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      Approaching a decade since HPV vaccine licensure: Racial and gender disparities in knowledge and awareness of HPV and HPV vaccine

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          Abstract

          <p id="d7271770e268">   <b>Purpose</b>: Gaps remain in the public's knowledge of the human papillomavirus (HPV). We assessed racial/ethnic and gender disparities in knowledge and awareness of HPV and the HPV vaccine among US adults. </p><p id="d7271770e273"> <b>Methods</b>: Data from the Health Information National Trends Survey 4 Cycle 3 (September – December 2013) and Cycle 4 (August – November 2014) were analyzed for 6,862 respondents aged 18 years and older. Weighted multivariable logistic regression models were used to estimate racial/ethnic and gender disparities in HPV knowledge and HPV vaccination awareness. </p><p id="d7271770e278"> <b>Results</b>: Sixty-six percent of respondents had heard of HPV and the HPV vaccine (57% of men vs. 75% of women). In multivariable analyses, compared with men, women were 225% (95% CI: 2.60 – 4.07) more likely to have heard of HPV, and 281% (95% CI: 3.06 – 4.74) more likely to have heard of the HPV vaccine. Non-Hispanic Blacks were 33% (95% CI: 0.47 – 0.96) and 44% (95% CI: 0.39 – 0.81) less likely than non-Hispanic Whites to have heard of HPV and the HPV vaccine, respectively. Hispanics were 27% (95% CI: 0.52 – 1.02) and 53% (95% CI: 0.34 – 0.64) less likely than non-Hispanic Whites to have heard of HPV and the HPV vaccine, respectively. </p><p id="d7271770e283"> <b>Conclusions</b>: There was evidence of disparities in HPV and HPV vaccine awareness among men compared with women and non-Hispanic Blacks and Hispanics compared with non-Hispanic Whites. To foster improvements in HPV vaccine uptake and reduce disparities in HPV associated cancers, future interventions must target men and minority populations, for whom knowledge gaps exist. </p>

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          Most cited references35

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          HPV prophylactic vaccines and the potential prevention of noncervical cancers in both men and women.

          Human papillomavirus (HPV) is a necessary cause of cervical cancer. In addition, on the basis of the fulfillment of a combination of viral as well as epidemiological criteria, it is currently accepted that a proportion of anal, oropharyngeal, vulvar, and vaginal cancers among women and anal, oropharyngeal, and penile cancers among men are etiologically related to HPV. At these noncervical sites with etiologic heterogeneity, HPV-associated cancers represent a distinct clinicopathological entity, which is generally characterized by a younger age at onset, basaloid or warty histopathology, association with sexual behavior, and better prognosis, when compared with their HPV-negative counterparts. Currently available estimates indicate that the number of HPV-associated noncervical cancers diagnosed annually in the US roughly approximates the number of cervical cancers, with an equal number of noncervical cancers among men and women. Furthermore, whereas the incidence of cervical cancers has been decreasing over time, the incidence of anal and oropharyngeal cancers, for which there are no effective or widely used screening programs, has been increasing in the US. The efficacy of HPV vaccines in preventing infection at sites other than the cervix, vagina, and vulva should, therefore, be assessed (eg, oral and anal). Given that a substantial proportion of cervical cancers (approximately 70%) and an even greater proportion of HPV-associated noncervical cancers (approximately 86% to 95%) are caused by HPV16 and 18 (HPV types that are targeted by the currently available vaccines), current HPV vaccines may hold great promise (provided equivalent efficacy at all relevant anatomic sites) in reducing the burden of HPV-associated noncervical cancers, in addition to cervical cancers.
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            Prevalence of HPV After Introduction of the Vaccination Program in the United States.

            Since mid-2006, human papillomavirus (HPV) vaccination has been recommended for females aged 11 to 12 years and through 26 years if not previously vaccinated.
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              National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years - United States, 2015.

              The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents aged 11-12 years routinely receive vaccines to prevent diseases, including human papillomavirus (HPV)-associated cancers, pertussis, and meningococcal disease (1). To assess vaccination coverage among adolescents in the United States, CDC analyzed data collected regarding 21,875 adolescents through the 2015 National Immunization Survey-Teen (NIS-Teen).* During 2014-2015, coverage among adolescents aged 13-17 years increased for each HPV vaccine dose among males, including ≥1 HPV vaccine dose (from 41.7% to 49.8%), and increased modestly for ≥1 HPV vaccine dose among females (from 60.0% to 62.8%) and ≥1 quadrivalent meningococcal conjugate vaccine (MenACWY) dose (from 79.3% to 81.3%). Coverage with ≥1 HPV vaccine dose was higher among adolescents living in households below the poverty level, compared with adolescents in households at or above the poverty level.(†) HPV vaccination coverage (≥1, ≥2, or ≥3 doses) increased in 28 states/local areas among males and in seven states among females. Despite limited progress, HPV vaccination coverage remained lower than MenACWY and tetanus, diphtheria, and acellular pertussis vaccine (Tdap) coverage, indicating continued missed opportunities for HPV-associated cancer prevention.

                Author and article information

                Journal
                Human Vaccines & Immunotherapeutics
                Human Vaccines & Immunotherapeutics
                Informa UK Limited
                2164-5515
                2164-554X
                July 25 2017
                November 02 2017
                August 30 2017
                November 02 2017
                : 13
                : 11
                : 2713-2722
                Affiliations
                [1 ] Saint Louis University Center for Health Outcomes Research (SLUCOR), Saint Louis University, Saint Louis, MO, USA
                [2 ] Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
                [3 ] Saint Louis University School of Medicine, Department of Internal Medicine, Saint Louis, MO, USA
                [4 ] Department of Biostatistics and Bioinformatics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
                [5 ] Saint Louis University School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Saint Louis, MO, USA
                [6 ] Saint Louis University Cancer Center, Saint Louis, MO, USA
                Article
                10.1080/21645515.2017.1363133
                5703403
                28853980
                f1fa9a22-1d56-432f-a666-d7c642f594b6
                © 2017
                History

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