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. 2013 Dec;53(6):756-62.
doi: 10.1016/j.jadohealth.2013.07.002. Epub 2013 Aug 27.

Racial disparities in human papillomavirus vaccination: does access matter?

Amanda Gelman  1 , Elizabeth Miller, Eleanor Bimla Schwarz, Aletha Y Akers, Kwonho Jeong, Sonya Borrero
Affiliations

Racial disparities in human papillomavirus vaccination: does access matter?

Amanda Gelman et al. J Adolesc Health. 2013 Dec.

Abstract

Purpose: To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship.

Methods: We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years.

Results: There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p < .001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR], .76; 95% confidence interval [CI], .50-1.16; and AOR, .67; 95% CI, .37-1.19) but not for African-Americans (AOR, .47, 95% CI, .33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR, .85, 95% CI, .54-1.34; and AOR, .84, 95% CI, .45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR, .49, 95% CI, .36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years.

Conclusions: Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population.

Keywords: Disparities; Human papillomavirus; National Survey of Family Growth; Race/ethnicity; Vaccination.

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Conflict of interest statement

Author Disclosure Statement: No competing financial interests exist. This paper is not under consideration in any other journal.

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