Abstract C90: Sociodemographic predictors of HPV vaccine recommendation and initiation among female and male college students in Georgia
Authors: Vu Milkie , Bednarczyk Robert A. , Prood Nadya , Le Lana , Berg Carla J. 
Published: February 2019

Background and Objective: Human papillomavirus (HPV) vaccine is recommended as a safe and effective preventive method against several types of cancers, including cervical cancer. We assessed HPV vaccine recommendation and initiation rates in a sample of female and male college students and compared these outcomes across sociodemographic factors.

Methods: In 2016, surveys were administered to 1552 female and 845 male students aged 18-25 years old from 7 colleges in Georgia. Descriptive statistics were used to assess prevalence of doctor recommendation for HPV vaccine, HPV vaccine initiation, completion of three-dose series, and facilitators and barriers to HPV vaccine initiation. Logistic regressions stratified by sex were used to examine sociodemographic predictors of HPV vaccine recommendation and initiation.

Results: In our sample, 48.32% of women (n=750) and 18.82% of men (n=159) had received a doctor's recommendation for HPV vaccine. Among women, sociodemographic predictors of doctor recommendation included older age (OR=1.23, CI=[1.16 – 1.31], p&lt;0.001), being U.S.-born as opposed to foreign-born (OR=2.56, CI=[1.54 – 4.35], p&lt;0.001), and having a parent with a highest education of a bachelor's degree or above (OR=1.31, CI=[1.04 – 1.65], p=0.02). Compared to women at private schools, women at state schools had lower odds of receiving a doctor's recommendation (OR=0.41, CI=[0.30 – 0.57], p&lt;0.001). Among men, younger age (OR=0.82, CI=[0.74 – 0.91], p&lt;0.001) was a predictor of doctor recommendation. Compared to heterosexual men, homosexual men had higher odds of receiving a doctor's recommendation (OR=3.78, CI=[1.84 – 7.75], p=0.01). Compared to White men, Asian American and Pacific Islander men had lower odds of receiving a doctor's recommendation (OR=0.51, CI=[0.24 – 1.08], p=0.04).

In our sample, 43.30% of women (n=672) and 16.69% of men (n=141) had initiated HPV vaccine. For both women and men, doctor recommendation was a strong predictor of vaccine initiation. Among women, sociodemographic predictors of vaccine initiation included older age (OR=1.23, CI=[1.16 – 1.30], p&lt;0.001) and being U.S.-born (OR=2.44, CI=[1.45 – 4.12], p&lt;0.001). Compared to women at private schools, women at state schools had lower odds of vaccine initiation (OR=0.43, CI=[0.31 – 0.60], p&lt;0.001). Among men, younger age (OR=1.16, CI=[0.78 – 0.96], p=0.006) was a predictor of vaccine initiation. Compared to heterosexual men, homosexual men had higher odds of vaccine initiation (OR=3.13, CI=[1.51 – 6.52], p=0.01).

Moreover, 575 women (85.56% of initiators and 37.05% of the sample) and 115 men (81.56% of initiators and 13.61% of the sample) completed the three-dose series. The average age when receiving the first doctor's recommendation for vaccine was higher for Black women compared to White women (15.78 vs. 14.70, p&lt;0.001). For both women and men, common facilitators of vaccine initiation included doctor recommendation and recommendation by parents, while common barriers to vaccine initiation included lack of doctor recommendation and sexual inactivity.

Conclusions: For women, sociodemographic factors that influenced differences in vaccine recommendation and initiation likelihoods were age, socioeconomic status, and place of birth; for men, these were age, race, and sexual orientation. Black women had a higher age when receiving the first doctor's recommendation for vaccine compared to White women. Future studies should continue to investigate these associations in order to reduce disparities in HPV vaccination. Our results also highlight key points of intervention/messaging for HPV vaccine. A doctor's recommendation remains a strong predictor of vaccine initiation and should be incorporated in interventions. Perception that the vaccine is not needed because of sexual inactivity should also be further explored in depth.

Citation Format: Milkie Vu, Robert A. Bednarczyk, Nadya Prood, Lana Le, Carla J. Berg. Sociodemographic predictors of HPV vaccine recommendation and initiation among female and male college students in Georgia [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C90.