HPV vaccination uptake among those at greatest risk: Lessons learned from the field

Introduction:Although genital HPV is the most prevalent STI in the U.S., rates of vaccination uptake among high-risk subgroups remain low. Investigations of vaccine compliance have mainly targeted mother-daughter dyads, which in some settings may prove difficult. This research examines an innovative approach that is culturally tailored to the individual. Lessons learned specific to vaccination initiation are presented.

Methods:Data, inclusive of sociodemographics, sexual behaviors, and knowledge, attitudes, and beliefs about HPV and vaccination were collected via ACASI from 216 African-American adolescent females (ages 14-18 years) seeking services in family planning and STI public health clinics in metropolitan Atlanta. Data were obtained prior to randomization and participation in an interactive media-based intervention to increase HPV vaccination uptake. Medical record abstraction was conducted 7-months post-randomization to assess initial uptake and compliance.

Results:While 82% of participants believed their doctor would think it was a “good idea” to get vaccinated only 19% “believed they were at risk for getting HPV”. Intervention participants were more compliant to vaccination relative to controls (26 doses vs. 17 doses, p = .12). However, vaccine initiation remained lower than the national average.

Conclusion:  While this study was among the first to focus solely on young African-American adolescents in a clinical setting, remove all financial barriers associated with vaccination, and provide a culturally tailored intervention experience grounded in formative research, results were less than optimal. Thorough evaluation is needed to better understand perceived susceptibility and how it changes post-intervention and to determine what occurs during the patient-provider encounter.