Qualitative assessment of sex-stratified human papillomavirus transmission dynamics in South Korea

Abstract Background Human papillomavirus (HPV) vaccination, primarily targeting females aged 9–14 years, is pivotal in preventing HPV infections. This case study evaluates the effects of HPV vaccination in South Korea within the primary target group using incidence data and proposes optimal interven...

Full description

Saved in:
Bibliographic Details
Main Authors: Soyoung Kim, Olive R. Cawiding, Aurelio A. de los Reyes V, Sunhwa Choi
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-025-23810-0
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849738582093201408
author Soyoung Kim
Olive R. Cawiding
Aurelio A. de los Reyes V
Sunhwa Choi
author_facet Soyoung Kim
Olive R. Cawiding
Aurelio A. de los Reyes V
Sunhwa Choi
author_sort Soyoung Kim
collection DOAJ
description Abstract Background Human papillomavirus (HPV) vaccination, primarily targeting females aged 9–14 years, is pivotal in preventing HPV infections. This case study evaluates the effects of HPV vaccination in South Korea within the primary target group using incidence data and proposes optimal intervention strategies for maximizing the effectiveness of HPV mitigation programs. Methods We developed a mathematical model to simulate HPV transmission dynamics in South Korea, incorporating sex-stratified groups. We assessed vaccination rates before and after HPV inclusion in the National Immunization Program (NIP). Using the optimal control theory, we identified effective strategies involving HPV treatment and vaccination for females and males and analyzed their implementation costs and effectiveness. Results The inclusion of female HPV vaccination in the NIP increased the transmission rate from females to males, increasing HPV prevalence among males. As a standalone intervention, treatment is more cost effective and can minimize HPV infections by 2030. In dual control strategies, simultaneously treating both sexes is more effective in reducing infections and improving the average cost effectiveness ratio (ACER) compared to vaccination alone. Targeting males exclusively could potentially achieve greater reductions than targeting females. In triple strategies, combining treatment interventions for both sexes with either male or female vaccination achieves a lower ACER and higher reductions in HPV infections. Overall, implementing a combined (quadruple) strategy is projected to reduce infections by approximately 266,000 in 2030. Simultaneous implementation of controls significantly reduces the burden on vaccination control and treatment duration. Conclusion Treatment control provides an immediate reduction in HPV infections but requires consistent implementation. Increasing vaccination rates by expanding the target population enlarges the protected group. Although vaccination control may not yield rapid reductions compared to treatment, it demonstrates more sustained effects. Combining intervention strategies reduces the cost for each measure and significantly increases the total infections averted. These results can aid public health decision-making in South Korea and guide HPV prevention strategies in other countries.
format Article
id doaj-art-a4a0f8df83c448a78b7e18f329cf0a93
institution DOAJ
issn 1471-2458
language English
publishDate 2025-08-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj-art-a4a0f8df83c448a78b7e18f329cf0a932025-08-20T03:06:31ZengBMCBMC Public Health1471-24582025-08-0125111410.1186/s12889-025-23810-0Qualitative assessment of sex-stratified human papillomavirus transmission dynamics in South KoreaSoyoung Kim0Olive R. Cawiding1Aurelio A. de los Reyes V2Sunhwa Choi3Innovation Center for Industrial Mathematics, National Institute for Mathematical SciencesDepartment of Mathematical Sciences, KAISTBiomedical Mathematics Group, Pioneer Research Center for Mathematical and Computational Sciences, Institute for Basic ScienceInnovation Center for Industrial Mathematics, National Institute for Mathematical SciencesAbstract Background Human papillomavirus (HPV) vaccination, primarily targeting females aged 9–14 years, is pivotal in preventing HPV infections. This case study evaluates the effects of HPV vaccination in South Korea within the primary target group using incidence data and proposes optimal intervention strategies for maximizing the effectiveness of HPV mitigation programs. Methods We developed a mathematical model to simulate HPV transmission dynamics in South Korea, incorporating sex-stratified groups. We assessed vaccination rates before and after HPV inclusion in the National Immunization Program (NIP). Using the optimal control theory, we identified effective strategies involving HPV treatment and vaccination for females and males and analyzed their implementation costs and effectiveness. Results The inclusion of female HPV vaccination in the NIP increased the transmission rate from females to males, increasing HPV prevalence among males. As a standalone intervention, treatment is more cost effective and can minimize HPV infections by 2030. In dual control strategies, simultaneously treating both sexes is more effective in reducing infections and improving the average cost effectiveness ratio (ACER) compared to vaccination alone. Targeting males exclusively could potentially achieve greater reductions than targeting females. In triple strategies, combining treatment interventions for both sexes with either male or female vaccination achieves a lower ACER and higher reductions in HPV infections. Overall, implementing a combined (quadruple) strategy is projected to reduce infections by approximately 266,000 in 2030. Simultaneous implementation of controls significantly reduces the burden on vaccination control and treatment duration. Conclusion Treatment control provides an immediate reduction in HPV infections but requires consistent implementation. Increasing vaccination rates by expanding the target population enlarges the protected group. Although vaccination control may not yield rapid reductions compared to treatment, it demonstrates more sustained effects. Combining intervention strategies reduces the cost for each measure and significantly increases the total infections averted. These results can aid public health decision-making in South Korea and guide HPV prevention strategies in other countries.https://doi.org/10.1186/s12889-025-23810-0Human papillomavirus (HPV)Mathematical modelOptimal control theoryCost-effectiveness
spellingShingle Soyoung Kim
Olive R. Cawiding
Aurelio A. de los Reyes V
Sunhwa Choi
Qualitative assessment of sex-stratified human papillomavirus transmission dynamics in South Korea
BMC Public Health
Human papillomavirus (HPV)
Mathematical model
Optimal control theory
Cost-effectiveness
title Qualitative assessment of sex-stratified human papillomavirus transmission dynamics in South Korea
title_full Qualitative assessment of sex-stratified human papillomavirus transmission dynamics in South Korea
title_fullStr Qualitative assessment of sex-stratified human papillomavirus transmission dynamics in South Korea
title_full_unstemmed Qualitative assessment of sex-stratified human papillomavirus transmission dynamics in South Korea
title_short Qualitative assessment of sex-stratified human papillomavirus transmission dynamics in South Korea
title_sort qualitative assessment of sex stratified human papillomavirus transmission dynamics in south korea
topic Human papillomavirus (HPV)
Mathematical model
Optimal control theory
Cost-effectiveness
url https://doi.org/10.1186/s12889-025-23810-0
work_keys_str_mv AT soyoungkim qualitativeassessmentofsexstratifiedhumanpapillomavirustransmissiondynamicsinsouthkorea
AT olivercawiding qualitativeassessmentofsexstratifiedhumanpapillomavirustransmissiondynamicsinsouthkorea
AT aurelioadelosreyesv qualitativeassessmentofsexstratifiedhumanpapillomavirustransmissiondynamicsinsouthkorea
AT sunhwachoi qualitativeassessmentofsexstratifiedhumanpapillomavirustransmissiondynamicsinsouthkorea