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Metz CK, Skof AS, Henrich W, Sehouli J, Kaufmann AM, Rohr I. Human papillomavirus prevalence in pregnant women living with human immunodeficiency virus infection: a scoping review of the literature. J Perinat Med 2024; 52:1-13. [PMID: 37540166 DOI: 10.1515/jpm-2023-0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/01/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Studies already pointed out the increased risk of human papillomavirus (HPV) positivity and the implied risk of cervical dysplasia and even cervical carcinoma in pregnant women with human immunodeficiency virus (HIV) infection. Nevertheless, due to less data there is still no standardised and expanded screening for this high-risk group. CONTENT Two online databases (PubMed, EMBASE) were used to identify eligible studies. Results are shown in percentages. Wherever useful the arithmetic mean was calculated. SUMMARY Seven studies were included. Pregnant WLWH showed HPV prevalence between 34 and 98.4 %. Different sensitivity and specificity among PCR methods for HPV detection could be a reason for the large range concerning HPV prevalence. Risk factors like Age, Smoking, Sexuality, HIV status and education level should always be taken into account. Association between HPV prevalence and level of CD4 cells or HIV virus load was seen. In which way use of Antiretroviral Therapy (ART) could decries the risk for HPV infections is still discussed. When cytology was performed only few high-grade squamous intraepithelial lesion (HSIL) were found. OUTLOOK Standardisation and expansion of preventive screening for cervical dysplasia and carcinoma for pregnant WLWH is necessary. Then better comparability of the data will also be achieved.
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Affiliation(s)
- Charlotte Kalinka Metz
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Anna Sophie Skof
- Laboratory for Gynaecological Tumorimmunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Wolfgang Henrich
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Jalid Sehouli
- Laboratory for Gynaecological Tumorimmunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
- Department of Gynecology with Center for Oncological Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Andreas M Kaufmann
- Laboratory for Gynaecological Tumorimmunology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
| | - Irena Rohr
- Department of Obstetrics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Berlin, Germany
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Khalil L, Russo E, Venkatakrishnan K, Mazul AL, Zevallos JP. Barriers to Human Papillomavirus Vaccination Initiation and Completion among Adults Aged 18-26 Years in a Large Healthcare System. Cancers (Basel) 2023; 15:4243. [PMID: 37686521 PMCID: PMC10487182 DOI: 10.3390/cancers15174243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/20/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Human papillomavirus (HPV) is a common sexually transmitted infection, with over 40% prevalence in the US. Oropharyngeal cancers (OPCs) driven by high-risk HPV are increasing (up to 90%), with HPV vaccination being the only prevention available. The aim of this study was to investigate HPV vaccination among patients aged between 18 and 26 years old with at least one encounter at a large healthcare system and identify sociodemographic factors associated with vaccine initiation and completion. A cross-sectional retrospective study was conducted between 2018 and 2021, including 265,554 patients identified from the Clinical Data Warehouse. HPV vaccination status by age, sex, race/ethnicity, insurance type, primary care (PCP) visits in the past year, alcohol, tobacco, illicit drug use, and age at vaccination was examined. Overall, 33.6% of females and 25.4% of males have completed the HPV vaccine. Black Americans were 35% more likely to initiate the vaccine than White Americans but were less likely to complete the entire course. Overall, HPV vaccination prevalence was far below the Health People 2030 goal of 80%, especially in young males. This low rate is troubling, since many patients had a PCP visit and remained unvaccinated, which serves as a missed opportunity for vaccination.
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Affiliation(s)
- Lucien Khalil
- Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA; (L.K.); (A.L.M.)
| | - Elena Russo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy;
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Kripa Venkatakrishnan
- Department of Clinical Analytics, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA;
| | - Angela L. Mazul
- Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA; (L.K.); (A.L.M.)
| | - Jose P. Zevallos
- Department of Otolaryngology, Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA; (L.K.); (A.L.M.)
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Sethi S, Santiago PHR, Soares GH, Ju X, Antonsson A, Canfell K, Smith M, Garvey G, Hedges J, Jamieson L. Development and validation of an HPV infection knowledge assessment scale among Aboriginal and Torres Strait Islander Peoples. Vaccine X 2023; 14:100317. [PMID: 37288370 PMCID: PMC10241973 DOI: 10.1016/j.jvacx.2023.100317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/15/2023] [Accepted: 05/21/2023] [Indexed: 06/09/2023] Open
Abstract
Background An increased incidence of Human Papillomavirus (HPV) infection and its related cancers has been observed in recent years. Correct knowledge about HPV infection can lead to a significant decrease in transmission and a subsequent increase in vaccine uptake. Awareness and behavioural perception towards HPV infections are critical for improving HPV vaccination rates among Aboriginal and/or Torres Strait Islander Peoples. However, to the best of our knowledge, there has been no instrument designed to measure knowledge about HPV infection that is culturally appropriate and validated among Aboriginal and/or Torres Strait Islander People. Aim To address this research gap, this paper aims to examine the psychometric properties of the HPV Knowledge Tool (HPV-KT) in an Indigenous population sample from South Australia. Methodology Data from 747 Indigenous Australian Adults who participated in the 12-month follow-up of the HPV and Oropharyngeal Carcinoma in Indigenous Australians Study was utilised for this study. The psychometric properties examined included1) dimensionality and item redundancy; (2) network loadings; (3) model fit; (4) criterion validity; and (5) reliability. The network model was estimated using the Graphical Least Absolute Shrinkage and Selector Operator (GLASSO). Evaluation of the HPV-KT (10 items) dimensionality and item redundancy was conducted within the framework of Exploratory Graph Analysis (EGA). Reliability was evaluated with the McDonald's Omega (ω) coefficient. Results After the exclusion of two items, the HPV-KT exhibited good psychometric properties for Aboriginal and/or Torres Strait Islander Peoples. The two dimensions of "General HPV Knowledge" and "Commonness of HPV" were identified. The dimension of "Commonness of HPV" displayed poor reliability, so a sum score for this subscale is not recommended (i.e. the items can still be used individually) The network model of the 7-item HPV-KT was fitted in the validation sample and model fit was adequate (x2 (7) = 17.17, p < 0.016; CFI = 0.980; TLI = 0.94; RMSEA = 0.063, 90% CI = 0.025-0.010). Furthermore, the reliability of the "General HPV Knowledge" subscale (ω = 0.76, 95% CI: 0.72-0.79), while the reliability of the "Commonness of HPV" subscale (ω = 0.58, 95% CI0.58-0.88) was poor. Conclusion The HPV-KT was adapted for an Aboriginal and/or Torres Strait Islander population and is readily available for future use in Australia. The addition of items assessing specifications of HPV infection, natural history and behaviour will improve the reliability and usability to assess the level of accurate knowledge about HPV infection. Future studies should investigate the possibility of developing new items for the dimension 'Commonness of HPV'.
