Knowledge of HPV : Differences across at-risk groups over time

Since FDA approval of the HPV vaccine in 2006, there has been heightened media attention about HPV and cervical cancer. Yet, little is known about how these increases may differ across populations most likely to benefit from the vaccine. This study assessed trends in knowledge and awareness of HPV and cervical cancer before and after FDA approval and subsequent direct to consumer advertising of the HPV vaccine. We used data from telephone samples of the Health Information National Trends Survey (HINTS), administered in 2005 (n=3,072) and 2008 (n=1,903). Respondents were included if female, if they were between the ages 18 to 75, and if they had no previous history of cervical cancer. Dependent variables were ever having heard of HPV and knowledge that HPV causes cervical cancer. Independent variables of interest were sociodemographics, including race, ethnicity, marital status, education, occupation, and income; health care access, including insurance status and attendance at a health care visit in the last year; health communication, including trust of health information sources and ever looked for cancer information; familial and personal cancer history; cervical cancer screening history. Bivariate relationships were assessed using Chi-square tests; variables with p-values<.10 were included in multivariate logistic regression models. From 2005 to 2008, the proportion of women aged 18-75 who had heard of HPV increased significantly from 40% to 82% (p<.001). Among those who had heard of HPV, the proportion who knew that HPV causes cervical cancer increased significantly from 48% to 69% (p<.001). Although both HPV awareness and cancer knowledge increased significantly from 2005 to 2008 across all subgroups under study, gains differed in magnitude. In a multivariate model controlling for age, education, occupation, and race/ethnicity, Black and Hispanic women, and women of lower income were less likely to have experienced an increase in HPV awareness from 2005 to 2008 than White women or those with higher income. Though there have been substantial gains in HPV knowledge and awareness overall, traditionally underserved groups lag behind. Targeted health communication campaigns are recommended for these populations to prevent widening health disparities related to HPV and cervical cancer.