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. 2025 Feb;50(1):98-110.
doi: 10.1007/s10900-024-01401-1. Epub 2024 Sep 5.

Evaluation of Human Papillomavirus Vaccination and Cancer Prevention Behaviors among LGBTQI + Individuals: A Cross-Sectional Study

Sanjana K Rana  1 , Rebecca B Perkins  2 , Devan Carr  3 , Sarah Feldman  4 , Kelly Welch  1 , Eileen Duffey-Lind  1   5 , Alessandro Villa  6
Affiliations

Evaluation of Human Papillomavirus Vaccination and Cancer Prevention Behaviors among LGBTQI + Individuals: A Cross-Sectional Study

Sanjana K Rana et al. J Community Health. 2025 Feb.

Abstract

Human Papillomavirus (HPV) vaccination and cervical cancer screening rates are suboptimal in the US, particularly among historically underserved groups like Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+)-identifying women and transgender men. Therefore, our cross-sectional study assessed factors associated with these rates among LGBTQI+-identifying women and transgender men.HPV-related cancer knowledge, HPV vaccination and cervical cancer screening status, and the acceptability of self-collection for screening of 1983 LGBTQI+-identifying women and transgender men was assessed via an online survey available to members of the HER mobile app from March to May 2022. Associations between sociodemographic factors, vaccination, and screening were assessed using multivariable logistic regressions from November 2022 to December 2023.Most participants aged 18-26 (77.0%) and 6.3% of participants aged ≥46 (P < 0.001) had received at least one dose of the HPV vaccine. Cervical cancer screening rates were positively associated with age: 70.5% of those aged 21-26 and 96.1% aged ≥46 (P < 0.001). Screening was negatively associated with male gender identity (OR, 0.13; 95% CI, 0.04-0.42; P < 0.001), being uninsured (OR, 0.40; 95% CI, 0.24-0.67; P < 0.001), and being unvaccinated against HPV (OR, 0.28; 95% CI, 0.18-0.43; P < 0.001). 29.6% of those unscreened believed screening was not needed, and 22.1% were uncomfortable with pelvic exams. 40.4% of all participants would prefer self-collection for screening. Our findings indicate opportunities to increase screening and vaccination. Among under-screened individuals, lack of knowledge about screening necessity and discomfort with pelvic exams were important barriers. Targeted interventions addressing patient knowledge, practitioner communication, and exploring self-screening strategies are warranted.

Keywords: Cancer screening; Human papillomavirus; LGBTQI+; Vaccine.

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Conflict of interest statement

Declarations. Ethics Approval: DFHCC OHRS IRB Protocol Number:22 − 021; exempt. Competing interests: A. Villa: Consultant for the American Cancer Society national HPV vaccination Roundtable, Merck, K Pharmaceuticals, AfyxTherapeutics, LipellaPharmaceuticals, WSK Medical and Primary Endpoint Solutions. He has funded research from Merck, MeiraGtx and Mureva. R. Perkins: Dr. Perkins serves on the American Cancer Society national HPV vaccination Roundtable. E. Duffey-Lind: Serves on the American Cancer Society National Cervical Cancer Roundtable and Team Maureen. K. Welch: Serves on the American Cancer Society HPV Roundtable and Team Maureen.

References

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