Physician Practice Affiliation and its Effect on Physician Recommendation and Receipt of HPV Vaccine among Black and Hispanic Teen Girls

Background/Significance: Human Papillomavirus (HPV) is the most common sexually transmitted disease (STD) in the United States (US).  Nearly all cervical cancers and many vulvar and vaginal cancers are caused by recurring infection with high-risk HPV types.  Black and Hispanic women have higher mortality rates of cervical cancer than white women.  HPV vaccination coverage levels remain below the national goal of 80%.  Lack of recommendation from a physician has been reported as one of the main responses for not vaccinating teens against HPV. 

Purpose: The objective of this study is to examine the relationship between physician practice affiliation, and the recommendation and receipt of HPV vaccine among Black and Hispanic teen girls.

Methods: Secondary data analysis of the 2012 National Immunization Survey – Teen (NIS-Teen) was conducted.  Bivariate and Multiple logistic regressions were used to estimate odds ratios (OR), adjusted odds ratios (aOR), and their 95% confidence intervals (CI).

Results: Black and Hispanic teen girls receiving care from a physician working in a public/community health practice were more likely to receive a recommendation for HPV vaccination (aOR: 2.0; 95% CI: 2.0 – 2.1; p=<.0001).  However, they were 5% less likely to receive the HPV vaccine (aOR: 0.95; 95% CI: 0.94 – 0.96; p=<.0001).

Conclusion: While Black and Hispanic teen girls who receive care at public/community health practices are more likely to receive a recommendation for HPV vaccination, actual receipt of the vaccine remains low.  Further studies should explore what additional physician characteristics may contribute to HPV vaccination rates.