Social media use and human papillomavirus awareness and knowledge among adults with children in the household: examining the role of race, ethnicity, and gender

Figures & data

Table 1. Respondent characteristics with children <18 in the household, 2019–2017 (N = 2,720)

Characteristic	N (%)
Age
18–34	688 (25.3)
35–49	1,374 (50.5)
50–65	588 (21.6)
>65	71 (2.6)
Gender
Male	1,191 (43.8)
Female	1,529 (56.2)
Marital status
Married/living as married	1,923 (70.7)
Divorced/separated/widowed	254 (9.35)
Single, never been married	541 (19.9)
Education
Less than high school	250 (9.2)
High school graduate	579 (21.3)
Some college	966 (35.5)
College graduate or more	925 (34.0)
Household income
$0 to $19,999	400 (14.7)
$20,000 to $34,999	286 (10.5)
$35,000 to $49,999	359 (13.2)
$50,000 to $74,999	457 (16.8)
$75,000 to $99,999	373 (13.7)
$100,000 or more	846 (31.1)
Race/ethnicity
Non-Hispanic African American	302 (11.1)
Non-Hispanic White	1,485 (54.6)
Asian	174 (6.4)
Hispanic	653 (24.0)
English language proficiency
Very well/well	2,595 (95.4)
Not very well/not at all	125 (4.6)
Regular provider status
Yes	1,654 (60.8)
No	1,066 (39.2)
General health status
Excellent/very good	1,352 (49.7)
Good	1,020 (37.5)
Fair/poor	351 (12.9)
Outcomes
No social media use	394 (14.5)
Engaged in one social media behavior	1,140 (41.9)
Engaged in two social media behaviors	732 (26.9)
Engaged in three social media behaviors	313 (11.5)
Engaged in four social media behaviors	141 (5.2)

HPV: Human papillomavirus

Figure 1. Estimates of social media use among respondents with children <18 in the household, 2019–2017 (N = 2,720)

Table 2. Weighted frequencies and bivariate associations between HPV awareness and HPV vaccine awareness and social media use variables

	Aware of HPV		Aware of HPV vaccine
Social media use	%	P-value	%	P-value
No social media use	47.5	<.001	42.0	<.001
Engaged in one social media behavior	75.3		71.3
Engaged in two social media behaviors	77.8		73.7
Engaged in three social media behaviors	81.9		84.9
Engaged in four social media behaviors	80.9		82.9

HPV: Human papillomavirus

Table 3. Weighted frequencies and bivariate associations between HPV cancer knowledge and social media use variables

	Knowledgeable That HPV Is a Cause of Cervical Cancer %		Knowledgeable That HPV Is a Cause of Penile Cancer %		Knowledgeable That HPV Is a Cause of Anal Cancer %		Knowledgeable That HPV Is a Cause of Oral Cancer %
Social media use	%	P-value	%	P-value	%	P-value	%	P-value
No social media use	71.3	P = .067	35.2	P = .391	30.0	P = .507	27.7	P = .772
Engaged in one social media behavior	77.5		31.6		26.5		29.3
Engaged in two social media behaviors	77.5		32.3		32.5		29.0
Engaged in three social media behaviors	85.6		40.9		34.8		35.2
Engaged in four social media behaviors	84.3		38.9		32.9		33.0

HPV: Human papillomavirus

Table 4. Weighted, fully adjusted multivariable logistic regression of the association between social media use and HPV and HPV vaccine awareness, 2019–2017

