Study cites racial, gender imbalance in HPV vaccinations

White women are far more likely to complete the human papillomavirus, or HPV, vaccine series than black or Latina women, according to a new study by two University of Iowa College of Public Health researchers.

Those women also are more likely to be vaccinated against the cancer-causing, sexually transmitted infection than their male counterparts.

The study, published in the February edition of 'American Journal of Public Health,” analyzed data from more than 6,400 respondents ages 18 to 30 years old who participated in the 2013 National Health Interview Survey. The annual survey asks respondents about a broad range of topics on mental and physical health and is completed by the Centers for Disease Control and Prevention.

The HPV vaccine is a series of three shots spread out over six months and is recommended to girls and boys 11 to 12 years old. Catch-up vaccines are recommended for males through age 21 and for females through age 26 if they were not vaccinated when they were younger.

About 14 million people become infected with HPV each year, according to the CDC. But a person with HPV doesn't always show symptoms, and symptoms may not develop until years after having sex with the partner who initially carried the disease.

If left untreated, HPV can cause genital warts as well as multiple types of cancer, including cervical cancer, throat cancer and cancer of the penis or anus.

Compared with white women, the study found that black women had 30 percent lower odds of starting the HPV vaccine series. And among those who begin the three-shot series, black and Latina women had approximately one-quarter and one-half the odds, respectively, of completing the series as did white women.

Gathering this information is an important first step, said Paul Gilbert, assistant professor in the Department of Community and Behavioral Health and co-author of the study. That's because you must establish what the gaps are to begin discussing how they can be fixed, he said.

Gilbert added that lower vaccination rates can be tied to numerous factors, including lower education levels and lack of insurance coverage.

'Locally outreach has been tailored to the white community,” said Jason Daniel-Ulloa, assistant research scientist in the Department of Community and Behavioral Health and a co-author of the study. 'We need more culturally tailored interventions.”

Starting initiatives such as tying vaccinations to well-child exams or having pharmacists complete the series outside the clinic setting could reduce barriers and improve outcomes, he said.

The study also found that about 30 percent of women reported receiving the vaccine compared with 5 percent of men.

'We weren't surprised by the results,” Gilbert said. 'There's a perception that men are not affected by (HPV) because they can be asymptomatic” - that is, they don't necessarily show the symptoms.

The researchers said the reframing of the vaccine - from what can prevent a sexually transmitted infection to something that can prevent cancer - has been important in combating parental concerns that the vaccine increases sexual activity among teens. Something Gilbert said research has proved to not be true.

But there still is a long way to go, especially when eliminating health disparities. The two urged for researchers to continue to look at HPV vaccination rates in the future to see if any of these gaps begin to close over time.

They also would like to look specifically at state surveillance data broken down by demographics.

'It's important that states like Iowa - which are undergoing a dramatic shift in demographics - understand that our public health system needs to be better at reaching out to these people,” Daniel-Ulloa said.