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Affiliation(s)
- Sneha Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Pedro Henrique Ribeiro Santiago
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Gustavo Hermes Soares
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | | | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW
| | - Megan Smith
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW
| | - Gail Garvey
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
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Kim J, Dove MS, Dang JHT. Sociodemographic factors associated with HPV awareness/knowledge and cervical cancer screening behaviors among caregivers in the U.S. BMC Womens Health 2022; 22:335. [PMID: 35941594 PMCID: PMC9358833 DOI: 10.1186/s12905-022-01918-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 08/03/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Family caregivers may be at a higher risk for several chronic diseases, including cancer. Cervical cancer is one of the most common causes of cancer death among women. Despite family caregivers' vulnerability, the status of their HPV awareness, knowledge, and preventive health behaviors, including cervical cancer screening, has been understudied. Thus, this study aimed to examine the sociodemographic factors associated with HPV awareness and knowledge and adherence to the cervical cancer screening guidelines among caregivers in the U.S. METHODS Nationally representative cross-sectional survey data were obtained from the Health Information National Trends Survey (HINTS 5, 2017-2020). Female caregivers aged 21-65 were included (N = 1190). Weighted multivariable logistic regression was performed to identify factors associated with HPV awareness (heard of HPV), knowledge (HPV can cause cervical cancer), and adherence to the United States Preventive Service Task Force 2018 cervical cancer screening guidelines by sociodemographic factors (age, race/ethnicity, education, household income, marital status,) and the intensity of caregiving. RESULTS An estimated 79% of female caregivers were aware of HPV and 84% adhered to the cervical cancer screening guidelines. Caregivers who were older than 50 (OR = 3.62, 1.91-6.85, adherence of aged 21-50 vs. 51-65), Hispanics of race/ethnicity compared with Black/African Americans (OR = 3.14, 1.31-7.52, adherence of Black/African Americans vs. Hispanics), with a high school education or less (OR = 2.34, 1.14-4.82, adherence of Some college or more vs. High school education or less), and with intense caregiving duty (spending 35 h/week or more on caregiving) compared with light-duty (OR = 2.34, 1.10-5.00, adherence of 5-14 h vs. 35 h or more, weekly) had poor adherence to the cervical cancer screening guidelines. Caregivers who were older, racial minorities (Asian, Native Hawaiian/Pacific Islander, American Indian/Alaska Native, Multiple races), and less educated showed lower HPV awareness (Heard of HPV) than their counterparts. CONCLUSIONS There are caregiving populations whose HPV awareness and cervical cancer screening adherence are low. To improve their awareness and knowledge of HPV and support their cervical cancer screening behaviors, we need to consider interventions that target those specific populations.
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Affiliation(s)
- Jiyeong Kim
- Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, Davis, USA.
| | - Melanie S. Dove
- grid.27860.3b0000 0004 1936 9684Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, Davis, USA
| | - Julie H. T. Dang
- grid.27860.3b0000 0004 1936 9684Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, Davis, USA
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Lee HY, Luo Y, Daniel C, Wang K, Ikenberg C. Is HPV vaccine awareness associated with HPV knowledge level? Findings from HINTS data across racial/ethnic groups in the US. ETHNICITY & HEALTH 2022; 27:1166-1177. [PMID: 33307774 DOI: 10.1080/13557858.2020.1850648] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 11/09/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND PURPOSE Human papillomavirus (HPV) is recognized as a leading cause of multiple types of cancer. The current study examined HPV knowledge level and its associated factors, especially its relationship with HPV vaccine awareness, across race/ethnicity, including non-Hispanic White, non-Hispanic African American, and Hispanic. METHODS Cross-sectional data were merged from Cycles 1 (2017) and Cycle 2 (2018) of the National Cancer Institute (NCI) Health Information National Trends Survey 5 (HINTS5, total N = 3648), which was collected in the United States. A multiple linear regression was performed across the three race/ethnicity groups to determine potential associated factors with level of HPV knowledge. FINDINGS Overall HPV knowledge level among participants was low (Mean = 1.68; SD = 1.44; range 0-4). Among three racial/ethnic groups, non-Hispanic African American had the lowest level of HPV knowledge (Mean = 1.51). Less than 30% answered correctly to each of the three items assessing knowledge of HPV-associated (HPVa) cancers other than cervical (e.g. if HPV can cause penile, anal, and/or oral cancer). The HPV vaccine awareness was significantly associated with HPV knowledge across all three racial/ethnic groups. CONCLUSIONS AND IMPLICATIONS The lowest level of HPV knowledge among non-Hispanic African American suggests that HPV education is urgently needed for this population. Specific interventions should emphasize information regarding HPVa cancers other than cervical cancer. Additionally, promoting awareness of the HPV vaccine will help to improve HPV knowledge among general population. Lastly, various factors associated with HPV knowledge across different racial/ethnic groups need to be addressed when implementing HPV education programs.