	Heard of HPV (N = 2,436) aOR (95%CI)	Heard of HPV Vaccine (N = 2,419) aOR (95%CI)
Social media use
No social media use	Ref	Ref
Engaged in one social media behavior	2.09* (1.18–3.70)	2.21** (1.29–3.79)
Engaged in two social media behaviors	2.49** (1.40–4.42)	2.89** (1.70–4.91)
Engaged in three social media behaviors	2.64* (1.15–6.05)	5.16*** (2.51–10.60)
Engaged in four social media behaviors	2.44* (1.11–5.36)	3.61** (1.53–8.53)
Covariates
Age
18–34	Ref	Ref
35–49	0.91 (0.57–1.44)	1.00 (0.60–1.68)
50–65	0.58 (0.34–1.01)	0.96 (0.50–1.85)
>65	0.30** (0.13–0.69)	0.54 (0.23–1.26)
Gender
Male	0.38*** (0.25–0.58)	0.33*** (0.24–0.45)
Female	Ref	Ref
Marital status
Married/living as married	Ref	Ref
Divorced/separated/widowed	1.02 (0.61–1.69)	0.87 (0.56–1.36)
Never married	0.98 (0.55–1.74)	0.79 (0.46–1.35)
Education
Less than high school	0.16*** (0.08–0.32)	0.21*** (0.11–0.41)
High school graduate	0.38*** (0.23–0.59)	0.30*** (0.19–0.47)
Some college	0.89 (0.61–1.29)	0.67* (0.45–0.99)
College graduate or more	Ref	Ref
Household income
<$20,000	0.70 (0.34–1.44)	0.91 (0.46–1.81)
$20,000 to $34,999	0.79 (0.39–1.61)	0.98 (0.47–2.02)
$35,000 to $49,999	0.84 (0.49–1.43)	0.98 (0.56–1.72)
$50,000 to $74,999	1.15 (0.64–2.07)	1.24 (0.65–2.36)
$75,000 to $99,999	0.91 (0.56–1.49)	0.96 (0.55–1.66)
≥$100,000	Ref	Ref
Race/ethnicity
Non-Hispanic White	Ref	Ref
Non-Hispanic African American	0.53* (0.31–0.92)	0.48** (0.29–0.81)
Hispanic	0.63 (0.39–1.01)	0.62* (0.41–0.93)
Asian	0.17*** (0.09–0.32)	0.16*** (0.09–0.28)
English language proficiency
Very well/well	Ref	Ref
Not very well/not at all	1.23 (0.60–2.52)	0.63 (0.30–1.32)
Regular provider status
Yes	Ref	Ref
No	0.73 (0.54–1.01)	0.69 (0.48–0.98)
General health status
Excellent/very good	Ref	Ref
Good	1.17 (0.78–1.74)	0.77 (0.52–1.14)
Fair/poor	1.19 (0.67–2.09)	0.66 (0.38–1.16)

HPV: Human papillomavirus

CI: Confidence interval

*<.05; **<.01; ***<.001

Table 5. Weighted, fully adjusted multivariable logistic regression of the association between social media use and HPV cancer knowledge, 2019–2017

	Knowledgeable That HPV Causes Cervical Cancer (N = 1,863) aOR (95%CI)	Knowledgeable That HPV Causes Penile Cancer (N = 1,824) aOR (95%CI)	Knowledgeable That HPV Causes Anal Cancer (N = 1,824) aOR (95%CI)	Knowledgeable That HPV Causes Oral Cancer (N = 1,824) aOR (95%CI)
Social media use
No social media use	Ref	Ref	Ref	Ref
Engaged in one social media behavior	0.97 (0.54–1.75)	0.83 (0.52–1.32)	0.82 (0.44–1.51)	1.12 (0.57–2.20)
Engaged in two social media behaviors	0.95 (0.53–1.69)	0.85 (0.50–1.45)	1.04 (0.53–2.05)	1.01 (0.49–2.10)
Engaged in three social media behaviors	1.73 (0.85–3.53)	1.20 (0.63–2.30)	1.24 (0.59–2.60)	1.33 (0.60–2.99)
Engaged in four social media behaviors	1.26 (0.45–3.54)	1.17 (0.58–2.39)	1.03 (0.45–2.36)	1.23 (0.47–3.19)
Covariates
Age
18–34	Ref
35–49	1.42 (0.81–2.50)	1.09 (0.71–1.67)	1.00 (0.64–1.56)	0.99 (0.66–1.47)
50–65	0.94 (0.49–1.82)	1.05 (0.64–1.71)	1.22 (0.72–2.08)	1.16 (0.68–1.99)
>65	0.63 (0.25–1.60)	1.03 (0.37–2.83)	0.64 (0.20–2.02)	0.74 (0.27–2.03)
Gender
Male	0.58* (0.38–0.88)	1.11 (0.76–1.62)	1.10 (0.75–1.62)	1.03 (0.71–1.49)
Female	Ref	Ref	Ref	Ref
Marital status
Married/living as married	Ref	Ref	Ref	Ref
Divorced/separated/widowed	1.56 (0.85–2.85)	1.68* (1.00–2.83)	1.48 (0.91–2.43)	1.75* (1.04–2.94)
Single, never married	0.81 (0.43–1.52)	1.10 (0.67–1.82)	1.31 (0.72–2.36)	1.07 (0.57–2.01)
Education
Less than high school	0.23** (0.09–0.60)	0.79 (0.30–2.05)	0.58 (0.18–1.83)	0.54 (0.19–1.54)
High school graduate	0.36*** (0.22–0.60)	0.98 (0.56–1.71)	0.66 (0.35–1.25)	0.45* (0.24–0.84)
Some college	0.65 (0.40–1.05)	1.37* (1.03–1.84)	1.01 (0.69–1.48)	0.76 (0.52–1.12)
College graduate or more	Ref	Ref	Ref	Ref
Household income
<$20,000	0.52 (0.22–1.23)	0.92 (0.49–1.74)	0.94 (0.44–2.00)	1.17 (0.55–2.51)
$20,000 to $34,999	1.03 (0.46–2.30)	0.87 (0.48–1.60)	1.22 (0.66–2.27)	1.00 (0.48–2.09)
$35,000 to $49,999	0.49 (0.22–1.09)	0.52* (0.31–0.86)	0.84 (0.44–1.58)	0.80 (0.44–1.46)
$50,000 to $74,999	0.68 (0.36–1.28)	1.08 (0.70–1.67)	1.31 (0.84–2.07)	1.00 (0.61–1.64)
$75,000 to $99,999	0.76 (0.39–1.47)	0.89 (0.54–1.45)	1.14 (0.70–1.89)	0.95 (0.56–1.60)
≥$100,000	Ref	Ref	Ref	Ref
Race/ethnicity
Non-Hispanic White	Ref	Ref	Ref	Ref
Non-Hispanic African American	0.69 (0.40–1.19)	0.87 (0.53–1.43)	0.69 (0.41–1.19)	0.62 (0.35–1.10)
Hispanic	1.14 (0.67–1.92)	1.22 (0.74–2.02)	1.12 (0.67–1.87)	1.20 (0.72–1.99)
Asian American	0.67 (0.24–1.86)	1.02 (0.46–2.27)	1.25 (0.58–2.72)	1.46 (0.71–3.01)
English language proficiency
Very well/well	Ref	Ref	Ref	Ref
Not very well/not at all	0.89 (0.31–2.57)	1.27 (0.49–3.28)	1.47 (0.57–3.78)	1.63 (0.61–4.36)
Regular provider status
Yes	Ref	Ref	Ref	Ref
No	0.75 (0.31–2.57)	0.76 (0.54–1.06)	0.73 (0.52–1.04)	0.91 (0.65–1.28)
General health status
Excellent/very good	Ref	Ref	Ref	Ref
Good	0.59 (0.37–0.92)	0.85 (0.58–1.24)	0.96 (0.70–1.38)	0.89 (0.61–1.29)
Fair/poor	0.68 (0.40–1.15)	1.03 (0.60–1.06)	1.28 (0.71–2.31)	1.26 (0.70–2.29)

