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Racial disparities in human papillomavirus vaccination: does access matter?
J Adolesc Health. 2013 Dec; 53(6):756-62.JA

Abstract

PURPOSE

To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship.

METHODS

We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years.

RESULTS

There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p < .001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR], .76; 95% confidence interval [CI], .50-1.16; and AOR, .67; 95% CI, .37-1.19) but not for African-Americans (AOR, .47, 95% CI, .33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR, .85, 95% CI, .54-1.34; and AOR, .84, 95% CI, .45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR, .49, 95% CI, .36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years.

CONCLUSIONS

Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population.

Authors+Show Affiliations

University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23992645

Citation

Gelman, Amanda, et al. "Racial Disparities in Human Papillomavirus Vaccination: Does Access Matter?" The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine, vol. 53, no. 6, 2013, pp. 756-62.
Gelman A, Miller E, Schwarz EB, et al. Racial disparities in human papillomavirus vaccination: does access matter? J Adolesc Health. 2013;53(6):756-62.
Gelman, A., Miller, E., Schwarz, E. B., Akers, A. Y., Jeong, K., & Borrero, S. (2013). Racial disparities in human papillomavirus vaccination: does access matter? The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine, 53(6), 756-62. https://doi.org/10.1016/j.jadohealth.2013.07.002
Gelman A, et al. Racial Disparities in Human Papillomavirus Vaccination: Does Access Matter. J Adolesc Health. 2013;53(6):756-62. PubMed PMID: 23992645.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Racial disparities in human papillomavirus vaccination: does access matter? AU - Gelman,Amanda, AU - Miller,Elizabeth, AU - Schwarz,Eleanor Bimla, AU - Akers,Aletha Y, AU - Jeong,Kwonho, AU - Borrero,Sonya, Y1 - 2013/08/27/ PY - 2013/01/24/received PY - 2013/06/30/revised PY - 2013/07/01/accepted PY - 2013/9/3/entrez PY - 2013/9/3/pubmed PY - 2014/7/25/medline KW - Disparities KW - Human papillomavirus KW - National Survey of Family Growth KW - Race/ethnicity KW - Vaccination SP - 756 EP - 62 JF - The Journal of adolescent health : official publication of the Society for Adolescent Medicine JO - J Adolesc Health VL - 53 IS - 6 N2 - PURPOSE: To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship. METHODS: We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years. RESULTS: There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p < .001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR], .76; 95% confidence interval [CI], .50-1.16; and AOR, .67; 95% CI, .37-1.19) but not for African-Americans (AOR, .47, 95% CI, .33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR, .85, 95% CI, .54-1.34; and AOR, .84, 95% CI, .45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR, .49, 95% CI, .36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years. CONCLUSIONS: Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population. SN - 1879-1972 UR - https://www.unboundmedicine.com/medline/citation/23992645/Racial_disparities_in_human_papillomavirus_vaccination:_does_access_matter DB - PRIME DP - Unbound Medicine ER -