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Affiliation(s)
- Hee Yun Lee
- School of Social Work, The University of Alabama, Tuscaloosa, AL, USA
| | - Yan Luo
- School of Social Work, The University of Alabama, Tuscaloosa, AL, USA
| | - Casey Daniel
- USA Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA
| | - Kun Wang
- School of Social Work, The University of Alabama, Tuscaloosa, AL, USA
| | - Carin Ikenberg
- School of Social Work, The University of Alabama, Tuscaloosa, AL, USA
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Kepka D, Bodson J, Lai D, Sanchez-Birkhead AC, Davis FA, Lee D, Tavake-Pasi F, Napia E, Villalta J, Mukundente V, Mooney R, Coulter H, Stark LA. Diverse caregivers' HPV vaccine-related awareness and knowledge. ETHNICITY & HEALTH 2021; 26:811-826. [PMID: 30589389 PMCID: PMC6597331 DOI: 10.1080/13557858.2018.1562052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
Objectives: To assess factors associated with HPV vaccine-related awareness and knowledge among caregivers of adolescents from five ethnic community groups in Utah.Design: For this community-based participatory research study, we surveyed N = 228 caregivers of teens aged 11-17 years from African American, African refugee, American Indian/Alaskan Native, Hispanic/Latino, and Native Hawaiian/Pacific Islander community groups in Utah about their HPV vaccine awareness and knowledge.Results: Participants exhibited high awareness of cervical cancer (71.05%), moderate awareness of HPV (53.95%), and low awareness of the HPV vaccine (46.49%). HPV vaccine-related knowledge was mostly worse, with fewer than half the participants reporting knowing that HPV can cause cervical cancer (46.93%), that most people are infected with HPV at some point in their lives (28.95%), that HPV is asymptomatic in females (36.40%) and males (37.28%), that the HPV vaccine is recommended for adolescent females (41.67%) and males (36.40%), and that the HPV vaccine requires more than one dose (27.19%). HPV vaccine-related awareness and knowledge were significantly associated with race/ethnicity, educational attainment, income, occupation, birthplace, parents' birthplace, English usage, health insurance coverage, type of health insurance, and child having a primary care provider (all p < 0.05). HPV vaccine-related knowledge (p < 0.05) and awareness (p < 0.05) of caregivers were associated with a child in the household receiving the HPV vaccine.Conclusion: Our findings indicate a need to develop educational interventions in collaboration with diverse communities in Utah. We underscore the importance of promoting knowledge about the existence of the HPV vaccine, as well as deeper HPV vaccine-related issues (e.g. HPV risks, treatment, and recommendations).
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Affiliation(s)
- Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Julia Bodson
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Djin Lai
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Community Faces of Utah, Salt Lake City, Utah, USA
| | - Ana C. Sanchez-Birkhead
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Community Faces of Utah, Salt Lake City, Utah, USA
- Hispanic Health Care Task Force, Salt Lake City, Utah, USA
| | - France A. Davis
- Community Faces of Utah, Salt Lake City, Utah, USA
- Calvary Baptist Church, Salt Lake City, Utah, USA
| | - Doriena Lee
- Community Faces of Utah, Salt Lake City, Utah, USA
- Calvary Baptist Church, Salt Lake City, Utah, USA
| | - Fahina Tavake-Pasi
- Community Faces of Utah, Salt Lake City, Utah, USA
- National Tongan American Society, Salt Lake City, Utah, USA
| | - Edwin Napia
- Community Faces of Utah, Salt Lake City, Utah, USA
- Urban Indian Center, Salt Lake City, Utah, USA
| | - Jeannette Villalta
- Community Faces of Utah, Salt Lake City, Utah, USA
- Hispanic Health Care Task Force, Salt Lake City, Utah, USA
| | - Valentine Mukundente
- Community Faces of Utah, Salt Lake City, Utah, USA
- Best of Africa, West Valley City, Utah, USA
| | - Ryan Mooney
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Heather Coulter
- Center for Clinical and Translational Science, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Louisa A. Stark
- Center for Clinical and Translational Science, School of Medicine, University of Utah, Salt Lake City, Utah, USA
- Department of Human Genetics, School of Medicine, University of Utah, Salt Lake City, Utah, USA
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Nasserie T, Bendavid E. Systematic identification and replication of factors associated with human papillomavirus vaccine initiation among adolescents in the United States using an environment-wide association study approach. Sex Transm Infect 2021; 98:203-209. [PMID: 34039744 DOI: 10.1136/sextrans-2021-054976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/08/2021] [Accepted: 04/25/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Human papillomavirus (HPV) vaccination coverage is low among adolescents in the USA. Identification of factors associated with HPV vaccine initiation (receipt of ≥1 dose) is critical for improving uptake. Our objective was to systematically investigate all eligible factors available in a nationally representative sample of adolescents to identify drivers of HPV vaccine initiation using a novel methodological approach. METHODS We performed multiple cross-sectional analyses using data from the adolescent component of the National Immunization Surveys (NIS)-Teen between 2014 and 2019. Study participants were parents or caregivers of adolescents aged 13-17 years. Exposure variables measured sociodemographic and geographical characteristics, health conditions and healthcare provision. We tested the association between each factor and HPV vaccine initiation using univariate logistic regression and multivariate logistic regression adjusted for mother's age, mother's education level, mother's marital status, poverty status and adolescent's sex. We validated findings for each type of analysis within surveys, between surveys (across years 2014-2019) and across several subgroups (age, sex, poverty status and race/ethnicity). RESULTS Six factors were replicated in the multivariate analysis. Most replicated factors characterised the role of healthcare providers and healthcare-seeking behaviours. After adjustment, provider HPV recommendation remained the most strongly associated with HPV vaccine initiation (2019 NIS-Teen: OR 13.4, 95% CI 11.3 to 17.3, p<0.001). The variance explained by a full model including replicated factors was 0.39. CONCLUSIONS This is the first study to explore the association between all available factors in the NIS-Teen and HPV vaccine initiation in a systematic manner. Our study suggests that healthcare-seeking behaviours and interactions with the health system may be drivers of HPV vaccine initiation and warrant further study. Addressing these factors could improve the rate of HPV vaccine initiation among adolescents in the USA.
