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White MC, Osazuwa-Peters OL, Abouelella DK, Barnes JM, Cannon TY, Watts TL, Adjei Boakye E, Osazuwa-Peters N. Trends and factors associated with receipt of human papillomavirus (HPV) vaccine in private, public, and alternative settings in the United States. Vaccine 2024; 42:126036. [PMID: 38876838 DOI: 10.1016/j.vaccine.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/15/2024] [Accepted: 06/01/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND One of the goals of the President's Cancer Panel was to maximize access to human papillomavirus (HPV) vaccination through expansion of alternative settings for receiving the vaccine, such as in public health settings, schools, and pharmacies. METHODS In a cross-sectional analysis, we utilized the National Immunization Survey-Teen data from 2014 to 2020 (n = 74,645) to describe trends and factors associated with HPV vaccine uptake in private, public, and alternative settings. We calculated annual percent change (APC) between 2014 and 2020, estimating rate of HPV vaccine uptake across settings. Using multinomial logistic regression, we estimated the odds of receipt of HPV vaccine in public health settings and other alternative settings compared to private healthcare settings, adjusting for sociodemographic covariates. RESULTS We found a 5 % annual increase in the use of private facilities between 2014-2018 (APC = 5.3; 95 % CI 3.4, 7.1), and almost 7 % between 2018-2020 (APC = 6.7; 95 % CI 1.4, 12.3). Adjusted multinomial logistic regression analyses found that odds of receiving vaccinations at a public facility vs. a private facility increased almost two times for adolescents living below poverty (aOR = 1.82, 95 % CI: 1.60, 2.08) compared to above poverty. Additionally, adolescents without physician recommendations had lower odds of receiving vaccines at public versus private facilities (aOR = 1.75, 95 % CI: 1.44, 2.12). Finally, odds of receiving HPV vaccines at public facilities vs. private facilities decreased by 33 % for White adolescents (aOR = 0.67, 95 % CI: 0.57, 0.78) versus Black adolescents. CONCLUSIONS Sociodemographic factors such as race, and socioeconomic factors such as poverty level, and receipt of physician HPV recommendations are associated with receiving the vaccine at private settings vs. public health facilities and alternative settings. This information is important in strengthening alternative settings for HPV vaccine uptake to increase access to the vaccine among disadvantaged individuals.
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Affiliation(s)
- Melissa C White
- Duke University School of Medicine, Durham, NC, United States
| | - Oyomoare L Osazuwa-Peters
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, United States
| | - Dina K Abouelella
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, United States
| | - Justin M Barnes
- Department of Radiation Oncology, Washington University School of Medicine in St Louis, St Louis, MO, United States
| | - Trinitia Y Cannon
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, United States; Duke Cancer Institute, Duke University, Durham, NC, United States
| | - Tammara L Watts
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, United States; Duke Cancer Institute, Duke University, Durham, NC, United States
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, United States; Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, MI, United States
| | - Nosayaba Osazuwa-Peters
- Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, United States; Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, United States; Duke Cancer Institute, Duke University, Durham, NC, United States.
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Okoli GN, Neilson CJ, Grossman Moon A, Kimmel Supron H, Soos AE, Grewal A, Etsell K, Alessi-Severini S, Richardson C, Harper DM. Exploration of individual socioeconomic and health-related characteristics associated with human papillomavirus vaccination initiation and vaccination series completion among adult females: A comprehensive systematic evidence review with meta-analysis. Vaccine 2024; 42:125994. [PMID: 38796328 DOI: 10.1016/j.vaccine.2024.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/08/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION Human papillomavirus (HPV) vaccination rates among females are lower than the World Health Organization target and vaccination rates specifically among adult females are even much lower. METHODS We systematically evaluated individual socioeconomic and health-related characteristics associated with HPV vaccination initiation and vaccination series completion among adult females (PROSPERO: CRD42023445721). We performed a literature search on December 14, 2022, and supplemented the search on August 1, 2023. We pooled appropriate multivariable-adjusted results using an inverse variance random-effects model and expressed the results as odds ratios with associated 95 % confidence intervals. A point pooled significantly increased/decreased odds of 30-69 % was regarded to be strongly associated, and ≥ 70 % was very strongly associated. RESULTS We included 63 cross-sectional studies. There were strongly increased odds of vaccination initiation among White women compared with Black or Asian women, and those with higher education, health insurance, a history of sexually transmitted infection (STI), receipt of influenza vaccination in the preceding year, not married/cohabiting, not smoking, using contraception, and having visited a healthcare provider in the preceding year. We observed very strongly increased odds of vaccination initiation among those younger and having been born in the country of study. Similarly, there were strongly increased odds of completing the vaccination series for the same variables as initiating vaccination, except for higher education, prior STI, smoking and contraception use. Additional variables associated with strongly increased odds of vaccination series completion not seen in initiation were higher annual household income, being lesbian/bisexual, and having a primary care physician. We observed very strongly increased odds of vaccination series completion similar to vaccination initiation but including for White compared with Black women, higher education, and prior cervical cancer screening. CONCLUSIONS These individual characteristics may be the key to identifying women at increased risk of not being vaccinated against HPV and could inform targeted messaging to drive HPV vaccination.
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Affiliation(s)
- George N Okoli
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | | | | | | | - Alexandra E Soos
- University of Michigan Medical School, University of Michigan, Michigan, USA
| | - Avneet Grewal
- University of Michigan Medical School, University of Michigan, Michigan, USA
| | - Katharine Etsell
- University of Michigan Medical School, University of Michigan, Michigan, USA
| | - Silvia Alessi-Severini
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Caroline Richardson
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Diane M Harper
- Departments of Family Medicine and Obstetrics & Gynecology, University of Michigan, Michigan, USA
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Greaney ML, Cohen SA, Allen JD. Pap test recency and HPV vaccination among Brazilian immigrant women in the United States: a cross-sectional study. BMC Public Health 2024; 24:1954. [PMID: 39039466 PMCID: PMC11264428 DOI: 10.1186/s12889-024-19424-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 07/09/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND The United States (U.S.) has a growing population of Brazilian immigrant women. However, limited research has explored Pap tests and human papillomavirus (HPV) vaccination among this population. METHODS Participants completed an online survey between July-August 2020. Bivariate analyses examined associations between healthcare-related variables (e.g., insurance, having a primary care provider) and demographics (e.g., age, education, income, marital status, years living in the U.S., primary language spoken at home) with 1) Pap test recency (within the past 3 years) and 2) HPV vaccination (0 doses vs. 1 + doses). Variables significant at p < 0.10 in bivariate analyses were included in multivariable logistic regression models examining Pap test recency and HPV vaccination. RESULTS The study found that 83.7% of the sample had a Pap test in the past three years. Women who did not know their household income were less likely to be than women who reported a household income of < $25,000 (adjusted OR [aOR] = 0.34, 95% CI: 0.12, 0.95). Women who had seen a healthcare provider in the past year were more likely to have had a Pap test within the last three years than those who had not seen a provider in the past year ([aOR] = 2.43, 95% CI: 1.32, 4.47). Regarding HPV vaccination, 30.3% of respondents reported receiving one or more doses of the HPV vaccine. The multivariable logic regression models determined that women aged 27 -45 (aOR = 0.35, 95% CI: 0.18, 0.67) were less likely than women aged 18-26 to have been vaccinated against HPV). and that women with a PCP were more likely to be vaccinated than those without a PCP (aOR = 2.47. 95% CI:1.30, 4.59). CONCLUSION This study found that Brazilian immigrant women in the youngest age groups (21 - 29) for Pap test, 18- 26 for HPV vaccination) had somewhat better rates of Pap screening and HPV vaccination than the general U.S. POPULATION This study adds new information about cervical cancer prevention and control behaviors among Brazilian immigrant women.
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Affiliation(s)
- Mary L Greaney
- Department of Public Health, University of Rhode Island, 25 West Independence Way, Kingston, RI, 02181, USA.
| | - Steven A Cohen
- Department of Public Health, University of Rhode Island, 25 West Independence Way, Kingston, RI, 02181, USA
| | - Jennifer D Allen
- Department of Community Health, Tufts University, 574 Boston Avenue, Medford, MA, 02155, USA
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Cernasev A, Oyedeji O, Springer CM, Hagemann TM, Hohmeier KC, Kintziger KW. Demographic Influences on Adult HPV Vaccination: Results from a Cross-Sectional Survey in Tennessee. Healthcare (Basel) 2024; 12:1305. [PMID: 38998840 PMCID: PMC11241226 DOI: 10.3390/healthcare12131305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/19/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024] Open
Abstract
HPV is the most prevalent sexually transmitted infection in the U.S., with more than 80% of all Americans contracting it by age 45. Effective vaccines for HPV exist and were recently approved for adults aged 27-45 years, though uptake remains low in all age groups, particularly in Tennessee where 1089 cancers were attributed to HPV in 2020. Between 29 June and 17 August 2023, we conducted a cross-sectional survey to gain insights about the barriers and facilitators of HPV in 2011 adults aged 18 to 45 years in Tennessee. We developed our survey based on previous instruments to understand predictors of HPV vaccination in adults. Using descriptive statistics and bivariate and logistic regression analyses, we found higher vaccination rates in females, participants aged 18-38 years, participants with a high school education or higher, Hispanic or Latine individuals, and participants identifying as moderate or liberal. These insights highlight the need for public health interventions that consider demographic differences to successfully increase vaccination rates and reduce HPV-associated cancer risk.
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Affiliation(s)
- Alina Cernasev
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, 301 S. Perimeter Park Dr., Suite 220, Nashville, TN 37211, USA; (T.M.H.); (K.C.H.)
| | - Oluwafemifola Oyedeji
- Department of Public Health, University of Tennessee, Knoxville, 390 HPER, 1914 Andy Holt Ave., Knoxville, TN 37996, USA;
| | - Cary M. Springer
- Research Computing Support, Office of Innovative Technologies, University of Tennessee, Knoxville, 2309 Kingston Pike, Suite 132, Knoxville, TN 37996, USA;
| | - Tracy M. Hagemann
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, 301 S. Perimeter Park Dr., Suite 220, Nashville, TN 37211, USA; (T.M.H.); (K.C.H.)
| | - Kenneth C. Hohmeier
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, 301 S. Perimeter Park Dr., Suite 220, Nashville, TN 37211, USA; (T.M.H.); (K.C.H.)
| | - Kristina W. Kintziger
- Department of Environmental, Agricultural & Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA;
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Quist KM, Fontenot HB, Zimet G, Lim E, Matsunaga M, Liebermann E, Allen JD. HPV Vaccine Awareness, Past Behaviors, and Future Intentions Among a Diverse Sample of Fathers Aged 27 to 45 Years: A National Survey. Am J Mens Health 2024; 18:15579883241258823. [PMID: 38879825 PMCID: PMC11181892 DOI: 10.1177/15579883241258823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/06/2024] [Accepted: 05/13/2024] [Indexed: 06/19/2024] Open
Abstract
Men aged 27 to 45 are eligible for human papillomavirus (HPV) vaccination as of 2019, yet relatively little is known about whether they have received or intend to receive it. We conducted a cross-sectional, online survey among fathers aged 27 to 45 between March and April 2022, to assess associations between HPV vaccination awareness, behaviors, intentions, and psychosocial constructs from the Health Belief Model. We examined the characteristics of those who had (a) heard of the HPV vaccine, (b) already received ≥ 1 dose, and (c) intentions for future vaccination among those who had never been vaccinated. Among 400 men who completed the survey, 32% were not aware of the HPV vaccine. Among those who were aware, 41% had received ≥ 1 dose. Sixty-three percent of unvaccinated men reported that they intended to get vaccinated in the future. Multivariable logistic regression analyses revealed that age and race/ethnicity were associated with having been vaccinated previously. Among the unvaccinated, multivariable logistic regression analyses revealed that those with a higher perceived risk of HPV-associated cancer had 3.73 greater odds of reporting they would seek vaccination compared to those with lower perceived risk (95% confidence interval [CI] = [1.28, 12.3]). We did not find perceived benefits, barriers, or decision self-efficacy to be related to future vaccine intentions. Since recommendations for this group include shared clinical decision-making, public health efforts should focus on raising awareness of vaccine eligibility, emphasizing risk factors for HPV-associated cancers so that individuals have an accurate perception of risk, and encouraging conversation between men and their providers.
