Disparities in human papillomavirus (HPV) vaccine initiation and completion based on sexual orientation among women in the United States

ABSTRACT

Objectives

We compared HPV vaccine initiation and completion of heterosexual with lesbian and bisexual (LB) women.

Methods

We aggregated National Health and Nutrition Examination Survey data from 2009 to 2016 for 3,017 women aged 18 to 34 y in the United States. HPV vaccine initiation was defined as reported receipt of ≥1 dose of the vaccine and completion as receipt of the three recommended doses. Weighted percentages and multivariable logistic regression models were used to examine differences in HPV vaccine initiation and completion between heterosexual and LB women.

Results

Approximately 12% of respondents self-identified as LB women. Overall, a higher percentage of respondents (26%) had initiated the HPV vaccine than completed the three vaccine doses (17%). In the bivariate analysis, LB women had higher initiation ([35% of LB women versus 25% heterosexual]; p = .0012) and completion rates ([24% of LB women versus 17% heterosexual]; p = .0052) than heterosexual women. After adjusting for covariates, compared to heterosexual women, LB women were 60% (aOR = 1.60, 95% CI: 1.16–2.19) more likely to initiate and 63% (aOR = 1.63, 95% CI: 1.12–2.37) more likely to complete the HPV vaccine.

Conclusions

Although LB women had higher likelihood of HPV vaccine initiation and completion compared with heterosexual women, their HPV vaccine uptake was well below the Healthy People 2020 target (80%). Understanding differences in the drivers of vaccine uptake in the LB population may inform strategies that would further increase HPV vaccine uptake toward achieving the 80% completion target.

KEYWORDS:

• Human papillomavirus
• HPV vaccine
• sexual orientation
• lesbian and bisexual women
• young adults
• HPV vaccination initiation and completion

Acknowledgments

Portion of this work was presented at the Ninth Annual AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Under-served, Fort Lauderdale, FL.

Authors would like to acknowledge Ms. Erika Juhlin for her technical assistance and for proofreading this manuscript.

Disclosure statement

All authors have no conflict of interest to declare.