Contribution of communication inequalities to disparities in HPV vaccine awareness and knowledge

There are significant disparities in HPV vaccine completion rates across racial and social groups. The purpose of our study is to examine the impact of Internet-related communication inequalities on HPV vaccine awareness and infection knowledge. Data for this study were drawn from National Cancer Institute's 2007 HINTS survey (n= 7674). Multivariate logistic regression models were estimated to assess three dimensions of Internet use and information seeking behavior (general Internet-user, general health Internet information seeker and cancer Internet information seeker) on awareness and knowledge (having heard of the HPV vaccine, HPV as a cause of cervical cancer, and HPV transmitted through sexual contact). Models included socio-demographic characteristics along with relevant covariates. General Internet users, compared to non-users are 2.41 times (CI:1.96,2.95) more likely to be aware of the HPV vaccine and 1.42 times more likely (CI:1.05,1.94) to know that HPV causes cervical cancer. Among general health information seekers, non-Internet seekers, compared to Internet information seekers, exhibited lower odds of being aware of HPV vaccine OR=0.59 (CI:0.46,0.75), knowing about HPV cancer outcomes OR=0.79 (CI:0.63,0.99), and HPV and sexual contact OR=0.71 (CI:0.57,0.89). Among cancer information seekers, there were no differences in outcomes between Internet seekers and non-Internet seekers. Our results offer evidence that we have to be concerned with reliance on Internet-based direct-to-consumer marketing as the main source of HPV information in the US. Using a communication channel, such as the Internet, whose use is already socially and racially patterned, may play an important role in widening observed disparities in vaccine completion rates.