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Affiliation(s)
- Kevin M. Quist
- Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Gregory Zimet
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Masako Matsunaga
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Erica Liebermann
- College of Nursing, The University of Rhode Island, Providence, RI, USA
| | - Jennifer D. Allen
- Department of Community Health, School of Arts and Sciences, Tufts University, Medford, MA, USA
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6
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Akpan IN, Taskin T, Wheldon CW, Rossheim ME, Thompson EL. Human papillomavirus vaccination uptake among 27-to-45-year-olds in the United States. Prev Med 2024; 182:107951. [PMID: 38604575 DOI: 10.1016/j.ypmed.2024.107951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/07/2024] [Accepted: 04/07/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE The human papillomavirus (HPV) vaccine prevents six types of cancer. Previously, this vaccine was only approved for 9-26-year-olds. However, in October 2018 the U.S. Food and Drug Administration approved the HPV vaccine for 27- to 45-year-olds (mid-adults). The current study aimed to assess HPV vaccination among a national sample of U.S adults aged 27-45 years. This study also assessed factors associated with HPV vaccine initiation after age 26. METHODS Data were analyzed using the 2019 National Health Interview Survey. The study included two samples: (1) mid-adults aged 27-45 (n = 8556), and (2) mid-adults who self-reported they had initiated HPV vaccination within the 27-45 age range and those who were unvaccinated (n = 7307). The outcome variables were HPV vaccination status and HPV vaccine initiation. The independent variables represented constructs from Andersen's Behavioral Model of Health Services Use. The odds of HPV vaccination were estimated using weighted multivariable logistic regression models. RESULTS Overall, 15.6% had ever received the HPV vaccine and 13.1% initiated their first dose of the vaccine after age 26. Hispanic (aOR = 0.73; 95% CI = 0.58, 0.92) and non-Hispanic Asian persons (aOR = 0.59; 95% CI = 0.41, 0.84) had lower odds of ever receiving the vaccine than non-Hispanic White persons. Females (aOR = 2.17; 95% CI = 1.42, 3.32) had higher odds of initiating the vaccine after age 26 than males. CONCLUSIONS The ACIP recommendation of shared clinical decision-making emphasizes the role of clinical interactions in HPV vaccine decision-making. Study findings highlight the need to further explore contextual factors that may influence HPV vaccine behavior among mid-adults.
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Affiliation(s)
- Idara N Akpan
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA.
| | - Tanjila Taskin
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B. Moore Ave., Philadelphia, PA 19122, USA.
| | - Matthew E Rossheim
- Department of Health Administration and Health Policy, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA.
| | - Erika L Thompson
- Department of Population and Community Health, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA; Department of Quantitative and Qualitative Health Sciences, Univeristy of Texas School of Public Health San Antonio, 8403 Floyd Curl Drive, San Antonio, TX 78229, USA.
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7
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Lee M, Gerend MA, Whittington KD, Collins SK, McKinney SL, Franca MC, Boyer VE, McKinnies RC, Chen CC, Villegas J, Adjei Boakye E. Factors associated with HPV-associated sexual risk behaviors among sexually active college students. J Behav Med 2024; 47:334-341. [PMID: 38180576 DOI: 10.1007/s10865-023-00463-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024]
Abstract
High-risk sexual behavior is the primary risk factor for the acquisition and persistence of human papillomavirus (HPV) infection and the development of HPV-associated diseases including cancer. Incidence of HPV infection is high among individuals in their late teens and early 20s. Thus, college students represent a historically high-risk group for HPV infection yet are also a group with the ability to independently access HPV vaccination for HPV prevention. To inform future interventions, we examined factors associated with HPV-associated risky sexual behaviors among sexually active college students. Data (N = 741) were from an anonymous online survey distributed to students at a public Midwestern university in 2021. The outcomes were HPV-associated sexual risk behaviors-number of oral or vaginal sexual partners [high (≥ 5) or low (< 5)] and age of oral or vaginal sexual debut [early (< 18 years) or late (≥ 18 years)]. Multivariable logistic regression models estimated the association between HPV-associated risky sexual behaviors and several predictors including age, gender, relationship status, academic level, country of birth, and rural-urban status. Among sexually active students, approximately 47% and 41% had a high number of lifetime vaginal and oral partners, respectively. Among the same group, 60% and 64% had early vaginal and oral sexual debut. Students who were single and dating (aOR = 1.93; 95% CI = 1.21, 3.08) or single and not dating (2.11; 1.28, 3.48) were more likely to have a high number of vaginal lifetime partners compared with married students. Single (vs. married) students were also about twice as likely to have a high number of oral lifetime partners. Relative to graduate students, freshmen/sophomores were more likely to have an early vaginal (2.44; 1.45, 4.11) and oral (2.14; 1.26, 3.63) sexual debut. Interventions tailored to college freshmen/sophomores and unmarried students should encourage students to receive the HPV vaccine for prevention of future HPV-associated diseases.
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Affiliation(s)
- Minjee Lee
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL, USA
- Simmons Cancer Institute at Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Mary A Gerend
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Kelli D Whittington
- Department of Nursing, School of Health Sciences, Southern Illinois University, Carbondale, IL, USA
| | - Sandra K Collins
- Department of Health Care Management, School of Health Sciences, Southern Illinois University, Carbondale, IL, USA
| | - Stacey L McKinney
- Department of Dental Hygiene, School of Health Sciences, Southern Illinois University, Carbondale, IL, USA
| | - Maria C Franca
- Department of Communication Disorders and Sciences, School of Health Sciences, Southern Illinois University, Carbondale, IL, USA
| | - Valerie E Boyer
- Department of Communication Disorders and Sciences, School of Health Sciences, Southern Illinois University, Carbondale, IL, USA
| | - Richard C McKinnies
- Department of Radiologic Sciences, School of Health Sciences, Southern Illinois University, Carbondale, IL, USA
| | - Cheng-Chia Chen
- Department of Public Health, University of Illinois Springfield, Springfield, IL, USA
| | - Jorge Villegas
- Department of Management, Marketing, and Operations, University of Illinois Springfield, Springfield, IL, USA
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, One Ford Place, Detroit, MI, 48202, USA.
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El Hussein MT, Dhaliwal S. HPV vaccination for prevention of head and neck cancer among men. Nurse Pract 2023; 48:25-32. [PMID: 37751612 DOI: 10.1097/01.npr.0000000000000099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
ABSTRACT The incidence of human papillomavirus (HPV)-associated head and neck cancer (HNC) has been rapidly increasing in developed countries, with HPV-associated HNC now accounting for 70% of all HNC cases. An increased incidence has been noted particularly among males. The disparities in HPV vaccine uptake rates and the increasing number of individuals with HPV-associated HNC suggest a lack of public awareness of both HPV sequelae and prevention options. This review highlights the importance of prophylactic HPV vaccination for preventing HPV-associated HNC, particularly in males. Current evidence substantiates the need for gender-neutral HPV vaccination programs and reinforces the recommendations made by the CDC. This article raises awareness of the association between HPV and HNC as well as the effectiveness of HPV vaccination in HNC prevention.
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Soulakova JN, Crockett LJ, Schmidt-Owens M, Schrimshaw EW. Correlates of COVID-19 vaccine uptake among U.S. College students. Prev Med Rep 2023; 34:102232. [PMID: 37234565 PMCID: PMC10197435 DOI: 10.1016/j.pmedr.2023.102232] [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: 12/09/2022] [Revised: 03/26/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023] Open
Abstract
Hesitance toward COVID-19 vaccination has greatly decreased over the course of the pandemic in the U.S. However, some populations have lower vaccination rates than the general population. This study was conducted to identify correlates of being fully vaccinated (i.e., having received all doses required to be fully vaccinated) among college students using students' responses to the 2022 Spring American College Health Association-National College Health Assessment. The surveys were administered in March of 2022. The sample (n = 617) included 18-to-30-year-old students. Firth logistic regression models were performed that controlled for age, sex assigned at birth, and food security (at a 5% significance level). The model-assisted results indicated that being a member of sexual and gender minority communities, being a graduate student, and being concerned about someone close getting COVID-19 were positively associated with being fully vaccinated, while current use of any tobacco product and current use of e-cigarettes were negatively associated with being fully vaccinated (all p-values < 0.05). In addition, the percentage of fully vaccinated students was higher among transgender/gender non-binary students (95%) than among cisgender men and women (85-87%), and among sexual minority groups (93-97%) than among heterosexual/straight students (82%). Among the racial/ethnic groups considered, the percentage of fully vaccinated students was lowest among non-Hispanic Black/African American students (77%), but the racial/ethnic differences were not statistically significant (at 5% level). The study points to a critical need for development and implementation of tailored vaccination campaigns to help students from diverse communities, including tobacco users, make informed decisions and become fully vaccinated.
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Affiliation(s)
- Julia N Soulakova
- Department of Population Health Sciences, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd., Orlando, FL 32827, USA
| | - Lisa J Crockett
- Department of Psychology, University of Nebraska-Lincoln, 315 Burnett Hall, Lincoln, NE 68588-0308, USA
| | - Mary Schmidt-Owens
- Student Health Services, University of Central Florida, 4098 Libra Drive, Orlando, FL 32816, USA
| | - Eric W Schrimshaw
- Department of Population Health Sciences, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd., Orlando, FL 32827, USA
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Rames JD, Frisco NA, Jiang R, Shah KP, Kahmke RR, Puscas L, Osazuwa-Peters N, Rocke DJ. Integrated Health Maintenance Reminders for Improved HPV Vaccine Administration: Toward Improvements in Completion Disparities. Otolaryngol Head Neck Surg 2023; 169:76-85. [PMID: 36939623 PMCID: PMC10293109 DOI: 10.1002/ohn.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/23/2022] [Accepted: 12/11/2022] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To evaluate the effect of a health maintenance reminder (HMR) on human papillomavirus (HPV) vaccine administration and completion across different age, insurance, and race cohorts. STUDY DESIGN Retrospective pre-post analysis. SETTING Academic primary care. METHODS Patients aged 9 to 26 who had initiated the HPV vaccine series from 2016 to 2021 were analyzed, based on current age-based standards. The cohort was divided based on vaccine uptake before and after the implementation of the HMR program in February 2020. The multivariate analysis estimated the odds of vaccine completion based on sociodemographic factors, and variable interactions were investigated to determine independent associations between sociodemographic factors and HMR implementation. RESULTS There were 7654 individual patients (mean age was 15.8 years; 46.7 were males; and 50.7% were white). HPV vaccine completion rates increased post-HMR implementation by 59.2% (37% pre-, and 58.9% post-HMR; p < .001) in the entire cohort. Overall, black patients (adjusted odds ratio [aOR] = 0.68; 95% confidence interval [CI]: 0.60, 0.70) and patients ≥18 years (aOR = 0.13; 95% CI: 0.11, 0.15) were significantly less likely to complete their vaccine series; however, this improved significantly following HMR in these groups (p < .001). Post-HMR, race, and insurance status were not independently associated with disparate vaccine completion rates, however, age was, and patients ≤14 or younger had higher odds of vaccine completion (aOR = 3.54; 95% CI: 2.91, 4.32). CONCLUSION The implementation of an HMR was associated with increased HPV vaccine uptake across age and race groups in this single-institution study. Future research should explore barriers to implementing HMRs in different health care settings.
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Affiliation(s)
- Jess D. Rames
- Duke University, Department of Head and Neck Surgery &
Communication Sciences, Durham, North Carolina, USA
- Duke University Pratt School of Engineering, Durham, North
Carolina, USA
- Mayo Clinic, Department of Plastic and Reconstructive
Surgery, Rochester, Minnesota, USA
| | - Nicholas A. Frisco
- Duke University, Department of Head and Neck Surgery &
Communication Sciences, Durham, North Carolina, USA
| | - Rong Jiang
- Department of Psychiatry and Behavioral Sciences, School of
Medicine, Duke University, Durham, North Carolina, USA
| | - Kevin P. Shah
- Department of Medicine, Duke Primary Care, Durham, North
Carolina, USA
| | - Russel R. Kahmke
- Duke University, Department of Head and Neck Surgery &
Communication Sciences, Durham, North Carolina, USA
- Duke Cancer Institute, Durham, North Carolina, USA
| | - Liana Puscas
- Duke University, Department of Head and Neck Surgery &
Communication Sciences, Durham, North Carolina, USA
| | - Nosayaba Osazuwa-Peters
- Duke University, Department of Head and Neck Surgery &
Communication Sciences, Durham, North Carolina, USA
- Duke University School of Medicine, Durham, North Carolina,
Department of Population Health Sciences, Durham, North Carolina, USA
- Duke Cancer Institute, Durham, North Carolina, USA
| | - Daniel J. Rocke
- Duke University, Department of Head and Neck Surgery &
Communication Sciences, Durham, North Carolina, USA
- Duke Cancer Institute, Durham, North Carolina, USA
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Reiter PL, Gower AL, Kiss DE, Shoben AB, Katz ML, Bauermeister JA, Paskett ED, McRee AL. Efficacy of the Outsmart HPV Intervention: A Randomized Controlled Trial to Increase HPV Vaccination among Young Gay, Bisexual, and Other Men Who Have Sex with Men. Cancer Epidemiol Biomarkers Prev 2023; 32:760-767. [PMID: 36958851 PMCID: PMC10239352 DOI: 10.1158/1055-9965.epi-23-0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/02/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Routine human papillomavirus (HPV) vaccination is recommended for young adults, yet many young gay, bisexual, and other men who have sex with men (YGBMSM) remain unvaccinated. We report the efficacy of Outsmart HPV, a web-based HPV vaccination intervention for YGBMSM. METHODS From 2019 to 2021, we recruited YGBMSM in the United States who were ages 18-25 and unvaccinated against HPV (n = 1,227). Participants were randomized to receive either: (i) Outsmart HPV content online and monthly interactive text reminders (interactive group); (ii) Outsmart HPV content online and monthly unidirectional text reminders (unidirectional group); or (iii) standard information online about HPV vaccine (control group). Regression models compared study groups on HPV vaccination outcomes. RESULTS Overall, 33% of participants reported initiating the HPV vaccine series and 7% reported series completion. Initiation was more common among participants in the interactive group compared with the control group [odds ratio (OR) = 1.47, 98.3% confidence interval (CI): 1.03-2.11]. Completion was more common among participants in both the interactive group (OR = 3.70, 98.3% CI: 1.75-7.83) and unidirectional group (OR = 2.26, 98.3% CI: 1.02-5.00) compared with the control group. Participants who received Outsmart HPV content reported higher levels of satisfaction with online content compared with the control group. CONCLUSIONS Outsmart HPV is an efficacious and acceptable HPV vaccination intervention for YGBMSM. Future efforts are needed to determine how to optimize the intervention and disseminate it to settings that provide services to YGBMSM. IMPACT Outsmart HPV is a promising tool for increasing HPV vaccination among YGBMSM with the potential for wide dissemination.