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Affiliation(s)
- Tahmina Nasserie
- Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Eran Bendavid
- Primary Care and Population Health, Stanford University School of Medicine, Stanford, California, USA
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Amboree TL, Darkoh C. Barriers to Human Papillomavirus Vaccine Uptake Among Racial/Ethnic Minorities: a Systematic Review. J Racial Ethn Health Disparities 2020; 8:1192-1207. [PMID: 33025422 DOI: 10.1007/s40615-020-00877-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/21/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is associated with poor health outcomes, including cervical cancer. Racial/ethnic minority populations experience poor health outcomes associated with HPV at higher rates. A vaccine is available to protect against HPV infections and prevent HPV-related sequelae; however, vaccination rates have remained low in the United States (U.S.) population. Thus, there is an urgent need to increase the HPV vaccination rate. Moreover, little is known about barriers to HPV vaccination in racial/ethnic minority groups. This paper highlights the most recent findings on barriers experienced by these groups. METHODS The PubMed database was searched on July 30, 2020, for peer-reviewed articles and abstracts that had been published in English from July 2010 to July 2020 and covered racial/ethnic disparities in HPV vaccination. RESULTS Similar findings were observed among the articles reviewed. The low HPV vaccination initiation and completion rates among racial/ethnic minority populations were found to be associated with lack of provider recommendations, inadequate knowledge and awareness of HPV and HPV vaccination, medical mistrust, and safety concerns. CONCLUSIONS Provider recommendations and accurate distribution of information must be increased and targeted to racial/ethnic minority populations in order to bolster the rate of vaccine uptake. To effectively target these communities, multi-level interventions need to be established. Further, research to understand the barriers that may affect unvaccinated adults in the catch-up age range, including males, may be beneficial, as majority of the previous studies focused on either parents of adolescents or women.
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Affiliation(s)
- Trisha L Amboree
- Department of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Room E715, Houston, TX, 77030, USA
| | - Charles Darkoh
- Department of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, University of Texas Health Science Center at Houston, School of Public Health, 1200 Pressler Street, Room E715, Houston, TX, 77030, USA. .,Microbiology and Infectious Diseases Program, University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.
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9
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Lott BE, Okusanya BO, Anderson EJ, Kram NA, Rodriguez M, Thomson CA, Rosales C, Ehiri JE. Interventions to increase uptake of Human Papillomavirus (HPV) vaccination in minority populations: A systematic review. Prev Med Rep 2020; 19:101163. [PMID: 32714778 PMCID: PMC7372149 DOI: 10.1016/j.pmedr.2020.101163] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 06/27/2020] [Accepted: 07/04/2020] [Indexed: 12/16/2022] Open
Abstract
Nine studies intervened on vaccination in racial/ethnic and sexual and gender minorities. Education and reminders increased HPV vaccine series initiation and completion. Lack of high-quality, adequately powered studies warrants further investigation.
Minority youth represent a unique population for public health interventions given the social, economic, and cultural barriers they often face in accessing health services. Interventions to increase uptake of Human Papillomavirus (HPV) vaccination in minority youth have the potential to reduce disparities in HPV infection and HPV-related cancers. This systematic review assesses the effectiveness of interventions to increase HPV vaccine uptake, measured as vaccine series initiation and series completion, among adolescents and young adults, aged 9–26 years old, identifying as a racial and ethnic minority or sexual and gender minority (SGM) group in high-income countries. Of the 3013 citations produced by a systematic search of three electronic databases (PubMed, Embase, and Web of Science) in November 2018, nine studies involving 9749 participants were selected for inclusion. All studies were conducted in the United States and were published from 2015 to 2018. Interventions utilized education, vaccine appointment reminders, and negotiated interviewing to increase vaccination. Participants were Black or African American (44.4%), Asian (33.3%), Hispanic or Latinx (22.2%), American Indian or Alaska Native (11.1%), and SGM (22.2%). Studies enrolled parent–child dyads (33.3%), parents alone (11.1%), and youth alone (55.6%). Vaccine series initiation ranged from 11.1% to 84% and series completion ranged from 5.6% to 74.2% post-intervention. Educational and appointment reminder interventions may improve HPV vaccine series initiation and completion in minority youth in the U.S. Given the lack of high quality, adequately powered studies, further research is warranted to identify effective strategies for improving HPV vaccine uptake for minority populations.
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Affiliation(s)
- Breanne E Lott
- Department of Health Promotion Sciences, Mel and Enid Zukerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Babasola O Okusanya
- Department of Health Promotion Sciences, Mel and Enid Zukerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Elizabeth J Anderson
- Department of Health Promotion Sciences, Mel and Enid Zukerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Nidal A Kram
- Department of Health Promotion Sciences, Mel and Enid Zukerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Melina Rodriguez
- Department of Health Promotion Sciences, Mel and Enid Zukerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Cynthia A Thomson
- Canyon Ranch Center for Prevention and Health Promotion, Department of Health Promotion Sciences, Mel and Enid Zukerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Cecilia Rosales
- Division of Public Health Practice and Translational Research, Mel and Enid Zukerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - John E Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zukerman College of Public Health, University of Arizona, Tucson, AZ, USA
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10
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Madrigal JM, Johnson CA, Green J, Patel A. Using Peer Health Educators to Conduct Community Level Surveillance of HPV Vaccination Status: Findings Among Women Who Live in Medically Underserved Areas of Chicago. J Community Health 2020; 45:1043-1049. [PMID: 32410088 DOI: 10.1007/s10900-020-00828-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Young women are key stakeholders in efforts to increase human papillomavirus (HPV) vaccination uptake. Community health workers who engage with young women can provide valuable information to inform intervention strategies to increase vaccine uptake. We aimed to determine HPV vaccination and sexually transmitted infection (STI) rates among urban women and to identify barriers to vaccination. A trained health educator collaborated with community-based organizations to host health education and STI testing sessions for women in Chicago, Illinois. Forty-nine sessions took place at 15 sites over two years. Each attendee met with the educator about sexual health and HPV vaccination, and completed a health survey. We used contingency tables and logistic regression to determine factors associated with HPV vaccination using the cross-sectional survey data. Of the 292 women who answered questions about history of HPV vaccination, the average age was 17 (SD 2.3) years old, 63% (n = 184) were African American, and 33% (n = 98) Hispanic. Only 13.4% (n = 39) previously received the vaccine, and 6.2% (n = 18) received two to three doses. After adjustment, prior HIV testing was associated with 4.6 times higher odds (95% CI 1.71, 12.53, p = 0.002) of being vaccinated compared to women without prior testing. Our study provides evidence that young African American and Hispanic women living in Chicago may have low HPV vaccination rates. Women who received prior STI testing (i.e., sought healthcare) were more likely to be vaccinated relative to their peers who did not, indicating that racial/ethnic or socioeconomic disparities may inhibit utilization of preventative services.
