Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States
AuthorHenry, Kevin A.
Swiecki-Sikora, Allison L.
Stroup, Antoinette M.
Warner, Echo L.
GroupFox Chase Cancer Center (Temple University)
Cancer Prevention and Control Program (Temple University)
DepartmentGeography and Urban Studies
Obstetrics, Gynecology and Reproductive Sciences
Permanent link to this recordhttp://hdl.handle.net/20.500.12613/8703
MetadataShow full item record
AbstractBackground: This study is the first to examine associations between several area-based socioeconomic factors and human papillomavirus (HPV) vaccine uptake among boys in the United States (U.S.). Methods: Data from the 2012-2013 National Immunization Survey-Teen restricted-use data were analyzed to examine associations of HPV vaccination initiation (receipt of ≥1 dose) and series completion (receipt of three doses) among boys aged 13-17 years (N = 19,518) with several individual-level and ZIP Code Tabulation Area (ZCTA) census measures. Multivariable logistic regression was used to estimate the odds of HPV vaccination initiation and series completion separately. Results: In 2012-2013 approximately 27.9% (95% CI 26.6%-29.2%) of boys initiated and 10.38% (95% CI 9.48%-11.29%) completed the HPV vaccine series. Area-based poverty was not statistically significantly associated with HPV vaccination initiation. It was, however, associated with series completion, with boys living in high-poverty areas (≥20% of residents living below poverty) having higher odds of completing the series (AOR 1.22, 95% CI 1.01-1.48) than boys in low-poverty areas (0-4.99%). Interactions between race/ethnicity and ZIP code-level poverty indicated that Hispanic boys living in high-poverty areas had a statistically significantly higher odds of HPV vaccine initiation (AOR 1.43, 95% CI 1.03-1.97) and series completion (AOR 1.56, 95% CI 1.05-2.32) than Hispanic boys in low-poverty areas. Non-Hispanic Black boys in high poverty areas had higher odds of initiation (AOR 2.23, 95% CI 1.33-3.75) and completion (AOR 2.61, 95% CI 1.06-6.44) than non-Hispanic Black boys in low-poverty areas. Rural/urban residence and population density were also significant factors, with boys from urban or densely populated areas having higher odds of initiation and completion compared to boys living in non-urban, less densely populated areas. Conclusion: Higher HPV vaccination coverage in urban areas and among racial/ethnic minorities in areas with high poverty may be attributable to factors such as vaccine acceptance, health-care practices, and their access to HPV vaccines through the Vaccines for Children Program, which provides free vaccines to uninsured and under-insured children. Given the low HPV vaccination rates among boys in the U.S., these results provide important evidence to inform public health interventions to increase HPV vaccination.
CitationHenry, K.A., Swiecki-Sikora, A.L., Stroup, A.M. et al. Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States. BMC Public Health 18, 19 (2018). https://doi.org/10.1186/s12889-017-4567-2
Citation to related workBMC
Has partBMC Public Health, Vol. 18, No. 19
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