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Affiliation(s)
- Paul L. Reiter
- College of Public Health, The Ohio State University, Columbus, OH
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | - Amy L. Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Dale E. Kiss
- College of Public Health, The Ohio State University, Columbus, OH
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | - Abigail B. Shoben
- College of Public Health, The Ohio State University, Columbus, OH
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | - Mira L. Katz
- College of Public Health, The Ohio State University, Columbus, OH
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | - José A. Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Electra D. Paskett
- College of Public Health, The Ohio State University, Columbus, OH
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
- Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, OH
| | - Annie-Laurie McRee
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
- Center for Scientific Review, National Institutes of Health, Bethesda, MD
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12
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Adekanmbi V, Guo F, Hsu CD, Shan Y, Kuo YF, Berenson AB. Incomplete HPV Vaccination among Individuals Aged 27-45 Years in the United States: A Mixed-Effect Analysis of Individual and Contextual Factors. Vaccines (Basel) 2023; 11:820. [PMID: 37112732 PMCID: PMC10142711 DOI: 10.3390/vaccines11040820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/27/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Background: In the United States, the human papillomavirus (HPV) vaccine is approved for use in individuals up to age 45. Individuals 15 years and older require three doses of the vaccine to complete the recommended dosing series. Incomplete HPV vaccination rates (i.e., one or two doses) among those over age 26, however, remain high. This study examined the independent effects of individual- and neighborhood-level factors on incomplete HPV vaccination rates in the United States (U.S.) among those aged 27-45 years. Methods: This retrospective cohort study used administrative data from Optum's de-identified Clinformatics® Data Mart Database to identify individuals aged 27-45 years who received one or more doses of HPV vaccine between July 2019 and June 2022. Multilevel multivariable logistic regression models were applied to the data on 7662 individuals identified as being fully or partially vaccinated against HPV, nested within 3839 neighborhoods across the U.S. Results: Approximately half of the patients in this study (52.93%) were not completely vaccinated against HPV. After adjusting for all other covariates in the final model, being older than 30 years old decreased the odds of not completing the HPV vaccine series. Participants living in South-region neighborhoods of the U.S. had enhanced odds of not completing the vaccine series compared with those residing in Northeast-region neighborhoods (aOR 1.21; 95% CrI 1.03-1.42). There was significant clustering of incomplete HPV vaccination rates at the neighborhood level. Conclusions: This study revealed that individual- and neighborhood-level factors were associated with the risk of not completing the HPV vaccine series among individuals aged 27-45 years in the U.S. Interventions to improve HPV vaccination series completion rates for this age group should take into consideration both individual and contextual factors.
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Affiliation(s)
- Victor Adekanmbi
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
| | - Fangjian Guo
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
| | - Christine D. Hsu
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
| | - Yong Shan
- Department of Biostatistics and Data Science, The University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Yong-Fang Kuo
- Department of Biostatistics and Data Science, The University of Texas Medical Branch, Galveston, TX 77555, USA
| | - Abbey B. Berenson
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch, Galveston, TX 77555, USA
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
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13
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Calderón-Mora J, Lara H, Hernandez B, Molokwu J. Factors Affecting Completion of Human Papillomavirus Vaccination Series by Gender in a Predominantly Hispanic Border Town Community. J Low Genit Tract Dis 2023; 27:161-167. [PMID: 36951986 DOI: 10.1097/lgt.0000000000000728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
OBJECTIVES The human papillomavirus (HPV) vaccine is recommended for females and males aged 9 to 45. Nationally, the HPV vaccination rates are lower for males than females; however, this has not been studied in a US-Mexico border community. Our study aims to report the HPV vaccination completion by gender and determine which sociodemographic factors influence vaccination. METHODS This cross-sectional study was conducted among uninsured and underinsured individuals aged between 9 and 26 years served through a community-based HPV vaccine program in El Paso, TX. Data collected included demographic information, psychosocial variables, and vaccine administration data. Descriptive statistics were used to summarize demographic data. Unadjusted t test/Fisher exact test and multivariable relative risk regression were run on significant variables to determine the association with vaccine completion by gender. RESULTS Most participants were female (63.4%), and an overall vaccine series completion was 30.67%. We found no significant difference in HPV vaccine completion rates by gender. Males who resided in the United States for more than a decade were 31% more likely to complete the vaccine series, and females who had 9 to 13 years of education had lower odds of vaccine completion. Knowledge significantly increased after the intervention for both genders (p = .002). There was no significant change in psychosocial variables from the preintervention to the immediate postintervention survey. CONCLUSIONS Our multicomponent, culturally tailored intervention may equally impact male and female participants and encourages all genders to complete their HPV vaccine series. Additional studies with a larger male sample are needed.
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Affiliation(s)
- Jessica Calderón-Mora
- Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, TX
| | - Hatty Lara
- Department of Psychology, University of Arizona College of Science, Tucson, AZ
| | - Blanca Hernandez
- Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, TX
| | - Jennifer Molokwu
- Department of Family and Community Medicine, Cancer Prevention and Control, Department of Molecular and Translational Medicine, Center of Emphasis for Cancer, Texas Tech University Health Sciences Center El Paso, Paul L. Foster School of Medicine, El Paso, TX
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14
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Guo F, Adekanmbi V, Hsu CD, Berenson AB. Incidence of human papillomavirus-related cancers among males and females aged 15-34 years in the United States. JNCI Cancer Spectr 2023; 7:pkad016. [PMID: 36821427 PMCID: PMC10029840 DOI: 10.1093/jncics/pkad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/24/2023] Open
Abstract
Postmarket surveillance of the incidence of human papillomavirus (HPV)-related cancers is essential to monitor the effectiveness of HPV vaccines. We directly compared HPV-related cancer incidences during the pre- and postvaccine era to assess the effects of HPV vaccination among vaccine-eligible age groups in the United States using data from the US Cancer Statistics database. The 5-year average annual incidence rates for HPV-related cancers decreased in 2015-2019 compared with 2002-2006 among females aged 15-24 years and 25-34 years. Overall, a decrease in young males was not observed, whereas males aged 25-34 years experienced a slight decline in oropharyngeal squamous cell carcinoma between 2005-2009 and 2015-2019. Incidence rates for HPV-related cancers statistically significantly decreased in the vaccine era compared with the prevaccine era among females aged 15-34 years, suggesting the potential early effects of the introduction of HPV vaccination in the United States.
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Affiliation(s)
- Fangjian Guo
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
- Center for Interdisciplinary Research in Women’s Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Victor Adekanmbi
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
- Center for Interdisciplinary Research in Women’s Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Christine D Hsu
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
- Center for Interdisciplinary Research in Women’s Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Abbey B Berenson
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
- Center for Interdisciplinary Research in Women’s Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
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15
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Amantea C, Foschi N, Gavi F, Borrelli I, Rossi MF, Spuntarelli V, Russo P, Gualano MR, Santoro PE, Moscato U. HPV Vaccination Adherence in Working-Age Men: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:vaccines11020443. [PMID: 36851321 PMCID: PMC9958554 DOI: 10.3390/vaccines11020443] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is the most common sexually transmitted viral infection in the world. HPV vaccination adherence rates in men are generally lower than in women. The aim of this systematic review and meta-analysis was to assess adherence to HPV vaccination in young working-age males (18-30 years old). METHODS A systematic review was performed using three databases: PubMed, Scopus, and Web of Science, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS After duplicate removal, the initial search resulted in 478 eligible papers. With the exclusion of 425 papers after screening the abstracts, full texts of 53 articles were reviewed. Subsequently, 45 were excluded. Among the eight studies included, four (50%) examined the vaccination adherence in young adults through data registered in nationwide insurance or private companies' databases, three (37.5%) in young adults in different settings through data collected from surveys and questionnaires, and one (12.5%) an HPV vaccination campaign in a family medicine residency practice. CONCLUSION Adherence to HPV vaccination in men of working age (18-30 years) does not appear to be adequate (pooled prevalence 11%). In order to achieve a higher level of compliance, it is important to place an emphasis on vaccination campaigns in schools as well as in the workplace, after consultation with and approval from local, regional, and federal public health agencies.
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Affiliation(s)
- Carlotta Amantea
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Nazario Foschi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Filippo Gavi
- Postgraduate School of Urology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Correspondence:
| | - Ivan Borrelli
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Maria Francesca Rossi
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Valerio Spuntarelli
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Pierluigi Russo
- Postgraduate School of Urology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Maria Rosaria Gualano
- School of Medicine, Saint Camillus International University of Health Sciences, UniCamillus, 00131 Rome, Italy
| | - Paolo Emilio Santoro
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Umberto Moscato
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
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16
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Alsulami FT, Sanchez J, Rabionet SE, Popovici I, Baraka MA. Predictor of HPV Vaccination Uptake among Foreign-Born College Students in the U.S.: An Exploration of the Role of Acculturation and the Health Belief Model. Vaccines (Basel) 2023; 11:422. [PMID: 36851299 PMCID: PMC9959595 DOI: 10.3390/vaccines11020422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/01/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVE to measure the HPV vaccination rate and knowledge about HPV and its vaccine among foreign-born college students; additionally, to measure the effect of acculturation and HBM constructs on the HPV vaccination behavior among foreign-born college students. METHODS a cross-sectional design with a non-probability sample of foreign-born college students was collected via a web-based self-administered survey that measured the HPV vaccination rate, assessed knowledge about HPV and its vaccine, and evaluated the effect of acculturation and HBM constructs on HPV vaccination behavior among foreign-born college students. RESULTS Foreign-born college students had moderate knowledge about HPV and the HPV vaccine, and about 63% were HPV-vaccinated. Perceived susceptibility, perceived barriers, and cues to action were significantly associated with the HPV vaccination behavior, while knowledge levels about HPV and the HPV vaccine and acculturation levels were not significantly associated with the HPV vaccination behavior of foreign-born college students. CONCLUSIONS The current study shows a moderate vaccination rate and moderate knowledge about HPV and its vaccine among foreign-born college students. Additionally, vaccination campaigns need to increase awareness about the susceptibility to acquiring HPV and minimize the barriers to receiving the vaccine to increase the HPV vaccination rate among foreign-born college students.
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Affiliation(s)
- Fahad T. Alsulami
- Sociobehavioral and Administrative Pharmacy Department, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Clinical Pharmacy Department, College of Pharmacy, Taif University, Taif 21944, Saudi Arabia
| | - Jesus Sanchez
- Sociobehavioral and Administrative Pharmacy Department, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| | - Silvia E. Rabionet
- Sociobehavioral and Administrative Pharmacy Department, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| | - Ioana Popovici
- Sociobehavioral and Administrative Pharmacy Department, College of Pharmacy, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| | - Mohamed A. Baraka
- Clinical Pharmacy Program, College of Pharmacy, Al Ain University, Al Ain P.O. Box 64141, United Arab Emirates
- Clinical Pharmacy Department, College of Pharmacy, Al-Azhar University, Cairo 11884, Egypt
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17
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Amboree TL, Wermuth PP, Montealegre JR, Fujimoto K, Mgbere O, Darkoh C. Sexual Behaviors and Human Papillomavirus Vaccination in a Heterosexually Active Adult Population at Increased Risk for HIV Infection. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:793-801. [PMID: 36255610 PMCID: PMC11077896 DOI: 10.1007/s10508-022-02438-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 08/25/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
Human papillomavirus (HPV) is the most common sexually acquired infection in the US. Vaccination is effective against infection with high-risk HPV strains, yet HPV vaccine coverage is lower in the US than the national target. This study aimed to determine the relationship between sexual behaviors and HPV vaccination in a heterosexually active population at increased risk for HIV infection. Data from 380 participants aged 18-45 years obtained from the National HIV Behavioral Surveillance system increased risk heterosexuals cycle 5 (2019) in Houston, Texas, was analyzed. RDS-Analyst was used to generate population-based descriptive statistics. Modified Poisson regression models clustered on recruitment chain were conducted in SAS 9.4 to assess the relationship between sexual behaviors and HPV vaccination. Only 11.5% of participants had received at least one dose of the HPV vaccine. Regarding behaviors within the past 12 months, 44.8% reported having condomless casual sex, 51.3% reported having concurrent sexual partnerships while in their most recent relationship, 14.5% reported exchanging sex, and participants had an average of 4-5 sex partners. Further, those who exchanged sex had a significantly lower prevalence of HPV vaccine uptake when compared to those who did not exchange sex (adjusted prevalence ratio 0.23; confidence interval 0.10-0.52), while all other measures of sexual behavior were not significantly associated with HPV vaccination. More research is needed to understand the relationship between exchange sex and low prevalence of vaccination, specifically in women who bear the highest burden of poor HPV-related morbidity and mortality.