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Affiliation(s)
- Jessica M Madrigal
- School of Public Health, University of Illinois At Chicago, 1603 W. Taylor St, Chicago, IL, 60612, USA. .,Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
| | - Camille A Johnson
- Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA
| | - Jenna Green
- Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA
| | - Ashlesha Patel
- Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.,Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
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Lee DB, Kim HW. Relationship between Mothers' Diagnosis of Cervical Cancer and Attitudes toward Preventing Cervical Cancer in Their Pubertal Daughters. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2019; 25:434-445. [PMID: 37679913 DOI: 10.4069/kjwhn.2019.25.4.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/13/2019] [Accepted: 11/20/2019] [Indexed: 09/09/2023] Open
Abstract
PURPOSE This study was conducted to examine the relationship between a mother's diagnosis of cervical cancer and attitudes toward cervical cancer prevention in their daughters. Their intention to recommend human papillomavirus (HPV) vaccination for their daughters, their confidence in 8 methods for cervical cancer prevention with their daughters, and their negative emotions about the assumption of their daughter's HPV infection. METHODS This study was a secondary analysis of data from the study of maternal health beliefs about preventing cervical cancer. The study sample were women who reported whether ever diagnosed with cervical cancer, who had pubertal daughters (n=1,578). Data were analyzed by cross-tabulation analysis, Spearman's rank correlation analysis, and logistic regression. RESULTS Mothers diagnosed with cervical cancer were more confident in using methods to prevent cervical cancer in their daughters (Z=-4.42, p<.001) and were more likely to feel negative emotions about the assumption of their daughters' HPV infection (Z=-2.44, p=.015) than mothers who were not diagnosed. Significant factors influencing their intention to recommend the HPV vaccination to their daughters were the mother's confidence in preventing cervical cancer in their daughters (odds ratio [OR], 1.003; 95% confidence interval [CI], 1.002-1.004) and their negative emotions about the assumption of their daughters' HPV infection (OR,1.016; 95% CI, 1.004-1.028). CONCLUSION For the early prevention of cervical cancer in pubertal daughters, the education of their mothers should include interventions to increase confidence in preventing cervical cancer in their daughters and sensitivity of HPV infection toward daughters.
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Affiliation(s)
- Da Bit Lee
- Graduate Student, College of Nursing, Seoul National University, Seoul, Korea
| | - Hae Won Kim
- Graduate Student, College of Nursing, Seoul National University, Seoul, Korea
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12
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Townsend JS, Puckett M, Gelb CA, Stewart SL. Response to Vajda et al. Re: “Improving Knowledge and Awareness of Human Papillomavirus-Associated Gynecologic Cancers: Results from the National Comprehensive Cancer Control Program/Inside Knowledge Collaboration” ( J Womens Health 2019;28:1173). J Womens Health (Larchmt) 2019; 28:1173. [DOI: 10.1089/jwh.2019.7718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Julie S. Townsend
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Mary Puckett
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cynthia A. Gelb
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Sherri L. Stewart
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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13
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Mascaro V, Pileggi C, Currà A, Bianco A, Pavia M. HPV vaccination coverage and willingness to be vaccinated among 18–30 year-old students in Italy. Vaccine 2019; 37:3310-3316. [DOI: 10.1016/j.vaccine.2019.04.081] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/22/2019] [Accepted: 04/25/2019] [Indexed: 10/26/2022]
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14
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Berenson AB, Hirth JM, Chang M, Merkley KH. Knowledge and Use of Cosmetic Contact Lenses Among Reproductive-Age Women. J Womens Health (Larchmt) 2019; 28:403-409. [PMID: 30601087 DOI: 10.1089/jwh.2018.7358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES To assess use, knowledge, and complications of cosmetic contact lenses (CCLs) among women of reproductive age. METHODS A cross-sectional, anonymous self-administered survey assessing cosmetic or decorative contact lens knowledge and experiences was completed by 686 women in Texas in 2017. Main outcome measures were use, knowledge, and associated complications. RESULTS Almost 1 in 4 women (164/686) reported prior use of CCLs and most had worn the lenses >3 times. Women born in the United States, who knew someone who wore cosmetic lenses, or had visited an eye doctor in the past year were more likely to have used CCLs. Knowledge scores were low and the majority of cosmetic lens users experienced complications (61%). The most frequently reported complications were eye pain and discomfort (35%); itchy, watery eyes (34%); and red, swollen eyes (28%). Borrowing lenses was significantly associated with medical complications (88% of borrowers reported complications). Among 18 respondents who sought medical attention for a CCL-related problem, only 11% obtained care within 24 hours. Few participants had discussed CCL use with an eye doctor in the past year. CONCLUSIONS Many U.S. women have used CCLs obtained from unauthorized sources. Knowledge of safe practices is very limited and most users develop complications. Interventions are needed to educate the public about the risk of CCL use to reduce adverse outcomes.
