Positive Side of an Abnormal Pap: Effects on HPV Vaccination Follow-up Behaviors

Background: Few studies have investigated factors related to return for subsequent doses of the HPV vaccine, including the effect of ever being told of an abnormal Pap test. Methods: 344 women (18-26 yrs) in rural Appalachia were provided dose 1 of the vaccine for free; women then completed a survey assessing sociodemographics, sexual health, and HPV vaccine attitudes. Results: Mean age was 22.0 years (SD=2.4). 44% reported ever being informed about an abnormal Pap (AP). 64% indicated an intent to return for subsequent doses; intent was greater for those ever having an AP (80.1% v. 51.3%, P<.0001). 30% indicated work would interfere with returning for subsequent doses; this barrier was indicated less among those with an AP (23.8% v. 35.8%, P=.017). 23.0% indicated transportation was a return issue; this indication was made less frequently for those ever having an AP (7.9% v. 26.9%, P=.047). Women ever having an AP were more likely to indicate cost as an issue (40.4%) compared to those no AP history (23.8%; P=.001). Childcare as a barrier did not vary as a function of AP history (6.6% v. 6.7%, P=.97). 73% of the women indicated they would be more likely to return if their mothers approved of the vaccine; this “approval” was not viewed as necessary for those ever having an AP (80.1%) compared to those never having an AP (67.9%; P=.011). Conclusion: The psychological effects of ever having an abnormal Pap test may be quite positive in regards to adherence to the HPV vaccination schedule.