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Affiliation(s)
- Trisha L Amboree
- Department of Management, Policy, and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler Street, Room E715, Houston, TX, 77030, USA
| | - Paige P Wermuth
- Department of Management, Policy, and Community Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jane R Montealegre
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Kayo Fujimoto
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Osaro Mgbere
- Disease Prevention and Control Division, Houston Health Department, Houston, TX, USA
- Institute of Community Health, University of Houston College of Pharmacy, Houston, TX, USA
| | - Charles Darkoh
- Department of Epidemiology, Human Genetics and Environmental Sciences, Center for Infectious Diseases, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler Street, Room E715, Houston, TX, 77030, USA.
- Microbiology and Infectious Diseases Program, UTHealth Graduate School of Biomedical Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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18
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Malone MA, Gower AL, Reiter PL, Kiss DE, McRee AL. "What does it matter?" Young sexual minority men discuss their conversations with sexual partners about HPV vaccination. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:489-495. [PMID: 33830878 PMCID: PMC9404533 DOI: 10.1080/07448481.2021.1895806] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/27/2020] [Accepted: 02/21/2021] [Indexed: 05/14/2023]
Abstract
Objective: Human papillomavirus vaccination coverage is suboptimal, especially among males. Social networks influence young adults' health behaviors and could be leveraged to promote vaccination. We sought to describe how young sexual minority men communicate about human papillomavirus (HPV) vaccination with their sexual partners. Participants: National (U.S.) sample of sexual minority men ages 18-26 (n = 42) from January 2019. Methods: We conducted four online focus groups and identified salient themes using inductive content analysis. Results: Across groups, participants described that HPV vaccination is not a focus of their conversations with sexual partners. Other key themes related to HPV vaccine communication included: varying discissions based on relationship type, and valuing conversations with partners about safer sex. Conclusions: Findings provide novel insight into how young sexual minority men communicate with their sexual partners about HPV vaccination and identify potential areas for interventions to promote communication. Future research is needed to investigate associations between partner communication and HPV vaccine uptake.
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Affiliation(s)
- Molly A. Malone
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Amy L. Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Paul L. Reiter
- Division of Health Behavior and Health Promotion, The Ohio State University, Columbus, OH, USA
| | - Dale E. Kiss
- Division of Health Behavior and Health Promotion, The Ohio State University, Columbus, OH, USA
| | - Annie-Laurie McRee
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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19
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Harry ML, Asche SE, Freitag LA, Sperl-Hillen JM, Saman DM, Ekstrom HL, Chrenka EA, Truitt AR, Allen CI, O'Connor PJ, Dehmer SP, Bianco JA, Elliott TE. Human Papillomavirus vaccination clinical decision support for young adults in an upper midwestern healthcare system: a clinic cluster-randomized control trial. Hum Vaccin Immunother 2022; 18:2040933. [PMID: 35302909 PMCID: PMC9009937 DOI: 10.1080/21645515.2022.2040933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Human papillomavirus (HPV) vaccination rates are low in young adults. Clinical decision support (CDS) in primary care may increase HPV vaccination. We tested the treatment effect of algorithm-driven, web-based, and electronic health record-linked CDS with or without shared decision-making tools (SDMT) on HPV vaccination rates compared to usual care (UC). METHODS In a clinic cluster-randomized control trial conducted in a healthcare system serving a largely rural population, we randomized 34 primary care clinic clusters (with three clinics sharing clinicians randomized together) to: CDS; CDS+SDMT; UC. The sample included young adults aged 18-26 due for HPV vaccination with a study index visit from 08/01/2018-03/15/2019 in a study clinic. Generalized linear mixed models tested differences in HPV vaccination status 12 months after index visits by study arm. RESULTS Among 10,253 patients, 6,876 (65.2%) were due for HPV vaccination, and 5,054 met study eligibility criteria. In adjusted analyses, the HPV vaccination series was completed by 12 months in 2.3% (95% CI: 1.6%-3.2%) of CDS, 1.6% (95% CI: 1.1%-2.3%) of CDS+SDMT, and 2.2% (95% CI: 1.6%-3.0%) of UC patients, and at least one HPV vaccine was received by 12 months in 13.1% (95% CI: 10.6%-16.1%) of CDS, 9.2% (95% CI: 7.3%-11.6%) of CDS+SDMT, and 11.2% (95% CI: 9.1%-13.7%) of UC patients. Differences were not significant between arms. Females, those with prior HPV vaccinations, and those seen at urban clinics had significantly higher odds of HPV vaccination in adjusted models. DISCUSSION CDS may require optimization for young adults to significantly impact HPV vaccination. TRIAL REGISTRATION clinicaltrials.gov NCT02986230, 12/6/2016.
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20
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Adjei Boakye E, McKinney SL, Whittington KD, Boyer VE, Franca MC, Lee M, McKinnies RC, Collins SK, Gerend MA. Association between Sexual Activity and Human Papillomavirus (HPV) Vaccine Initiation and Completion among College Students. Vaccines (Basel) 2022; 10:2079. [PMID: 36560489 PMCID: PMC9784235 DOI: 10.3390/vaccines10122079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
HPV vaccination is most effective if received before initiation of sexual activity. Previous studies suggested that young adult women who were not sexually active were not interested in receiving the vaccine because they did not think it was necessary. Whether this misperception is still prevalent today-and also shared by men-is unknown. This study examined whether sexual activity was associated with HPV vaccine uptake (initiation and completion) among university students. A cross-sectional study was conducted between February and May 2021 among students (n = 951) at a public Midwestern University. Sexual activity was categorized as "never" or "ever" had oral and/or vaginal sex. Outcome variables were HPV vaccine initiation, defined as receipt of ≥1 dose, and completion, defined as receipt of ≥3 doses. Multivariable logistic regression models estimated the association between sexual activity and HPV vaccine uptake, adjusting for sociodemographic factors. Approximately 18% of students reported never engaging in sexual activity. Overall, 45.5% initiated the HPV vaccine, and 16.5% completed the vaccine series. After adjusting for covariates, compared to students that reported never engaging in sexual activity, those that had ever engaged in sexual activity were more likely to have initiated the vaccine series (aOR = 2.06, 95% CI: 1.34-3.17); however, no difference was observed for completion. HPV vaccination was low; sexually naïve students were less likely to initiate the HPV vaccine. Since sexually naïve students may benefit from receiving the HPV vaccination, targeted interventions should be implemented towards this population to help increase vaccination rates and prevent HPV-associated diseases.
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Affiliation(s)
- Eric Adjei Boakye
- Department of Otolaryngology—Head and Neck Surgery, Henry Ford Health System, One Ford Place, Detroit, MI 48202, USA
- Department of Public Health Sciences, Henry Ford Health System, One Ford Place, Detroit, MI 48202, USA
| | - Stacey L. McKinney
- Department of Dental Hygiene, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Kelli D. Whittington
- Department of Nursing, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Valerie E. Boyer
- Department of Communication Disorders and Sciences, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Maria C. Franca
- Department of Communication Disorders and Sciences, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Minjee Lee
- Department of Population Science and Policy, Southern Illinois University School of Medicine, 201 E. Madison Street, Springfield, IL 62794, USA
| | - Richard C. McKinnies
- Department of Radiologic Sciences, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Sandra K. Collins
- Department of Health Care Management, School of Health Sciences, Southern Illinois University, 1263 Lincoln Dr, Carbondale, IL 62901, USA
| | - Mary A. Gerend
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, 1115 West Call Street, Tallahassee, FL 32306, USA
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21
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Du EY, Adjei Boakye E, Taylor DB, Kuziez D, Rohde RL, Pannu JS, Simpson MC, Patterson RH, Varvares MA, Osazuwa-Peters N. Medical students' knowledge of HPV, HPV vaccine, and HPV-associated head and neck cancer. Hum Vaccin Immunother 2022; 18:2109892. [PMID: 36070503 DOI: 10.1080/21645515.2022.2109892] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
On the basis of their training, medical students are considered "the best case scenario" among university students in knowledge of the human papillomavirus (HPV). We evaluated differences in knowledge of HPV, HPV vaccine, and head and neck cancer (HNC) among medical students. A previously validated questionnaire was completed by 247 medical students at a Midwestern university. Outcomes of interest were knowledge score for HPV and HPV vaccine, and HNC, derived from combining questionnaire items to form HPV knowledge and HNC scores, and analyzed using multivariate linear regression. Mean scores for HPV knowledge were 19.4 out of 26, and 7.2 out of 12 for HNC knowledge. In the final multivariate linear regression model, sex, race, and year of study were independently associated with HPV and HPV vaccine knowledge. Males had significantly lower HPV vaccine knowledge than females (β = -1.53; 95% CI: -2.53, -0.52), as did nonwhite students (β = -1.05; 95% CI: -2.07, -0.03). There was a gradient in HPV vaccine knowledge based on the year of study, highest among fourth year students (β = 6.75; 95% CI: 5.17, 8.33). Results were similar for factors associated with HNC knowledge, except for sex. HNC knowledge similarly increased based on year of study, highest for fourth year students (β = 2.50; 95% CI: 1.72, 3.29). Among medical students, gaps remain in knowledge of HPV, HPV vaccine, and HPV-linked HNC. Male medical students have significantly lower knowledge of HPV. This highlights the need to increase medical student knowledge of HPV and HPV-linked HNC.
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Affiliation(s)
- Eric Y Du
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.,Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, MI, USA
| | - Derian B Taylor
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Duaa Kuziez
- Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Rebecca L Rohde
- Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jaibir S Pannu
- Department of Otolaryngology-Head and Neck Surgery, Loma Linda University, Loma Linda, CA, USA
| | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St Louis, MO, USA.,Advanced Health Data Research Institute, Saint Louis University, St Louis, MO, USA
| | - Rolvix H Patterson
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Mark A Varvares
- Department of Otolaryngology, Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
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22
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Harper DM, Rego R, Tariq M, Patel MR, Resnicow K, Sheinfeld Gorin S. HPV vaccination initiation among white, black and Middle East North African (MENA) males. Prev Med Rep 2022; 30:102029. [PMID: 36281349 PMCID: PMC9587522 DOI: 10.1016/j.pmedr.2022.102029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/16/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives US males initiate HPV vaccination at older ages than females and currently have low population coverage. We aim to describe the prevalence and predictors of HPV vaccination initiation among males of White, Black, and Middle-Eastern/North-African (MENA) descent in southeast Michigan. Methods We conducted three community-based surveys in 2019 that provided primary data via self report. Using population weights and multivariate modeling, we measured the prevalence and predictors of HPV vaccine initiation in each race/ethnicity of men (age 18–34 years) analyzed. Results The vaccine initiation rates were 44.5 % (95 % CI: 44.4, 44.6) for White men, 46.2 % (46.0, 46.4) for Black men, and 23.2 % (22.8, 23.6) for MENA men, (p < 0.001). Being a student, compared to unemployed or disabled, was significantly associated with HPV vaccine initiation across all three races/ethnicities. Married men of any race/ethnicity were unlikely to be vaccinated. MENA men born in the US and having some college education were also more likely to initiate HPV vaccination. Conclusions White, Black, and MENA men are not vaccinated in accord with Healthy (Healthy People 2030, 2022) goals. Each race/ethnicity has different predictors of vaccination.
