Human Papillomavirus Vaccination Initiation and Completion Among Heterosexual and Sexual Minority U.S. Adults.

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.

[1]  J. Gargano,et al.  Declines in Prevalence of Human Papillomavirus Vaccine-Type Infection Among Females after Introduction of Vaccine — United States, 2003–2018 , 2021, MMWR. Morbidity and mortality weekly report.

[2]  Maria E Fernandez,et al.  Human Papillomavirus Vaccination Status and Parental Endorsement Intentions among Undergraduate Student Nurses , 2021, International journal of environmental research and public health.

[3]  M. Schootman,et al.  Disparities in human papillomavirus (HPV) vaccine initiation and completion based on sexual orientation among women in the United States , 2020, Human vaccines & immunotherapeutics.

[4]  S. Austin,et al.  Sexual Orientation Differences in Cervical Cancer Prevention among a Cohort of U.S. Women. , 2020, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[5]  S. Austin,et al.  Sexual orientation inequalities during provider-patient interactions in provider encouragement of sexual and reproductive health care. , 2019, Preventive medicine.

[6]  C. Vamos,et al.  Examining the Influence of Religious and Spiritual Beliefs on HPV Vaccine Uptake Among College Women , 2019, Journal of Religion and Health.

[7]  Andy S. L. Tan,et al.  Patient-Provider Sexually Transmitted Infection Prevention Communication among Young Adult Sexual Minority Cisgender Women and Nonbinary Assigned Female at Birth Individuals. , 2019, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[8]  JaHyun Kang,et al.  Human Papillomavirus Vaccine Predictors Among U.S. Adults Aged 18 to 45 by Sexual Orientation , 2019, Western journal of nursing research.

[9]  Shyam K. Sriram,et al.  Why human papilloma virus vaccination coverage is low among adolescents in the US? A study of barriers for vaccination uptake , 2019, Journal of family medicine and primary care.

[10]  Meredith G. F. Worthen.  “All the Gays Are Liberal?” Sexuality and Gender Gaps in Political Perspectives among Lesbian, Gay, Bisexual, Mostly Heterosexual, and Heterosexual College Students in the Southern USA , 2018, Sexuality Research and Social Policy.

[11]  S. Bremner,et al.  Men who have sex with men who do not access sexual health clinics nor disclose sexual orientation are unlikely to receive the HPV vaccine in the UK. , 2018, Vaccine.

[12]  J. Kahn,et al.  Factors Associated With HPV Vaccine Initiation, Vaccine Completion, and Accuracy of Self-Reported Vaccination Status Among 13- to 26-Year-Old Men , 2018, American journal of men's health.

[13]  D. Lew,et al.  Correlates of human papillomavirus (HPV) vaccination initiation and completion among 18–26 year olds in the United States , 2018, Human vaccines & immunotherapeutics.

[14]  S. Reisner,et al.  Sexual Orientation Disparities in Human Papillomavirus Vaccination in a Longitudinal Cohort of U.S. Males and Females. , 2017, LGBT health.

[15]  C. Polek,et al.  Changing HPV vaccination rates in bisexual and lesbian women , 2017, Journal of the American Association of Nurse Practitioners.

[16]  Janet D. Wilson.  Bacterial vaginosis: going full circle? , 2017, Sexually Transmitted Infections.

[17]  K. Mayer,et al.  Stigma, medical mistrust, and perceived racism may affect PrEP awareness and uptake in black compared to white gay and bisexual men in Jackson, Mississippi and Boston, Massachusetts , 2017, AIDS care.

[18]  J. Potter,et al.  Sexual orientation and sexual health services utilization among women in the United States. , 2017, Preventive medicine.

[19]  E. Meites,et al.  Use of a 2-Dose Schedule for Human Papillomavirus Vaccination - Updated Recommendations of the Advisory Committee on Immunization Practices. , 2016, MMWR. Morbidity and mortality weekly report.

[20]  S. Haneuse,et al.  Sexual orientation identity disparities in human papillomavirus vaccination initiation and completion among young adult US women and men , 2016, Cancer Causes & Control.

[21]  A. McRee,et al.  HPV infection among a population-based sample of sexual minority women from USA , 2016, Sexually Transmitted Infections.

[22]  S. Altekruse,et al.  US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. , 2015, Journal of the National Cancer Institute.

[23]  J. Fortenberry,et al.  Accuracy of self-reported human papillomavirus vaccine receipt among adolescent girls and their mothers. , 2012, Journal of Adolescent Health.

[24]  R. Hayes,et al.  Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. , 2010, International journal of epidemiology.