Assessing HPV-related quality of life among Iranian women: psychometric evaluation of the Persian HPV-QoL

Abstract

Abstract Background Human papillomavirus (HPV) infection can impose considerable psychological, emotional, and sexual challenges that adversely affect women’s health-related quality of life (HRQoL). Since experiences related to HPV-associated stigma, sexuality, and concerns about transmission are shaped by sociocultural factors, the availability of culturally relevant disease-specific assessment tools is essential for evaluating HPV-related quality of life in diverse populations. Objective The present study was designed to translate the Human Papillomavirus Quality of Life Questionnaire (HPV-QoL) into Persian and examine its psychometric properties among Iranian women diagnosed with HPV infection. Methods This methodological cross-sectional study was carried out between January and October 2024 and included 230 women with confirmed HPV infection. Of these, 200 participants were included in the psychometric evaluation, while an independent subsample of 30 participants completed the questionnaire twice for test–retest reliability assessment. The Persian adaptation of the HPV-QoL was developed through a forward–backward translation approach based on internationally accepted recommendations for cross-cultural instrument adaptation. The psychometric evaluation included assessment of face validity, content validity, structural validity, convergent and discriminant validity, reliability, measurement error, and interpretability. Responsiveness was not evaluated because of the cross-sectional study design. Structural validity was investigated using confirmatory factor analyses. Results The Persian HPV-QoL showed acceptable psychometric characteristics and was well aligned with the cultural context of the target population. Content validity findings were satisfactory (CVI ≥ 0.78; Kappa ≥ 0.75). Confirmatory factor analysis supported a multidimensional structure consisting of four domains: general well-being, contagiousness, health, and sexuality. Following model refinement, the final model demonstrated acceptable overall fit. The questionnaire demonstrated high internal consistency for the overall scale (Cronbach’s α = 0.929) and acceptable test–retest reliability (ICC = 0.833). Significant positive correlations with the Sexual Quality of Life–Female (SQOL-F) questionnaire supported criterion-related convergent validity. Conclusion The Persian version of the HPV-QoL provides preliminary evidence of satisfactory validity and reliability for assessing HPV-related quality of life among Iranian women. In addition to providing a culturally relevant patient-reported outcome measure, the study emphasizes the importance of considering psychosocial and sociocultural dimensions of HPV infection in clinical and research settings. The instrument may facilitate clinical assessment, future intervention studies, and cross-cultural research in women’s reproductive and sexual health.