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Affiliation(s)
- Diane M. Harper
- Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, MI, United States,Department of Obstetrics & Gynecology, University of Michigan School of Medicine, Ann Arbor, MI, United States,Department of Women's Studies, University of Michigan, College of Literature, Science and the Arts, Ann Arbor, MI, United States,Corresponding author at: Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, MI, United States..
| | - Ryan Rego
- Center for Global Health Equity, University of Michigan School of Medicine, Ann Arbor, MI, United States
| | - Madiha Tariq
- Arab Community Center for Economic and Social Services (ACCESS), Dearborn, MI, United States
| | - Minal R. Patel
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Arbor, MI, United States
| | - Kenneth Resnicow
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Arbor, MI, United States,Outreach and Health Disparities Research, University of Michigan Rogel Cancer Center, Ann Arbor, MI, United States,Center for Health Communications Research, University of Michigan, School of Public Health, Ann Arbor, MI, United States
| | - Sherri Sheinfeld Gorin
- Department of Family Medicine, University of Michigan School of Medicine, Ann Arbor, MI, United States,Department of Health Behavior & Health Education, University of Michigan School of Public Health, Arbor, MI, United States
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23
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Leader AE, Miller-Day M, Rey RT, Selvan P, Pezalla AE, Hecht ML. The impact of HPV vaccine narratives on social media: Testing narrative engagement theory with a diverse sample of young adults. Prev Med Rep 2022; 29:101920. [PMID: 36161120 PMCID: PMC9502044 DOI: 10.1016/j.pmedr.2022.101920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 07/10/2022] [Accepted: 07/18/2022] [Indexed: 11/28/2022] Open
Abstract
Rates of human papillomavirus (HPV) infection are highest in young adults, who can be vaccinated against HPV if they were not vaccinated as adolescents. Since young adults increasingly access health information on social media, we tested the impact of a social media campaign with narrative-based health information on intentions related to HPV vaccination. We also aimed to understand which ads resonated most with young adults and led to higher survey completion rates. We created social media posts featuring videos promoting HPV vaccination. We launched a sponsored ad campaign on Facebook to reach young women, ages 18-26, across the country. Participants were randomly assigned one of 6 videos and then completed a brief survey about video engagement and intentions to: talk with a health care professional, talk with friends or family, and vaccinate against HPV. A descriptive correlational design and a test for moderation were used to explore hypothesized relationships. Across all ads, 1332 link clicks led to 991 completed surveys that were reduced to 607 surveys (95 % ages 18-26, 63 % non-Caucasian; 58 % sexually active). Higher video engagement was associated with stronger intentions to talk with a health care professional (r = 0.44, p =.01), talk with friends/family (r = 0.52, p =.01), and vaccinate against HPV (r = 0.43, p =.01). Young adults were receptive to watching narrative-based health information videos on social media. When promoting HPV vaccination, more engaging information leads to greater intentions to talk about the vaccine and get vaccinated.
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Affiliation(s)
- Amy E. Leader
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, United States
| | | | - Rikishi T. Rey
- Department of Communication, Clemson University, United States
| | - Preethi Selvan
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, United States
| | - Anne E. Pezalla
- REAL Prevention, LLC, United States
- Department of Psychology, Macalester College, United States
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24
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Muthukrishnan M, Loux T, Shacham E, Tiro JA, Arnold LD. Barriers to human papillomavirus (HPV) vaccination among young adults, aged 18–35. Prev Med Rep 2022; 29:101942. [PMID: 36161130 PMCID: PMC9502683 DOI: 10.1016/j.pmedr.2022.101942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/14/2022] [Accepted: 08/05/2022] [Indexed: 10/31/2022] Open
Abstract
Most HPV vaccine eligible adults are not at all likely to get vaccinated for HPV. Motivational barriers include the belief that the vaccine is unnecessary and unsafe. When other barriers are present, lack of provider recommendation is not associated.
In the United States (US), an estimated 35,900 human papillomavirus (HPV)-related cancers are diagnosed annually. HPV vaccines are projected to eliminate ∼90% of these cancers. Routine vaccination is recommended at age 11–12 with “catch-up” vaccination through age 26 and shared clinical decision making for ages 27–45. However, vaccine uptake has been slow with many young adults remaining unvaccinated. This study examined barriers to HPV vaccination among individuals aged 18–35 years and assessed likelihood of future HPV vaccination. Age-eligible participants (n = 499) recruited through Facebook advertisements, Facebook posts, and clinics (6/2019–3/2020) completed an online survey. Descriptive statistics and bivariate analysis examined HPV vaccine barriers and intent. Logistic regression models examined predictors of HPV vaccine intent. Most (57.1%) reported they were not at all likely to get vaccinated for HPV in the future. Lower intent was associated with belief that the vaccine is not necessary (aOR: 0.134, 95% CI: 0.073, 0.246) and not safe (aOR: 0.312, 95% CI: 0.126, 0.773). Intent was positively associated with the belief that health insurance would not cover vaccination (aOR: 2.226, 95% CI: 1.070, 4.631). Provider recommendation was not significantly associated with vaccine intention. This study highlights challenges to HPV vaccine uptake for young adults. Though several successful interventions exist, most target adolescents and their parents or providers. Future steps should use this evidence to inform development of targeted interventions to increase HPV vaccine intention and uptake in adults, ultimately reducing the burden of HPV-related cancers.
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25
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Sidiropoulou M, Gerogianni G, Kourti FE, Pappa D, Zartaloudi A, Koutelekos I, Dousis E, Margari N, Mangoulia P, Ferentinou E, Giga A, Zografakis-Sfakianakis M, Dafogianni C. Perceptions, Knowledge and Attitudes among Young Adults about Prevention of HPV Infection and Immunization. Healthcare (Basel) 2022; 10:healthcare10091721. [PMID: 36141333 PMCID: PMC9498464 DOI: 10.3390/healthcare10091721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Human papilloma virus (HPV) is one of the most common sexually transmitted infections and is widely known as the main causative agent for cervical cancer. The aim of this study was to investigate the perceptions, knowledge and attitudes of young Greek adults concerning prevention of HPV infection and HPV immunization. Material and Methods: This constitutes a cross-sectional online survey. A convenience sample of young Greek adults (n = 883) residing in Greece, aged 17 to more than 35 years was surveyed from December 2020 to March 2021. Two validated questionnaires were used to collect data. Results: Participants demonstrated moderate knowledge about HPV infection and vaccination, with a mean knowledge score of 53.26 (SD ± 20.65) and 38.92 (SD ± 17.58), respectively. Cronbach’s alpha value was 0.77 and 0.80. Female participants were better informed than males. Approximately 52.3% of respondents had been vaccinated and 65.5% were willing to get vaccinated in the future. Vaccination rate was significantly associated with gender (OR = 11.99; 99% CI = 6.59–21.84), knowledge about the HPV vaccine (OR = 1.04; 99% CI = 1.03–1.04) and age (OR = 0.07; 99% CI = 0.03–0.15). Reasons for vaccine refusal were insufficient information (36.8%) and fear of side effects (19%). Correlates of positive vaccination intention were knowledge about HPV (OR = 1.02; 99% CI = 1.01–1.02). Conclusions: The findings suggest that the Greek government’s continuing HPV promotion efforts and education on the risks of HPV infection among young people are likely to increase vaccination acceptance among this group.
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Affiliation(s)
- Maria Sidiropoulou
- School of Social Sciences, Hellenic Open University, 26335 Patra, Greece
| | - Georgia Gerogianni
- Department of Nursing, University of West Attica, 12243 Athens, Greece
- Correspondence:
| | | | - Despoina Pappa
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | | | | | - Evangelos Dousis
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Nikoletta Margari
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Polyxeni Mangoulia
- Department of Nursing, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | | | - Anna Giga
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | | | - Chrysoula Dafogianni
- School of Social Sciences, Hellenic Open University, 26335 Patra, Greece
- Department of Nursing, University of West Attica, 12243 Athens, Greece
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26
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Ratnasamy P, Chagpar AB. HPV vaccination and factors influencing vaccine uptake among people of Indian ancestry living in the United States. Epidemiol Infect 2022; 150:e152. [PMID: 35894243 PMCID: PMC9428900 DOI: 10.1017/s0950268822001315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Approximately one-quarter of annual global cervical cancer deaths occur in India, possibly due to cultural norms promoting vaccine hesitancy. We sought to determine whether people of Indian ancestry (POIA) in the USA exhibit disproportionately lower human papilloma virus (HPV) vaccination rates than the rest of the US population. We utilised the 2018 National Health Interview Survey to compare HPV vaccine initiation and completion rates between POIA and the general US population and determined factors correlating with HPV vaccine uptake among POIA. Compared to other racial groups, POIA had a significantly lower rate of HPV vaccination (8.18% vs. 12.16%, 14.70%, 16.07% and 12.41%, in White, Black, Other Asian and those of other/mixed ancestry, respectively, P = 0.003), but no statistically significant difference in vaccine series completion among those who received at least one injection (3.17% vs. 4.27%, 3.51%, 4.31% and 5.04%, P = 0.465). Among POIA, younger individuals (vs. older), single individuals (vs. married), those with high English proficiency (vs. low English proficiency), those with health insurance and those born in the USA (vs. those born outside the USA) were more likely to obtain HPV vaccination (P = 0.018, P = 0.006, P = 0.029, P = 0.020 and P = 0.019, respectively). Public health measures promoting HPV vaccination among POIA immigrants may substantially improve vaccination rates among this population.
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Affiliation(s)
- Philip Ratnasamy
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Anees B. Chagpar
- Department of Surgery, Yale University School of Medicine, New Haven, CT, USA
- Author for correspondence: Anees Chagpar, E-mail:
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27
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Lewis RM, Markowitz LE. Disparities in human papillomavirus vaccination coverage in the United States, National Health and Nutrition Examination Survey, January 2017-March 2020. Vaccine 2022; 40:2828-2832. [PMID: 35393147 DOI: 10.1016/j.vaccine.2022.03.028] [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: 12/22/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND We assessed disparities in HPV vaccination coverage by sociodemographic characteristics in the United States. METHODS Using 2017-March 2020 National Health and Nutrition Examination Survey data, we estimated vaccination coverage of ≥ 1 dose of HPV vaccine by race/ethnicity and poverty, insurance, and nativity status for females and males aged 9-14, 15-19, and 20-29 years. RESULTS Among those aged 9-14 years, coverage among non-Hispanic Black (NHB), Hispanic, and non-Hispanic Asian (NHA) females (40.0%, 33.6%, 34.0%) and males (27.1%, 35.3%, 30.9%) was higher than non-Hispanic White (NHW) females (26.5%) and males (25.2%). Among those aged 15-19 and 20-29 years, coverage varied among NHB, Hispanic, and NHA compared to NHW females and was lower among NHB, Hispanic, and NHA than NHW males. Coverage was lower among uninsured than insured in most comparisons. CONCLUSIONS HPV vaccination coverage varied by race/ethnicity and other characteristics. Efforts are needed to increase HPV vaccination coverage in all populations.
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Affiliation(s)
- Rayleen M Lewis
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329-4027, USA; Synergy America, Inc., 6340 Sugarloaf Parkway, Suite 200, Duluth, GA 30097, USA.
| | - Lauri E Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329-4027, USA
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28
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Packnett ER, Zimmerman NM, Kim G, Novy P, Morgan LC, Chime N, Ghaswalla P. A Real-world Claims Data Analysis of Meningococcal Serogroup B Vaccine Series Completion and Potential Missed Opportunities in the United States. Pediatr Infect Dis J 2022; 41:e158-e165. [PMID: 35086118 PMCID: PMC8920016 DOI: 10.1097/inf.0000000000003455] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the United States, meningococcal serogroup B (MenB) vaccination is recommended for 16-23-year-olds based on shared clinical decision-making. We estimated series completion among individuals initiating MenB vaccination for the 2 available vaccines: MenB 4-component (MenB-4C, doses at 0 and ≥1 month) and MenB factor H binding protein (MenB-FHbp, doses at 0 and 6 months). METHODS This retrospective health insurance claims data analysis included 16-23-year-olds who initiated MenB vaccination (index date) during January 2017 to November 2018 (MarketScan Commercial Claims and Encounters Database) or January 2017 to September 2018 (MarketScan Multi-State Medicaid Database) and had continuous enrollment for ≥6 months before and ≥15 months after index. The main outcome was MenB vaccine series completion within 15 months. Among noncompleters, preventive care/well-child and vaccine administrative office visits were identified as potential missed opportunities for series completion. Robust Poisson regression models identified independent predictors of series completion. RESULTS In the Commercial (n = 156,080) and Medicaid (n = 57,082) populations, series completion was 56.7% and 44.7%, respectively, and was higher among those who initiated MenB-4C versus MenB-FHbp (61.1% versus 49.8% and 47.8% versus 33.9%, respectively; both P < 0.001). Among noncompleters, 40.2% and 34.7% of the Commercial and Medicaid populations, respectively, had ≥1 missed opportunity for series completion. Receipt of MenB-4C and younger age were independently associated with a higher probability of series completion. CONCLUSIONS Series completion rates were suboptimal but were higher among those who initiated MenB-4C. To maximize the benefits of MenB vaccination, interventions to improve completion and reduce missed opportunities should be implemented.
