 14. For females 21 or older, 76% of Democrats vs 69% Republican, and 65% Independent had received a Pap smear, p=0.040. 94% of Democrat vs 75% Republican and 83% Independent affiliated students recommended others get the HPV vaccine, p=<0.001. Age of first sex, percent sexually active, knowledge of HPV prevention, non-heterosexual orientation, and vaccination rates for COVID-19 and influenza were higher among Democrats. Number of sex partners, percentage with history of sexually transmitted infection, and reasons for not getting the HPV vaccine were similar between aligned Democrats, Republicans, and Independents.

Conclusion: HPV vaccination rate was highest among females and Democrats as was knowledge of HPV prevention and disease and support for HPV vaccination.