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. 2013 Dec;24(12):2089-98.
doi: 10.1007/s10552-013-0286-x. Epub 2013 Sep 17.

Are HPV vaccination services accessible to high-risk communities? A spatial analysis of HPV-associated cancer and Chlamydia rates and safety-net clinics

Jennifer Tsui  1 , Hector P Rodriguez, Gilbert C Gee, Loraine A Escobedo, Gerald F Kominski, Roshan Bastani
Affiliations

Are HPV vaccination services accessible to high-risk communities? A spatial analysis of HPV-associated cancer and Chlamydia rates and safety-net clinics

Jennifer Tsui et al. Cancer Causes Control. 2013 Dec.

Abstract

Purpose: While HPV vaccines can greatly benefit adolescents and young women from high-risk areas, little is known about whether safety-net immunization services are geographically accessible to communities at greatest risk for HPV-associated diseases. We explore the spatial relationship between areas with high HPV risk and proximity to safety-net clinics from an ecologic perspective.

Methods: We used cancer registry data and Chlamydia surveillance data to identify neighborhoods within Los Angeles County with high risk for HPV-associated cancers. We examined proximity to safety-net clinics among neighborhoods with the highest risk. Proximity was measured as the shortest distance between each neighborhood center and the nearest clinic and having a clinic within 3 miles of each neighborhood center.

Results: The average 5-year non-age-adjusted rates were 1,940 cases per 100,000 for Chlamydia and 60 per 100,000 for HPV-associated cancers. A large majority, 349 of 386 neighborhoods with high HPV-associated cancer rates and 532 of 537 neighborhoods with high Chlamydia rates, had a clinic within 3 miles of the neighborhood center. Clinics were more likely to be located within close proximity to high-risk neighborhoods in the inner city. High-risk neighborhoods outside of this urban core area were less likely to be near accessible clinics.

Conclusions: The majority of high-risk neighborhoods were geographically near safety-net clinics with HPV vaccination services. Due to low rates of vaccination, these findings suggest that while services are geographically accessible, additional efforts are needed to improve uptake. Programs aimed to increase awareness about the vaccine and to link underserved groups to vaccination services are warranted.

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Figures

Figure 1
Figure 1
Hot Spot Analysis of Chlamydia Rates in Los Angeles County
Figure 2
Figure 2
Hot Spot Analysis of HPV-associated Cancer Rates in Los Angeles County
See this image and copyright information in PMC

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