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Affiliation(s)
- Elizabeth R. Packnett
- From the IBM Watson Health, Life Sciences, Outcomes Research, Cambridge, Massachusetts
| | - Nicole M. Zimmerman
- From the IBM Watson Health, Life Sciences, Outcomes Research, Cambridge, Massachusetts
| | - Gilwan Kim
- IBM Watson Health, Life Sciences, Custom Data Analytics, Cambridge, Massachusetts
| | | | - Laura C. Morgan
- From the IBM Watson Health, Life Sciences, Outcomes Research, Cambridge, Massachusetts
| | - Nnenna Chime
- GSK, US Medical Affairs, Philadelphia, Pennsylvania
| | - Parinaz Ghaswalla
- GSK, US Health Outcomes & Epidemiology – Vaccines, Philadelphia, Pennsylvania
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29
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Kaniuka AR, Job SA, Brooks BD, Guo Y, Bowling J. Human Papillomavirus Vaccination Initiation and Completion Among Heterosexual and Sexual Minority U.S. Adults. LGBT Health 2022; 9:177-185. [PMID: 35180364 DOI: 10.1089/lgbt.2021.0369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The current study examined the relationship between sexual orientation and human papillomavirus (HPV) vaccination status (no vaccination vs. vaccination initiation [one to two doses] or completion [three or more doses]) among a nationally representative sample of U.S. adults. Methods: Pooled Integrated Public Use Microdata Series-National Health Interview Survey data from 2013 to 2017 were used. The analysis sample (N = 35,266) reported on HPV vaccination status, sexual orientation, and demographic covariates. Multinomial logistic regression, stratified by sex, was conducted to assess the relationship between sexual orientation and HPV vaccination status. Results: Most of the sample (80.37%) had not received any HPV vaccination dose, and only ∼10% reported vaccine completion (three or more doses). After adjusting for demographic covariates, gay and bisexual males were more likely than heterosexual males to initiate (gay: adjusted odds ratio [AOR] = 2.46, 95% confidence interval [CI] = 1.67-3.62; bisexual: AOR = 2.30, 95% CI = 1.28-4.12) and complete (gay: AOR = 2.59, 95% CI = 1.45-4.65; bisexual: AOR = 3.20, 95% CI = 1.56-6.55) HPV vaccination. Bisexual females were more likely than heterosexual females to initiate (AOR = 1.99, 95% CI = 1.55-2.54) and complete (AOR = 1.45, 95% CI = 1.23-1.86) HPV vaccination. Females of another sexual orientation were less likely than heterosexual females to complete HPV vaccination (AOR = 0.49, 95% CI = 0.26-0.92). Conclusions: HPV vaccination remains low across sexual orientation groups. Sexual minority status may be a promotive factor in HPV vaccination for specific subgroups.
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Affiliation(s)
- Andrea R Kaniuka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Sarah A Job
- Department of Population Health Sciences, University of Central Florida, Orlando, Florida, USA
| | - Byron D Brooks
- Department of Psychology, Loyola University Chicago, Chicago, Illinois, USA
| | - Yuqi Guo
- School of Social Work, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, North Carolina, USA.,School of Data Science, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Jessamyn Bowling
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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30
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Ashing KT, Ragin C, Ariyo O, Amini A. Thoughts and Consideration Regarding Immigrant Clinicians: Is Cultural Preservation Influencing Providers' Practice in HPV Vaccination? Cancer Invest 2021; 40:111-114. [PMID: 34663155 DOI: 10.1080/07357907.2021.1993879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Immigrant clinicians are vital to population healthcare delivery and therefore population health. One in four physicians in the United States are foreign-born and notably represented in family and pediatric medicine - specialties charged with administering childhood/adolescent vaccines, such as Human Papillomavirus vaccine (HPVV). Our examination suggests there may be unique cultural and socialization factors that influence clinician HPVV recommendation practice; however, immigrant clinicians have not been adequately engaged within the national HPVV agenda. Given the volume and significance of immigrant clinicians, engagement of these clinicians, in both community and nation-wide efforts to increase HPVV, is a necessary step for improving and achieving the national health goal of optimizing HPVV for cancer prevention.
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Affiliation(s)
- Kimlin T Ashing
- Division of Health Equities, City of Hope National Medical Center, Duarte, CA, USA
| | | | - Oluwatosin Ariyo
- Health Services Management and Policy, East Tennessee State University, Johnson City, TN, USA
| | - Arya Amini
- Department of Radiology, City of Hope National Medical Center, Duarte, CA, USA
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31
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Oliveira PSD, Gonçalves CV, Watte G, Costa JSDD. Vaccination coverage against human papillomavirus (HPV) and associated factors in female academics from a university in southwestern Goiás, Brazil. Rev Saude Publica 2021; 55:65. [PMID: 34706041 PMCID: PMC8522710 DOI: 10.11606/s1518-8787.2021055003144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/30/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To check the coverage of the HPV vaccine in women enrolled in health courses at a university in southwest Goiás, Brazil, and the factors associated with vaccination. METHODS This is a cross-sectional study, including female university students of health courses, aged 18 years or more. A standardized and self-applying questionnaire was used. Participants who received two or more doses of the vaccine were considered immunized. Multiple analysis was performed using multinomial logistic regression. RESULT We observed that, of the 1510 participants, 473 (31.3%) had two or more doses of HPV vaccine, 167 (11.0%) one dose and 870 (57.6%) were unvaccinated. Participants under 21 years of age and in socioeconomic stratum A were 2 times more likely to have received two or more doses of the vaccine (Prevalence Ratio = 1.95; 95%CI 1.40-2.70 and Prevalence Ratio = 2.09; 95%CI 1.39-3.13, respectively). CONCLUSIONS The research revealed extensive possibility for interventions with the aim of achieving greater vaccination coverage among female university students. Even women with more knowledge and high economic stratum showed low vaccination coverage, suggesting that results of higher vaccine coverage can be obtained with vaccination carried out in a school environment.
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Affiliation(s)
| | | | - Guilherme Watte
- Universidade Católica do Rio Grande do Sul. Programa de Pós-Graduação em Medicina e Ciências da Saúde da Pontifícia, Porto Alegre, RS, Brasil
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Shin H, Jeon S, Cho I, Park H. Factors affecting human papillomavirus (HPV) vaccination in men: A systematic literature review (Preprint). JMIR Public Health Surveill 2021; 8:e34070. [PMID: 35471242 PMCID: PMC9092232 DOI: 10.2196/34070] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 03/07/2022] [Accepted: 04/01/2022] [Indexed: 01/22/2023] Open
Abstract
Background Despite the high risks associated with human papillomavirus (HPV), the HPV vaccination rate of men is far lower than women. Most previous review studies have focused on female vaccination and related affecting factors. However, previous studies have reported that the factors affecting HPV vaccination differ by gender. Objective The aim of this review was to identify the factors affecting HPV vaccine initiation in men through a systematic review approach. Methods A literature review was conducted across 3 central electronic databases for relevant articles. A total of 30 articles published between 2013 and 2019 met the inclusion criteria and were reviewed in this study. Results In total, 50 factors affecting HPV vaccination in men were identified, including 13 sociodemographic factors and social structure factors, 12 belief-related variables, 4 family factors, 4 community factors, 14 variables related to needs, and 3 environmental factors. Conclusions To increase HPV vaccination rates in men, strategies targeting young males and their families should consider frequent visits to or contact with health care providers so that health care professionals can provide recommendations for HPV vaccination.
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Affiliation(s)
- Hyunjeong Shin
- College of Nursing, Korea University, Seoul, Republic of Korea
| | - Songi Jeon
- Department of Nursing, Catholic Kwandong University, Gangneung, Republic of Korea
| | - Inhae Cho
- College of Nursing, Korea University, Seoul, Republic of Korea
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Spînu AD, Anghel RF, Marcu DR, Iorga DL, Cherciu A, Mischianu DLD. HPV vaccine for men: Where to? (Review). Exp Ther Med 2021; 22:1266. [PMID: 34594403 DOI: 10.3892/etm.2021.10701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 05/27/2021] [Indexed: 12/23/2022] Open
Abstract
Human papillomavirus (HPV) is one of the most widespread human pathogens. For a long time, it was treated as an opportunistic infection, but it is in actuality one of the most dangerous carcinogens. It is responsible for numerous malignancies: Cervical, penile, oropharyngeal, vaginal, vulvar and some anal neoplasia. The need for a long-term solution was evident and thus HPV vaccines were proven to be a viable solution. Women and men who have sex with men, and young men are included in the vaccination template. A thorough review using PubMed and other databases that included articles on vaccine templates and targeted male patients was carried out. After review of all of the studies conducted on this subject, there is a clear benefit for HPV vaccination for men. Yet, even with the introduction of a national vaccine program for HPV for women and girls in most developed countries, regarding the male vaccine program, few countries have established a national program. Still, a gender-neutral vaccine remains a controversial issue. It is important to monitor the impact of HPV vaccine in men and the benefits that occur, to inform and spread the results in order to implement this vaccine program worldwide. Any monitoring plan regarding the HPV vaccination must include HPV prevalence, anogenital warts, and anal cancer. The largest impact regarding the range of this type of vaccine is the surveillance of the specific targeted population. HPV vaccine is a very efficient immunization method. Women are obviously the first target, but there are still many contradictions regarding men. Most of the reasons reside in the cost-efficiency aspect, but there is still great debate regarding the most efficient vaccine in the male population.
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Affiliation(s)
- Arsenie Dan Spînu
- Department 3-Nephrology, Urology, Immunology and Transplant Immunology, Dermatology, Allergology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Urology Department, Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Radu Florentin Anghel
- Department 3-Nephrology, Urology, Immunology and Transplant Immunology, Dermatology, Allergology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Urology Department, Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Dragoș Radu Marcu
- Department 3-Nephrology, Urology, Immunology and Transplant Immunology, Dermatology, Allergology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Urology Department, Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Daniel Lucian Iorga
- Department 3-Nephrology, Urology, Immunology and Transplant Immunology, Dermatology, Allergology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Urology Department, Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Alexandru Cherciu
- Department 3-Nephrology, Urology, Immunology and Transplant Immunology, Dermatology, Allergology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Dan Liviu Dorel Mischianu
- Department 3-Nephrology, Urology, Immunology and Transplant Immunology, Dermatology, Allergology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Urology Department, Central Military Emergency University Hospital, 010825 Bucharest, Romania.,Department of Medical Sciences, Academy of Romanian Scientists, 050045 Bucharest, Romania
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Boakye EA, Stierwalt T, Grundy S, Osazuwa-Peters N, Lee M, Elgee M, Schootman M. Human papillomavirus vaccination uptake among Native Hawaiian and Pacific Islander adults in the United States. Ann Epidemiol 2021; 66:52-55. [PMID: 34563569 DOI: 10.1016/j.annepidem.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/01/2021] [Accepted: 09/12/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To examined HPV vaccination rates and identified factors that are associated with HPV vaccination among Native Hawaiian and Pacific Islander (NHPI) young adults aged 18-34. METHODS Data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey were analyzed. The outcome variables were HPV vaccination initiation (receipt of ≥1 dose) and completion (receipt of ≥3 doses). Multivariable logistic regressions were used to identify socio-demographic, healthcare access and utilization factors that were associated with HPV vaccination. RESULTS A total of 663 adults were included in the study. The overall HPV vaccination initiation and completion rates were 17.6% and 7.9%, respectively. HPV vaccination initiation was higher among females than males (28.4% vs 7.2%; P<0.0001) and completion was also higher among females than males (13.7% vs 2.3%; P<0.0001). In the weighted multivariable models, compared with females, males were less likely to initiate (AOR=0.21, 95% CI=0.12, 0.34) and complete (AOR=0.16, 95% CI=0.07, 0.34) the HPV vaccination. CONCLUSIONS The low HPV vaccination coverage found in this study signals the need for more evidence-based, culturally relevant immunization and cancer prevention interventions for NHPIs. Failure to improve HPV vaccination rates may increase the burden of HPV associated preventable cancers among NHPIs and broaden disparities.
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Affiliation(s)
- Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL; Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, IL.
| | - Tori Stierwalt
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL
| | - Stacy Grundy
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Minjee Lee
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL; Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, IL
| | - Meghan Elgee
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL
| | - Mario Schootman
- Department of Clinical Analytics, SSM Health, Saint Louis, MO
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Daniel CL, Atkins A. HPV vaccination disparities and strategies to prevent oropharyngeal cancer in males. Prev Med Rep 2021; 24:101521. [PMID: 34466373 PMCID: PMC8383099 DOI: 10.1016/j.pmedr.2021.101521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 08/05/2021] [Accepted: 08/08/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Casey L Daniel
- University of South Alabama College of Medicine, Mobile, AL, USA
| | - Amanda Atkins
- University of South Alabama College of Medicine, Mobile, AL, USA
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36
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Fokom Domgue J, Yu RK, Shete S. Trends in the rates of health-care providers' recommendation for HPV vaccine from 2012 to 2018: a multi-round cross-sectional analysis of the health information national trends survey. Hum Vaccin Immunother 2021; 17:3081-3089. [PMID: 34085904 PMCID: PMC8381778 DOI: 10.1080/21645515.2021.1917235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/06/2021] [Indexed: 12/31/2022] Open
Abstract
The 2012 report of the President's Cancer Panel highlighted the overriding contribution of missed clinical opportunities to suboptimal HPV vaccination coverage. Since then, it remains unknown whether the rates of provider recommendations for the HPV vaccine in the US population have increased. We conducted an analysis of four rounds of the Health Information National Trends Survey (HINTS), a household survey of civilian US residents aged 18 y or older. A total of 1,415 (2012), 1,476 (2014), 1,208 (2017), and 1,344 (2018) respondents to the HINTS survey who were either HPV vaccine-eligible or living with HPV vaccine-eligible individuals were included. Overall, the rates of providers' recommendations remained stagnated from 2012 to 2018 in all categories of the study population, except for non-Hispanic Blacks (NHBs), where this prevalence increased during the study period (AAPC = 16.4%, p < .001). In vaccine-eligible individuals (18-27 y), declining trends were noted overall (AAPC = -21.6%, p < .001), among NHWs (AAPC = -30.2%, p < .001) and urban dwellers (AAPC = -21.4%, p < .001). Among vaccine-ineligible respondents (˃27 y) living with vaccine-eligible individuals, trends in the prevalence of provider recommendations for HPV vaccine were stagnating overall (AAPC = 0.5%, p = .90), and increasing only among NHBs (AAPC = 13.9%, p < .001). Despite recent progress, our findings indicate variations of trends in provider recommendations for the HPV vaccine in the US adult population according to age, sex, race/ethnicity, and residence. To accelerate HPV vaccination uptake, immediate actions to enhance provider recommendation for HPV vaccine are needed.
