Risk perceptions and Human Papillomavirus (HPV) vaccine uptake among a clinic-based sample of young rural women

Objective: To determine associations between HPV-related risk perceptions and uptake of Gardasil offered for free to rural Appalachian women 18 to 26 years of age attending local health clinics. Methods: Young women (N=247) were recruited from health clinics in rural Southeastern, Kentucky. Women completed a brief interview that assessed seven HPV-related risk perceptions and then they received a free voucher for HPV vaccination. Whether women redeemed the voucher for the initial dose of vaccine served as the study outcome variable. Hierarchical logistic regression was used to estimate the independent effects of each predictor variable on vaccine uptake. Results: Less than one-half (44.9%) redeemed the coupon to receive dose one of Gardasil. Five of the seven variables significantly predicted uptake. In a controlled analysis, only two predictors remained significant. For each unit of greater agreement that “in general, vaccines are a good thing” women were about 35% less likely to decline the free Gardasil (P=.02). Similarly, for each unit of greater agreement that “I believe that getting the vaccine will be painful” women were about 27% less likely to decline the free Gardasil (P=.03). The remaining three predictor variables (worry about having HPV [P=.07], HPV serious enough for vaccination [P=.43], and not sure vaccine is safe [P=.22]) were not significant in the model. Conclusion: Sexual health promotion programs designed for this population may enhance HPV vaccine uptake by creating more realistic perceptions about the inherent value of vaccines and by improving perceptions relative to pain of injections.