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Affiliation(s)
- Abbey B Berenson
- 1 Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas.,2 Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Jacqueline M Hirth
- 1 Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas.,2 Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Mihyun Chang
- 1 Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas
| | - Kevin H Merkley
- 1 Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas.,3 Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas
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Rodriguez SA, Savas LS, Baumler E, Nyitray AG, Mullen PD, Vernon SW, Fernandez ME. Parental predictors of HPV vaccine initiation among low-income Hispanic females aged 11-17 years. Vaccine 2018; 36:5084-5090. [PMID: 29980388 DOI: 10.1016/j.vaccine.2018.06.071] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE Hispanic women experience a disproportionate burden of cervical cancer morbidity and mortality compared to non-Hispanic women. Increasing HPV vaccination among Hispanic adolescents can help alleviate disparities. This study aimed to identify parental psychosocial predictors associated with HPV vaccine initiation and correlates of parental intentions to obtain the vaccine for their Hispanic adolescent daughters aged 11-17 years. METHODS This study is part of a larger three-arm randomized controlled trial testing the effectiveness of interventions to increase HPV vaccination. Parents of adolescent females were recruited in community clinics where we conducted baseline surveys. We obtained electronic medical records six months after baseline to assess vaccination status. Multilevel logistic regression was used to identify correlates of parental intentions to vaccinate and predictors of HPV vaccine initiation. Analyses with initiation as the outcome also controlled for intervention study arm. The Integrated Behavioral Model guided selection of psychosocial and outcome variables. RESULTS Our sample (n = 765) consisted mostly of mothers with less than a high school education born outside of the U.S. Forty-one percent had a household income less than $15,000. Most daughters had public or private insurance. Twenty-one percent initiated the HPV vaccine series. Correlates of intention to vaccinate intention included subjective norms related to daughter's doctor (AOR = 1.04; 95% CI 1.01-1.07), belief that the vaccine is safe (AOR = 1.38; 95% CI 1.06-1.78), self-efficacy to obtain the vaccine for their daughter (AOR = 2.39; 95% CI 1.52-3.77), and parental concern about vaccine side effects (AOR = 0.73; 95% CI 0.60-0.89). Intentions predicted initiation (AOR = 2.01; 95% CI 1.10-5.26); concern about sexual disinhibition decreased the odds of having a vaccinated daughter at follow-up (AOR = 0.66; 95% CI 0.47-0.92). DISCUSSION Parental intention and concerns about sexual disinhibition predict vaccine initiation. Further research is needed to explore the role of intention as a potential mediator between psychosocial variables and vaccination status.
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Affiliation(s)
- Serena A Rodriguez
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States; Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., E5.506S, Dallas, TX 75390, United States.
| | - Lara S Savas
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
| | - Elizabeth Baumler
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
| | - Alan G Nyitray
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Health Science Center at Houston School of Public Health, 1200 Pressler Street, Houston, TX 77030, United States.
| | - Patricia Dolan Mullen
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
| | - Sally W Vernon
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
| | - Maria E Fernandez
- Center for Health Promotion and Prevention Research, The University of Health Science Center at Houston School of Public Health, 7000 Fannin, 25th Floor, Houston, TX 77030, United States.
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Marić G, Birčanin Đ, Kisić V, Dotlić J, Zarić M, Kisić-Tepavčević D, Gazibara T. Parental perspective on human papillomavirus (HPV) vaccination in Serbia: Knowledge, attitudes and practice. SEXUAL & REPRODUCTIVE HEALTHCARE 2018; 16:192-198. [PMID: 29804766 DOI: 10.1016/j.srhc.2018.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 01/28/2023]
Abstract
STUDY OBJECTIVE Assessing knowledge and attitudes of parents towards human papillomavirus (HPV) vaccination of their children and estimating factors associated with parental positive attitude towards HPV immunization. STUDY DESIGN Cross-sectional. SETTING Two Community Health Centers. A total of 282 adult parents of boys and/or girls who presented at the pediatrician's office with their child aged ≤18 years from December 2015 to May 2016. MAIN OUTCOME MEASURES HPV vaccination coverage with one dose, knowledge and attitudes towards HPV vaccination. Parental knowledge was tested through a set of 10 items such as the infectious nature of HPV, mode of transmission, symptoms and its association with cervical cancer and circumstances surrounding HPV vaccine in Serbia. Answers were graded on a 5-point Likert scale from "strongly disagree" to "strongly agree". RESULTS Coverage with one dose of HPV vaccine was 2.0%. Majority of parents knew that the vaccine existed (71.0%). One quarter of parents confirmed that their child should be vaccinated against HPV. Parents expressed highest level of agreement with the statement that HPV vaccination in Serbia is not sufficiently promoted (4.17 ± 1.21 points). Having female child and more knowledge on HPV were independently associated with positive attitude towards vaccination among parents of children aged <9 years. Having received recommendation for HPV vaccination from a pediatrician was independently associated with positive attitude towards HPV vaccination among parents of children aged ≥9 years. CONCLUSION Coverage with one dose of HPV vaccine is low. Health-care authorities are urged to consider inclusion of HPV vaccination in immunization schedule.
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Affiliation(s)
- Gorica Marić
- Institute of Epidemiology, Višegradska 26a, Faculty of Medicine, University of Belgrade, Serbia
| | - Đurđa Birčanin
- Institute of Epidemiology, Višegradska 26a, Faculty of Medicine, University of Belgrade, Serbia
| | - Vesna Kisić
- Community Health Center "Voždovac", Krivolačka 4-6, Belgrade, Serbia
| | - Jelena Dotlić
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Višegradska 26, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića 8, Belgrade, Serbia
| | - Milica Zarić
- Institute of Epidemiology, Višegradska 26a, Faculty of Medicine, University of Belgrade, Serbia
| | - Darija Kisić-Tepavčević
- Institute of Epidemiology, Višegradska 26a, Faculty of Medicine, University of Belgrade, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, Višegradska 26a, Faculty of Medicine, University of Belgrade, Serbia.
