Little information is available on geographic disparity of human papillomavirus (HPV)
vaccination among women aged 18–26 years in the U.S. Genital HPV is the most common
sexually transmitted infection in the U.S. Persistent HPV infection with oncogenic
types can cause cervical cancer.
This study utilized data collected from the 2010 National Health Interview Survey
(NHIS). It identified geographic variability and other factors contributing to the
disparities in HPV vaccine series initiation in a nationally representative sample
of women aged 18–26 years.
The study utilized data collected from 1867 women who participated in the Cancer Control
Module Supplement of the 2012 NHIS. A multivariable logistic regression model was
used to assess characteristics associated with initiation of the HPV series. Analyses
were performed in 2012.
After adjusting for other characteristics, women living in the West and North Central/Midwest
had 54% and 20% greater odds of initiating the HPV series, respectively, compared
with those living in the Northeast. Other factors associated with HPV series initiation
were younger age, Hispanic background, being single/never married, childlessness,
a history of HPV, and current alcohol use. Factors correlated with failure to initiate
the HPV series were: not having insurance, living below the 200% poverty level, not
being a high school graduate, not currently using hormone-based birth control, most
recent Pap >1 year ago, no regular provider, last clinic visit ≥12 months ago, and
never having received the hepatitis B vaccine.
Results demonstrate disparity in HPV vaccine uptake by region of residence in the
U.S. among young women. Further research is needed to understand the factors contributing
to this geographic disparity. Evaluation of vaccination policies and practices associated
with higher coverage regions might help characterize effective methods to improve
HPV vaccination among women aged 18–26 years.