142nd APHA Annual Meeting and Exposition

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309291
Sexual orientation disparities in human papillomavirus vaccination among adolescent and young adult U.S. women aged 15-25 years

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Madina Agénor, ScD, MPH , Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
Sarah Peitzmeier, MSPH , Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Allegra R. Gordon, MPH , Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA
Sebastien Haneuse, PhD , Department of Biostatistics, Harvard School of Public Health, Boston, MA
Jennifer Potter, MD , Fenway Health, Boston, MA
S. Bryn Austin, ScD , Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA
Background: Vaccination is recommended for adolescent and young adult women aged 11-26 years to prevent infection by certain types of human papillomavirus (HPV) and associated cancers. Although lesbians are at risk of HPV, no study has examined whether sexual orientation disparities in HPV vaccination exist among U.S. girls and women.

Objective: To investigate the relationship between sexual orientation identity and HPV vaccination in a nationally representative sample of U.S. women.

Methods: We used multivariable logistic regression to identify sexual orientation disparities in HPV vaccine initiation among 2,698 U.S. women aged 15-25 years who participated in the National Survey of Family Growth between 2007 and 2010 and had heard of the HPV vaccine.

Results: Among U.S. women aged 15-25 years who had heard of the HPV vaccine, 29.35% reported initiating HPV vaccination. Adjusting for covariates, lesbians had significantly lower odds of HPV vaccination relative to heterosexual women (odds ratio [OR] = 0.13; 95% confidence interval [CI]: 0.04, 0.45). Including health insurance status and sexual and reproductive health services use only slightly attenuated the OR to 0.19 (95% CI: 0.06, 0.61).

Discussion: This is the first study to document sexual orientation disparities in HPV vaccination in a nationally representative sample of U.S. women. Health care institutions should facilitate access to and utilization of HPV vaccination among girls and women of all sexual orientations. Programs geared towards young lesbians, who face numerous barriers to health care, are needed to reduce sexual orientation disparities in HPV vaccination among adolescent and young adult U.S. women.

Learning Areas:

Epidemiology
Social and behavioral sciences

Learning Objectives:
Describe the risk of human papillomavirus (HPV) infection among lesbian women; explain the role of HPV vaccination in preventing infection by certain types of HPV and associated cancers; discuss the relationship between sexual orientation and HPV vaccination among adolescent and young adult U.S. women; identify strategies to help reduce sexual orientation disparities in HPV vaccination among young U.S. women

Keyword(s): Cancer and Women’s Health, Lesbian, Gay, Bisexual and Transgender (LGBT)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I received doctoral training in social epidemiology and women, gender, and health and have experience conducting research on social inequalities in women's sexual and reproductive health, including cervical cancer prevention and control. Most recently, I was principal investigator of a project on sexual orientation, race/ethnicity, and Pap test use among U.S. women.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.