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Affiliation(s)
- Joël Fokom Domgue
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Division of Cancer Prevention and Population Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robert K. Yu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Division of Cancer Prevention and Population Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sanjay Shete
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Division of Cancer Prevention and Population Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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McLendon L, Puckett J, Green C, James J, Head KJ, Yun Lee H, Young Pierce J, Beasley M, Daniel CL. Factors associated with HPV vaccination initiation among United States college students. Hum Vaccin Immunother 2021; 17:1033-1043. [PMID: 33325794 DOI: 10.1080/21645515.2020.1847583] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Human papillomavirus (HPV) remains the most common sexually transmitted infection (STI) in the U.S. despite widespread availability of a safe, effective vaccine. Although young adults are at greatest risk of HPV infection, extensive vaccine promotion and intervention efforts has been directed toward 11-12-year-olds. College students represent an ideal audience for HPV vaccine "catch-up;" however, research indicates inconsistent HPV vaccination rates within this demographic. An online survey assessing HPV and HPV vaccine knowledge and behaviors was distributed to all undergraduate college students at a large, public university in the Deep South region of the U.S. The primary outcome was receipt of HPV vaccination (binary response options of Yes/No). Logistic regression analyses were performed to determine predictors of HPV vaccination. Of the 1,725 who completed the survey, 47.0% reported having received at least one dose of HPV vaccine; overall series completion (series = 3 doses for this population) was 17.4%. The primary outcome was HPV initiation among college students, defined as having received at least one dose of the HPV vaccine. Results indicated substantial gaps in participants' knowledge of their vaccination status. Provider and parental recommendations as well as social influences were shown to significantly impact student vaccination status, emphasizing the importance of incorporating these elements in future interventions, potentially as multi-level strategies. Future college interventions should address HPV and vaccination knowledge and the importance of provider and parental recommendations.
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Affiliation(s)
- Lane McLendon
- Department of Family Medicine, University of South Alabama College of Medicine, Mobile, AL, USA
| | - Jesse Puckett
- Department of Family Medicine, University of South Alabama College of Medicine, Mobile, AL, USA
| | - Chelsea Green
- Department of Family Medicine, University of South Alabama College of Medicine, Mobile, AL, USA
| | - Jenna James
- Division of Cancer Control and Prevention, University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA
| | - Katharine J Head
- Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Hee Yun Lee
- School of Social Work, University of Alabama School of Social Work, Tuscaloosa, AL, USA
| | - Jennifer Young Pierce
- Division of Cancer Control and Prevention, University of South Alabama Mitchell Cancer Institute, Mobile, AL, USA
| | - Mark Beasley
- Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Casey L Daniel
- Department of Family Medicine, University of South Alabama College of Medicine, Mobile, AL, USA
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Adjei Boakye E, Babatunde OA, Wang M, Osazuwa-Peters N, Jenkins W, Lee M, Kim M. Geographic Variation in Human Papillomavirus Vaccination Initiation and Completion Among Young Adults in the U.S. Am J Prev Med 2021; 60:387-396. [PMID: 33342669 PMCID: PMC7902292 DOI: 10.1016/j.amepre.2020.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/13/2020] [Accepted: 09/04/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This study explores how human papillomavirus vaccination initiation and completion among men and women aged 18-34 years varies by geographic region. METHODS Data from the 2015-2017 Behavioral Risk Factor Surveillance System were analyzed. Geographic regions for the selected states were defined as South, Northeast, and Midwest/West. Human papillomavirus vaccination initiation was defined as receipt of ≥1 dose, and completion was defined as receipt of ≥3 doses. Weighted, multivariable logistic regression models estimated the association between geographic region and vaccine uptake, adjusting for sociodemographic, health, and healthcare factors. Analyses were performed in November 2019. RESULTS A total of 18,078 adults were included in the study, 80% of whom resided in the South. The overall vaccination initiation rate was 23.4%, and the completion rate was 11.0%. Initiation was higher among those who resided in the Northeast (38.6%), followed by Midwest/West (23.8%), and lowest for those in the South (21.8%) (p<0.0001). Completion rates followed the same trend as initiation. In the adjusted models, compared with the adults residing in the Northeast, those living in the South were less likely to initiate (AOR=0.47, 95% CI=0.40, 0.55) and complete (AOR=0.56, 95% CI=0.46, 0.68) human papillomavirus vaccination. CONCLUSIONS Human papillomavirus vaccine uptake was low for all regions, but vaccine uptake was significantly lower in the South region. This demonstrates the need to identify barriers specifically associated with the Southern population, which may include differing levels of education and insurance. Such work is especially pertinent because many Southern states face increased risk of human papillomavirus-associated cancers such as cervix and oral cavity and pharynx cancers.
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Affiliation(s)
- Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois; Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, Illinois.
| | - Oluwole A Babatunde
- Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina
| | - Maggie Wang
- Saint Louis University School of Medicine, St. Louis, Missouri
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Wiley Jenkins
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois; Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Minjee Lee
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois; Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, Illinois
| | - Minjin Kim
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Boston, Massachusetts
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Lee M, Gerend MA, Adjei Boakye E. Rural-Urban Differences in Human Papillomavirus Vaccination Among Young Adults in 8 U.S. States. Am J Prev Med 2021; 60:298-299. [PMID: 33067069 DOI: 10.1016/j.amepre.2020.07.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/23/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Minjee Lee
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois; Simons Cancer Institute, Southern Illinois University School of Medicine, Springfield, Illinois.
| | - Mary A Gerend
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida
| | - Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois; Simons Cancer Institute, Southern Illinois University School of Medicine, Springfield, Illinois
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Adjei Boakye E, Osazuwa-Peters N, López J, Pham VT, Tobo BB, Wan L, Schootman M, McElroy JA. Disparities in human papillomavirus (HPV) vaccine initiation and completion based on sexual orientation among women in the United States. Hum Vaccin Immunother 2021; 17:428-433. [PMID: 32701386 PMCID: PMC7899676 DOI: 10.1080/21645515.2020.1778407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/30/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES We compared HPV vaccine initiation and completion of heterosexual with lesbian and bisexual (LB) women. METHODS We aggregated National Health and Nutrition Examination Survey data from 2009 to 2016 for 3,017 women aged 18 to 34 y in the United States. HPV vaccine initiation was defined as reported receipt of ≥1 dose of the vaccine and completion as receipt of the three recommended doses. Weighted percentages and multivariable logistic regression models were used to examine differences in HPV vaccine initiation and completion between heterosexual and LB women. RESULTS Approximately 12% of respondents self-identified as LB women. Overall, a higher percentage of respondents (26%) had initiated the HPV vaccine than completed the three vaccine doses (17%). In the bivariate analysis, LB women had higher initiation ([35% of LB women versus 25% heterosexual]; p = .0012) and completion rates ([24% of LB women versus 17% heterosexual]; p = .0052) than heterosexual women. After adjusting for covariates, compared to heterosexual women, LB women were 60% (aOR = 1.60, 95% CI: 1.16-2.19) more likely to initiate and 63% (aOR = 1.63, 95% CI: 1.12-2.37) more likely to complete the HPV vaccine. CONCLUSIONS Although LB women had higher likelihood of HPV vaccine initiation and completion compared with heterosexual women, their HPV vaccine uptake was well below the Healthy People 2020 target (80%). Understanding differences in the drivers of vaccine uptake in the LB population may inform strategies that would further increase HPV vaccine uptake toward achieving the 80% completion target.
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Affiliation(s)
- Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL, USA
- Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Nosayaba Osazuwa-Peters
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA
- Saint Louis University Cancer Center, Saint Louis, MO, USA
| | - Julia López
- Department of Obstetrics & Gynecology, Washington University School of Medicine, St. Louis, MO, USA
| | - Vy T. Pham
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, MO, USA
| | | | - Leping Wan
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Mario Schootman
- Center for Clinical Excellence, SSM Health, Saint Louis, MO, USA
| | - Jane A. McElroy
- Family and Community Medicine Department, University of Missouri, Columbia, MO, USA
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Osazuwa-Peters N, Simpson MC, Rohde RL, Challapalli SD, Massa ST, Adjei Boakye E. Differences in Sociodemographic Correlates of Human Papillomavirus-Associated Cancer Survival in the United States. Cancer Control 2021; 28:10732748211041894. [PMID: 34696619 PMCID: PMC8552385 DOI: 10.1177/10732748211041894] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Human papillomavirus (HPV)-associated cancers account for about 9% of the cancer mortality burden in the United States; however, survival differs among sociodemographic factors. We determine sociodemographic and clinical variables associated with HPV-associated cancer survival. METHODS Data derived from the Surveillance, Epidemiology, and End Results 18 cancer registry were analyzed for a cohort of adult patients diagnosed with a first primary HPV-associated cancer (anal, cervical, oropharyngeal, penile, vaginal, and vulvar cancers), between 2007 and 2015. Multivariable Fine and Gray proportional hazards regression models stratified by anatomic site estimated the association of sociodemographic and clinical variables and cancer-specific survival. RESULTS A total of 77 774 adults were included (11 216 anal, 27 098 cervical, 30 451 oropharyngeal, 2221 penile, 1176 vaginal, 5612 vulvar; average age = 57.2 years). The most common HPV-associated cancer was cervical carcinoma (58%) for females and oropharyngeal (81%) for male. Among patients diagnosed with anal/rectal squamous cell carcinoma (SCC), males had a higher risk of death than females. NonHispanic (NH) blacks had a higher risk of death from anal/rectal SCC, oropharyngeal SCC, and cervical carcinoma; and Hispanics had a higher risk of death from oropharyngeal SCC than NH whites. Marital status was associated with risk of death for all anatomic sites except vulvar. Compared to nonMedicaid insurance, patients with Medicaid and uninsured had higher risk of death from anal/rectal SCC, oropharyngeal SCC, and cervical carcinoma. CONCLUSIONS There exists gender (anal) and racial and insurance (anal, cervical, and oropharyngeal) disparities in relative survival. Concerted efforts are needed to increase and sustain progress made in HPV vaccine uptake among these specific patient subgroups, to reduce cancer incidence.
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Affiliation(s)
- Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Matthew C. Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, St Louis, MO, USA
| | - Rebecca L. Rohde
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Sai D Challapalli
- Department of Otorhinolaryngology, Head and Neck Surgery, McGovern Medical School, Houston, TX, USA
| | - Sean T. Massa
- Department of Otolaryngology, Head and Neck Surgery, Washington University in Saint Louis School of Medicine, St Louis, MO, USA
| | - Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL, USA
- Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, IL, USA
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Deng C, Chen X, Liu Y. Human papillomavirus vaccination: coverage rate, knowledge, acceptance, and associated factors in college students in mainland China. Hum Vaccin Immunother 2020; 17:828-835. [PMID: 32873128 DOI: 10.1080/21645515.2020.1797368] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In China, there are about 131,500 new cases of human papillomavirus (HPV) infection every year. However, studies focused on the related cognitions in the general college-going population, who belong to an at-risk age group and are of childbearing age, are relatively limited. Thus, this cross-sectional online survey study, conducted from December 2018 to March 2019, sought to investigate HPV vaccination rates, knowledge, acceptance, and associated factors in this population. Descriptive analysis and ordinal logistic regression analysis were conducted to analyze the factors associated with HPV vaccination intention. A total of 1,029 questionnaires were collected, of which 1,022 were valid (males: 267, females: 755). As per the results, only 3.1% of the sample had been vaccinated against HPV. The overall levels of knowledge about HPV and its vaccination were low. Male students' knowledge about HPV types, infection symptoms, vaccination cycles, and preventable diseases was significantly lower than that of female students. As for acceptance, only 36.9% of females and 24.8% of males indicated that they would choose to undergo HPV vaccination. Chinese college students' knowledge of HPV and its vaccination is limited. More than half of the sample was unsure about undergoing HPV vaccination, with concerns about safety and effectiveness serving as the main barriers. Measures such as strengthening health education, improving vaccination safety and effectiveness, and reducing vaccine prices should be taken to promote HPV vaccination among Chinese college students.