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McBride KR, Singh S. Predictors of Adults' Knowledge and Awareness of HPV, HPV-Associated Cancers, and the HPV Vaccine: Implications for Health Education. HEALTH EDUCATION & BEHAVIOR 2017; 45:68-76. [PMID: 28595454 DOI: 10.1177/1090198117709318] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
High human papillomavirus (HPV) prevalence and low HPV vaccine uptake are significant public health concerns. Disparities in HPV-associated cancers and HPV vaccine uptake rates suggest the need for additional research examining factors associated with vaccine acceptance. This study assessed HPV awareness and knowledge and identified sociodemographic characteristics associated with HPV knowledge at the population level. Data from adult men ( n = 1,197) and women ( n = 1,906) who participated in the National Cancer Institute's 2014 Health Information National Trends Survey were analyzed. Multivariable regression was used to identify predictors of four HPV knowledge categories: (1) general knowledge, (2) cervical cancer knowledge, (3) "other" cancer knowledge (i.e., anal, oral, penile), and (4) vaccine knowledge. Significant gender differences in awareness and knowledge of HPV and the HPV vaccine were revealed. Most participants (>70%) knew that HPV could cause cervical cancer, but fewer (14.9% to 31.5%) knew of the association between HPV and "other" cancers. Women were more likely to report that a health care provider recommended vaccination. Significant predictors of general HPV and HPV vaccine knowledge included gender, education, income, race, and other sociodemographic characteristics. Age and income predicted cervical cancer knowledge. Knowledge of "other" HPV-associated cancers was predicted by having a child under 18 years in the household and relationship status. HPV knowledge appears to be socially patterned. Low HPV knowledge among men and some racial minorities suggests a need for further intervention. Health education should emphasize risks of noncervical HPV-associated cancers. Patient-provider communication that includes education, counseling, and clear recommendations favoring vaccination may improve uptake.
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Maness SB, Reitzel LR, Watkins KL, McNeill LH. HPV Awareness, Knowledge and Vaccination Attitudes among Church-going African-American Women. Am J Health Behav 2016; 40:771-778. [PMID: 27779945 DOI: 10.5993/ajhb.40.6.9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The purpose of this exploratory study was to improve understanding of the sociodemographic correlates of human papillomavirus (HPV) awareness, knowledge, and vaccination attitudes in a convenience sample of church-going, African-American women and how knowledge about HPV-related cancers relates to vaccination attitudes for girls and boys. METHODS Participants (N = 308) answered survey questions about HPV awareness, knowledge, and vaccination attitudes. Associations between variables were assessed using Bonferroni-adjusted chi-square tests and regression analyses. RESULTS Younger age was associated with having heard of HPV and willingness to vaccinate a daughter or son in covariate-adjusted analyses. Younger age and greater education were associated with knowledge that HPV causes cervical cancer. A positive association existed between willingness to vaccinate a daughter or son based on knowledge of the number of cancers associated with HPV. Knowledge that HPV was related to non-cervical cancers was significantly associated with greater willingness to vaccinate sons. CONCLUSIONS Knowledge that HPV causes multiple cancers is important to willingness to vaccinate a child. Education campaigns should emphasize that HPV is also related to non-cervical cancers. African-American women of older age and less education might benefit from church-based HPV educational campaigns.
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Affiliation(s)
- Sarah B. Maness
- Assistant Professor, The University of Oklahoma, Department of Health and Exercise Science, Norman, OK
| | - Lorraine R. Reitzel
- Associate Professor, Joint senior scientist, The University of Houston, Department of Psychological, Health, & Learning Sciences, Social Determinants/Health Disparities Lab, Houston, TX;,
| | - Kellie L. Watkins
- Graduate Student, The University of Texas School of Public Health, Department of Epidemiology, Houston, TX
| | - Lorna H. McNeill
- Associate Professor, Joint senior scientist, The University of Texas MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX
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Perez S, Tatar O, Ostini R, Shapiro GK, Waller J, Zimet G, Rosberger Z. Extending and validating a human papillomavirus (HPV) knowledge measure in a national sample of Canadian parents of boys. Prev Med 2016; 91:43-49. [PMID: 27471023 DOI: 10.1016/j.ypmed.2016.07.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/21/2016] [Accepted: 07/23/2016] [Indexed: 12/21/2022]
Abstract
As the human papillomavirus (HPV) vaccine is now recommended for males, a reliable, comprehensive HPV knowledge measurement tool which addresses issues relevant to males is needed. We aimed to replicate, validate and test the comprehensiveness of an existing general HPV and an HPV vaccination knowledge scale in English and French. We also measured parental HPV knowledge and changes over time. An online questionnaire was administered in February (Time 1; T1) and November 2014 (Time 2; T2) to a nationally representative sample of Canadian parents of boys. Dimensionality, internal consistency and model fit were evaluated at both time points and separately in English and French sub-samples. Differences in knowledge scores were measured. Analyses were performed on 3117 participants at T1 and 1427 at T2. The 25-item HPV general knowledge and an 11-item HPV vaccination scale were unidimensional, showed high internal consistency (α>0.87, α>0.73) and had good model fit. Both general HPV and vaccine-specific knowledge significantly increased over time in both languages, but remained low at T2, with only about half of the items being answered correctly. Correct responses at T2 are best explained by correct responses at T1, with some small changes from 'Don't know' at T1 to correct at T2. The extended general and vaccine-specific knowledge scales are valid, reliable and comprehensive, and could be used among parents of boys, in both English and French. Educational interventions could target specific knowledge gaps and focus on providing information rather than correcting misconceptions.
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Affiliation(s)
- Samara Perez
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal H3A 1B1, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine Road, Montreal H3T 1E4, Quebec, Canada.