HPV: Human papillomavirus

CI: Confidence interval

*<.05; **<.01; ***<.001

Table A1. Logistic regressions estimating HPV, HPV vaccine awareness, and cervical cancer knowledge stratified by gender

	Heard of HPV		Heard of HPV vaccine		Knowledgeable that HPV causes cervical cancer
	Women	Men	Women	Men	Women	Men
	aOR 95% CI	aOR 95% CI	aOR 95% CI	aOR 95% CI	aOR 95% CI	aOR 95% CI
Engaged in one social media behaviors	2.58** (1.29–5.20)	1.80 (0.84–3.88)	3.05** (1.39–6.72)	1.69 (0.87–3.27)	0.86 (0.39–1.90)	0.95 (0.37–2.47)
Engaged in two social media behaviors	2.86** (1.44–5.69)	2.46* (1.07–5.66)	4.28*** (2.03–9.01)	2.08 (0.95–4.58)	0.96 (0.44–2.09)	0.85 (0.28–2.56)
Engaged in three social media behaviors	6.84** (2.09–22.29)	1.20 (0.34–4.31)	8.78** (2.98–25.89)	3.42 (0.92–12.77)	1.38 (0.54–3.51)	3.61 (0.52–25.03)
Engaged in four social media behaviors	4.22* (1.23–14.49)	1.52 (0.41–5.65)	7.06* (1.62–30.86)	1.85 (0.51–6.73)	1.51 (0.51–4.50)	0.53 (0.06–5.01)

Table A2. Logistic regressions estimating HPV and HPV vaccine awareness stratified by race/ethnicity

	Heard of HPV^a	Heard of HPV vaccine
	Non-Hispanic Black	Non-Hispanic Black	Asian American	Hispanic
	aOR 95% CI	aOR 95% CI	aOR 95% CI	aOR 95% CI
Engaged in one social media behaviors	2.69 (0.97–7.44)	1.06 (0.33–3.37)	1.13 (0.16–8.06)	1.49 (0.50–4.45)
Engaged in two social media behaviors	2.62 (0.45–15.25)	0.77 (0.23–2.62)	9.70 (0.88–107.12)	1.33 (0.44–4.05)
Engaged in three social media behaviors	2.62 (0.51–13.50)	2.79 (0.51–15.24)	31.23* (1.09–894.73)	5.68** (1.73–18.62)
Engaged in four social media behaviors	5.32 (0.45–62.88)	13.44 (0.40–450.11)	10.25 (0.29–367.38)	1.26 (0.13–12.39)

^aNote: Due to lack of observations among Asian Americans for HPV awareness, odds ratios were not calculated.