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Affiliation(s)
- Che Deng
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Xiaoli Chen
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Yanqun Liu
- School of Health Sciences, Wuhan University, Wuhan, China
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Cocchio S, Bertoncello C, Baldovin T, Fonzo M, Bennici SE, Buja A, Majori S, Baldo V. Awareness of HPV and drivers of HPV vaccine uptake among university students: A quantitative, cross-sectional study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1514-1524. [PMID: 32182634 DOI: 10.1111/hsc.12974] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 01/17/2020] [Accepted: 02/23/2020] [Indexed: 06/10/2023]
Abstract
HPV vaccination is a milestone in primary prevention. However in Italy, vaccine coverage is still nowhere near the target of 95%. We investigated factors associated with inclination to get vaccinated in university students, as they are likely to have just assumed a central role in their healthcare decision-making. University students aged 18-25 were asked to fill in a questionnaire. The effect of socio-demographic and behavioural characteristics on HPV awareness was assessed with a logistic regression adjusting for age, gender, nationality, degree course, relationship, age at first intercourse, number of sexual partners, smoking, sexual orientation, past diagnosis of STDs and knowledge of people who had received HPV vaccine. A second regression adjusting also for information sources, awareness and knowledge investigated factors associated with inclination to receive vaccine. Nine thousand nine hundred and eighty-eight questionnaires were included (response rate 91.3%); awareness of HPV and vaccine was 83.3% and 69.9% respectively. Awareness (AOR: 3.3; 95% CI: 2.3-4.6) and a good knowledge positively affected acceptability, as well as a previous diagnosis of STDs and knowledge of vaccinated people. Healthcare workers (AOR: 1.6; 95% CI: 1.4-1.9) and family members (AOR: 1.7; 95% CI: 1.4-2.1) were the most influencing information sources, even if knowledge of vaccinated people was by far more persuasive (AOR: 2.7; 95% CI: 2.2-3.3). Only 12% of participants were acquainted with skin to skin HPV transmission, while 75% believed in a full effectiveness of condom; less than 22% associated HPV with cancer (other than cervical cancer). Efforts to increase awareness are likely to be worth considering that: awareness is the main determinant of vaccine acceptance; only 50% of individuals not interested in receiving vaccine were aware of it; males are much less aware (AOR: 0.09; 95% CI: 0.07-0.11). Moreover, this study spotlights some misconceptions around HPV and acknowledges a pivotal role of healthcare workers, family and peer influence.
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Affiliation(s)
- Silvia Cocchio
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padua, Padua, Italy
| | - Chiara Bertoncello
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padua, Padua, Italy
| | - Tatjana Baldovin
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padua, Padua, Italy
| | - Marco Fonzo
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padua, Padua, Italy
| | - Silvia Eugenia Bennici
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padua, Padua, Italy
| | - Alessandra Buja
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padua, Padua, Italy
| | - Silvia Majori
- Department of Public Health and Community Medicine, Hygiene and Environmental, Occupational and Preventive Medicine Division, University of Verona, Verona, Italy
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padua, Padua, Italy
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D’Errico MP, Tung WC, Lu M, D’Errico R. Barriers and Recommendations Associated With Human Papillomavirus Vaccination Among College Students. J Nurse Pract 2020. [DOI: 10.1016/j.nurpra.2020.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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45
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Peterson CE, Silva A, Holt HK, Balanean A, Goben AH, Dykens JA. Barriers and facilitators to HPV vaccine uptake among US rural populations: a scoping review. Cancer Causes Control 2020; 31:801-814. [DOI: 10.1007/s10552-020-01323-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 06/05/2020] [Indexed: 01/18/2023]
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46
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Amith M, Cohen T, Cunningham R, Savas LS, Smith N, Cuccaro P, Gabay E, Boom J, Schvaneveldt R, Tao C. Mining HPV Vaccine Knowledge Structures of Young Adults From Reddit Using Distributional Semantics and Pathfinder Networks. Cancer Control 2020; 27:1073274819891442. [PMID: 31912742 PMCID: PMC6950556 DOI: 10.1177/1073274819891442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The human papillomavirus (HPV) vaccine protects adolescents and young adults from 9 high-risk HPV virus types that cause 90% of cervical and anal cancers and 70% of oropharyngeal cancers. This study extends our previous research analyzing online content concerning the HPV vaccination in social media platforms used by young adults, in which we used Pathfinder network scaling and methods of distributional semantics to characterize differences in knowledge organization reflected in consumer- and expert-generated online content. The current study extends this approach to evaluate HPV vaccine perceptions among young adults who populate Reddit, a major social media platform. We derived Pathfinder networks from estimates of semantic relatedness obtained by learning word embeddings from Reddit posts and compared these to networks derived from human expert estimation of the relationship between key concepts. Results revealed that users of Reddit, predominantly comprising young adults in the vaccine catch up age-group 18 through 26 years of age, perceived the HPV vaccine domain from a virus-framed perspective that could impact their lifestyle choices and that their awareness of the HPV vaccine for cancer prevention is also lacking. Further differences in knowledge structures were elucidated, with implications for future health communication initiatives.
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Affiliation(s)
- Muhammad Amith
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, TX, USA
| | - Trevor Cohen
- Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
| | | | - Lara S Savas
- School of Public Health, The University of Texas Health Center at Houston, TX, USA
| | - Nina Smith
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, TX, USA
| | - Paula Cuccaro
- School of Public Health, The University of Texas Health Center at Houston, TX, USA
| | - Efrat Gabay
- School of Public Health, The University of Texas Health Center at Houston, TX, USA
| | - Julie Boom
- Texas Children's Hospital, Houston, TX, USA
| | - Roger Schvaneveldt
- Arizona State University, Tempe, AZ, USA.,New Mexico State University, Las Cruces, NM, USA
| | - Cui Tao
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, TX, USA
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47
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Adjei Boakye E, Zeng W, Governor S, Nagendra S, Tobo BB, Simpson MC, Osazuwa-Peters N. Differences in human papillomavirus (HPV) vaccine uptake by nativity status among men aged 18-34 years. Prev Med Rep 2019; 16:101010. [PMID: 31799106 PMCID: PMC6883324 DOI: 10.1016/j.pmedr.2019.101010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/01/2019] [Accepted: 10/20/2019] [Indexed: 12/27/2022] Open
Abstract
Only 1 in 11 men had initiated and 1 in 30 men had completed the HPV vaccine series. Immigrants from Indian subcontinent had the lowest HPV vaccination rates. Foreign-born men who reported US citizenship had higher rates of HPV vaccination rates. Foreign-born men had lower odds of having initiated the HPV vaccination compared with US-born men.
Annually, about 16,500 HPV-associated cancers occur in the US among men. Data regarding HPV vaccine uptake among men based on nativity status (i.e., US-versus foreign-born) is limited, yet potentially important for informing interventions. We assessed differences in HPV vaccine uptake by nativity status among men aged 18–34 years in the US. The 2014–2017 National Health Interview Survey was examined for men, aged 18–34 years (n = 14,056). HPV vaccine initiation was defined as receipt of at least one dose of the vaccine and completion as receipt of three doses. Weighted, multivariable binary logistic regression models were used to assess the association between nativity status and HPV vaccine uptake, adjusting for demographic, socioeconomic, and healthcare factors. Analyses were performed in July 2018. Overall, 17% of men self-identified as foreign-born, 9.9% of men had initiated the HPV vaccine, and 3.3% had completed the HPV vaccine. Among foreign-born men, Asians had the highest HPV vaccination rates whereas those from Indian subcontinental region had the lowest rates. After accounting for demographic, socioeconomic, and healthcare factors, compared to US-born men, foreign-born men were 46% (adjusted odds ratio = 0.54; 95% CI = 0.39–0.72) less likely to initiate the HPV vaccine but there was no difference between the two groups in terms of vaccine completion. We found that HPV vaccine uptake among men was very low overall, and foreign-born men had lower initiation compared to US-born men. Public health interventions which improve HPV vaccination need to be developed for all men, irrespective of nativity status.
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Affiliation(s)
- Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, IL, USA.,Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Wenhui Zeng
- Department of Chemistry, College of Arts and Sciences, Saint Louis University, Saint Louis, MO, USA
| | - Samuel Governor
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
| | - Shreya Nagendra
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
| | | | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Nosayaba Osazuwa-Peters
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, MO, USA.,Saint Louis University Cancer Center, Saint Louis, MO, USA
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48
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McGaffey A, Lombardo NP, Lamberton N, Klatt P, Siegel J, Middleton DB, Hughes K, Susick M, Lin CJ, Nowalk MP. A "Sense"-ational HPV Vaccination Quality Improvement Project in a Family Medicine Residency Practice. J Natl Med Assoc 2019; 111:588-599. [PMID: 31285042 DOI: 10.1016/j.jnma.2019.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/23/2019] [Accepted: 06/12/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination uptake for adolescents and young adults in the United States remains far from national goals. Using a multi-component intervention aligned with community-wide efforts, we implemented a quality improvement project to increase HPV vaccinations among 9-26 year-old male and female patients in an urban, low income, minority population family medicine residency practice. METHODS The pre-intervention year was November 2, 2014 to October 31, 2015 and the intervention year was November 1, 2015 to October 31, 2016. Based on community input and published literature, the interventions were creative, practice-specific provider-, patient-, and system-level strategies. To compare pre- and post-intervention vaccinations, HPV vaccination data were extracted from an electronic medical record request for age-eligible patients seen in the practice during the intervention year. Chi-square, McNemar's and 2-tailed, 2-sample Z tests were used to test differences in vaccination initiation (≥1 dose) and completion (3 doses) across groups and over time. RESULTS Despite high pre-intervention rates (58% and 75%), HPV vaccine initiation significantly increased 12.8 percentage points (PP) for males and 10.6 PP for females from pre- to post-intervention (P < 0.001). HPV vaccine completion also significantly increased 16 PP for males and 10.9 PP for females (P < 0.001). Young adult patients (18-26 years-old) had significant increases in completion rates (9.9 PP; P < 0.001), not observed among adolescents (20 PP; ns). CONCLUSIONS Consistent and abundant positive HPV vaccination messaging, low-cost sensory rewards, process change, and community, clinician, and nonclinical staff engagement were associated with higher HPV vaccine initiation and completion, especially among young adults.
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Affiliation(s)
- Ann McGaffey
- University of Pittsburgh Medical Center St. Margaret Family Medicine Residency and Bloomfield Garfield Family Health Center, Pittsburgh, PA, USA.
| | - Nicole Payette Lombardo
- University of Pittsburgh Medical Center St. Margaret Family Medicine Residency and Bloomfield Garfield Family Health Center, Pittsburgh, PA, USA
| | - Nathan Lamberton
- University of Pittsburgh Medical Center St. Margaret Family Medicine Residency and Bloomfield Garfield Family Health Center, Pittsburgh, PA, USA
| | - Patricia Klatt
- University of Pittsburgh Medical Center St. Margaret Family Medicine Residency and Bloomfield Garfield Family Health Center, Pittsburgh, PA, USA
| | - Jason Siegel
- University of Pittsburgh Medical Center St. Margaret Family Medicine Residency and Bloomfield Garfield Family Health Center, Pittsburgh, PA, USA
| | - Donald B Middleton
- University of Pittsburgh Medical Center St. Margaret Family Medicine Residency and University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh, PA, USA
| | - Kristin Hughes
- Carnegie Mellon University, School of Design, Pittsburgh, PA, USA
| | - Michael Susick
- University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh, PA, USA
| | - Chyongchiou Jeng Lin
- University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh, PA, USA
| | - Mary Patricia Nowalk
- University of Pittsburgh School of Medicine, Department of Family Medicine, Pittsburgh, PA, USA
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49
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Sledge JA, Jensen CE, Cibulka NJ, Hoffman M. The Male Voice: A Qualitative Assessment of Young Men’s Communication Preferences About HPV and 9vHPV. J Community Health 2019; 44:998-1008. [DOI: 10.1007/s10900-019-00674-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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50
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Kang J, Kim K. Human Papillomavirus Vaccine Predictors Among U.S. Adults Aged 18 to 45 by Sexual Orientation. West J Nurs Res 2019; 41:1761-1789. [PMID: 30915909 DOI: 10.1177/0193945919836448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Despite increased incidence rates of human papillomavirus (HPV)-associated cancers among sexual minorities, their HPV vaccine uptake remains suboptimal. This cross-sectional, correlational study aimed to investigate factors associated with HPV vaccination among a nationally representative sample of U.S. young adults by sexual orientation. We used the 2014 to 2017 Behavioral Risk Factor Surveillance System data for adults aged 18 to 45 years. HPV vaccination initiation was associated with being female and Hispanic, having higher educational attainment, and having ever been tested for HIV, whereas completion was associated with being female and non-Hispanic White and having higher educational attainment. Compared with those who reported identifying as straight, the lesbian or gay respondents were found to have been less likely not to complete the series. Providers should play a crucial part in addressing missed opportunities for HPV vaccination by implementing culturally competent communication strategies to empower sexual minorities to make informed HPV vaccine decisions.
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Affiliation(s)
- JaHyun Kang
- Seoul National University College of Nursing, Seoul, Republic of Korea.,Seoul National University Research Institute of Nursing Science, Seoul, Republic of Korea
| | - Kyounghae Kim
- University of Connecticut School of Nursing, Storrs, USA
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