| | - Ovidiu Tatar
- Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine Road, Montreal H3T 1E4, Quebec, Canada
| | - Remo Ostini
- Rural Clinical School Research Centre, School of Medicine, The University of Queensland, West Street, Toowoomba, Qld 4350, Australia
| | - Gilla K Shapiro
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal H3A 1B1, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine Road, Montreal H3T 1E4, Quebec, Canada
| | - Jo Waller
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, 1-19 Torrington Place, London WC1E 6BT, United Kingdom
| | - Gregory Zimet
- Indiana University School of Medicine, Section of Adolescent Medicine, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, USA
| | - Zeev Rosberger
- Department of Psychology, McGill University, 1205 Dr. Penfield Avenue, Montreal H3A 1B1, Quebec, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine Road, Montreal H3T 1E4, Quebec, Canada; Louise Granofsky-Psychosocial Oncology Program, Segal Cancer Center, Jewish General Hospital, 4333 Cote Ste-Catherine Road, Montreal H3T 1E4, Quebec, Canada
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Berenson AB, Rahman M, Hirth JM, Rupp RE, Sarpong KO. A human papillomavirus vaccination program for low-income postpartum women. Am J Obstet Gynecol 2016; 215:318.e1-9. [PMID: 26899907 PMCID: PMC4988928 DOI: 10.1016/j.ajog.2016.02.032] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/28/2016] [Accepted: 02/12/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Effective interventions are needed to address the low rate of human papillomavirus (HPV) vaccination in the United States, particularly among girls and women 16-26 years old. Counseling and offering the vaccine to postpartum patients could be an effective strategy to increase uptake among young women who did not complete the 3-dose series at an earlier age. OBJECTIVE The purpose of this evaluation was to assess the effectiveness of a multicomponent program designed for postpartum women that used patient navigators (PNs) and reminders for follow-up visits to improve uptake and completion of the HPV vaccine series. STUDY DESIGN As part of standard care, patients ≤26 years of age from Galveston County, Texas, who delivered an infant from November 2012 through June 2014 at a public hospital were counseled and offered the HPV vaccine postpartum. PNs assisted with scheduling follow-up injections during postpartum or well-child visits. A program evaluation was conducted after 20 months. RESULTS Of 1038 patients approached, only 161 (15.5%) had previously completed the vaccine series. Of the 877 patients who had not completed the series, 661 (75.4%) received at least 1 dose postpartum, with 575 patients receiving their first dose and 86 receiving their second or third doses. By April 2015, initiation rates had increased as a result of this program from 25.4% before the program was initiated to 80.8% and completion rates from 15.5-65.1%. Missed appointments for injections were less likely among those who received text message reminders and more likely among those with ≥2 prior pregnancies. Those who were Hispanic or had received an influenza vaccination in the last year were more likely to initiate and complete the series through this program. Patients who missed ≥1 follow-up appointments were less likely to complete the vaccine series. CONCLUSION Offering the HPV vaccine postpartum dramatically increased initiation rates among postpartum patients. PN and text messages ensured that a high percentage completed all 3 doses.
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Affiliation(s)
- Abbey B Berenson
- Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, TX; Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX.
| | - Mahbubur Rahman
- Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, TX; Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX
| | - Jacqueline M Hirth
- Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, TX; Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX
| | - Richard E Rupp
- Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, TX; Department of Pediatrics, University of Texas Medical Branch, Galveston, TX
| | - Kwabena O Sarpong
- Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, TX; Department of Pediatrics, University of Texas Medical Branch, Galveston, TX
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Parental acceptance and uptake of the HPV vaccine among African-Americans and Latinos in the United States: A literature review. Soc Sci Med 2016; 159:116-26. [DOI: 10.1016/j.socscimed.2016.04.028] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 03/31/2016] [Accepted: 04/22/2016] [Indexed: 11/23/2022]
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Berenson AB, Hirth JM, Rahman M, Laz TH, Rupp RE, Sarpong KO. Maternal and infant outcomes among women vaccinated against pertussis during pregnancy. Hum Vaccin Immunother 2016; 12:1965-1971. [PMID: 27002930 DOI: 10.1080/21645515.2016.1157241] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Tetanus, diphtheria, and acellular pertussis (Tdap) vaccination is recommended for all women during each pregnancy to prevent pertussis in young infants. However, data on the safety of this protective measure are limited and conflicting. To assess maternal and infant outcomes associated with administration of this vaccine during pregnancy, we reviewed medical records of 1,759 women who delivered a singleton infant at a southeast Texas public hospital between November 1, 2012 and June 30, 2014. After excluding women who had inadequate prenatal care or who delivered at <27 weeks gestation, we used multivariable logistic regression analyses to compare 13 outcomes between those who did and did not receive the Tdap vaccine. We examined 6 maternal outcomes (chorioamnionitis, postpartum endometritis, preterm delivery, preterm premature rupture of membranes, induced labor, and mode of delivery) and 7 infant outcomes (low birth weight, very low birth weight, small for gestational age, 5-minute Apgar score, birth defects, and neonatal intensive care unit admission). Maternal Tdap vaccination was associated with decreased odds of cesarean delivery. No associations between maternal Tdap vaccination and infant outcomes were observed. This study demonstrates that Tdap vaccination during pregnancy does not increase the risk of adverse outcomes.
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Affiliation(s)
- Abbey B Berenson
- a Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston , TX , USA.,b Department of Obstetrics & Gynecology, University of Texas Medical Branch , Galveston , TX , USA
| | - Jacqueline M Hirth
- a Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston , TX , USA.,b Department of Obstetrics & Gynecology, University of Texas Medical Branch , Galveston , TX , USA
| | - Mahbubur Rahman
- a Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston , TX , USA.,b Department of Obstetrics & Gynecology, University of Texas Medical Branch , Galveston , TX , USA
| | - Tabassum H Laz
- a Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston , TX , USA
| | - Richard E Rupp
- a Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston , TX , USA.,c Department of Pediatrics, University of Texas Medical Branch , Galveston , TX , USA
| | - Kwabena O Sarpong
- a Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston , TX , USA.,c Department of Pediatrics, University of Texas Medical Branch , Galveston , TX , USA
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Berenson AB. An update on barriers to adolescent human papillomavirus vaccination in the USA. Expert Rev Vaccines 2015; 14:1377-84. [PMID: 26292763 DOI: 10.1586/14760584.2015.1078240] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Human papillomavirus is the most common sexually transmitted infection in the USA. It is the primary cause of almost all cervical cancers as well as several other cancers that affect both men and women. Adolescents of both genders can now prevent transmission of the most common oncogenic strains of human papillomavirus by obtaining a safe, three-dose vaccine series. However, despite its potential to save lives and reduce severe morbidity, many US adolescents have not been vaccinated. This is in contrast to other countries where high rates of vaccination are already reducing rates of cervical intra-epithelial neoplasia and genital warts. This article describes barriers recently reported among families in the USA and concludes with suggestions for improving uptake.
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Affiliation(s)
- Abbey B Berenson
- a The University of Texas Medical Branch at Galveston, Center for Interdisciplinary Research in Women's Health, Department of Obstetrics and Gynecology, 301 University Boulevard, Mail Route 0587, Galveston, TX 77555-0587, USA
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