Abstract PO-244: Association between sexual naivety and human papillomavirus (HPV) vaccination initiation and completion
Authors: Boakye Eric Adjei , McKinney Stacey L. , Franca Maria C. , Whittington Kelli D. , Boyer Valerie E. , Lee Minjee , McKinnies Richard C. , Collins Sandra K. 
Published: January 2022

Abstract
Background: Human papillomavirus (HPV) accounts for about 35,000 HPV-associated cancers per year. In the United States, a gender-neutral HPV vaccine was recommended by the Advisory Committee on Immunization Practices in 2011 with the primary goal of preventing HPV-associated cancers. Although the HPV vaccine is safe and effective, vaccine uptake is low especially in young adult population. College students comprise the age-group with the highest risk of HPV infection. The HPV vaccines are thought to be most effective before initiation of sexual activity. However, there is a dearth of information on the association between HPV vaccine uptake and sexual activity among college students. This study examined if sexual naivety was associated with HPV vaccination uptake (initiation and completion) among university students. Methods: A cross-sectional study was conducted between February and May 2021 among students at a Midwestern University. Sexual naivety was assessed with these questions: “Have you ever had vaginal sexual intercourse?”, and “Have you ever had oral sex?” Responses were categorized as “no oral or vaginal sex”, “had oral or vaginal sex”, or “had oral and vaginal sex”. The outcome variable was HPV vaccination uptake; initiation was defined as receipt of ≥1 dose, and completion as receipt of ≥3 doses. Multivariable logistic regression models estimated the association between sexual naivety and vaccine uptake, adjusting for age, gender, race, relationship status, academic level, and rural-urban status. Results: Approximately 18% of students reported being sexually naïve. Overall, 45.5% had initiated the HPV vaccination, and 16.5% had completed the vaccination. After adjusting for covariates, compared to students who reported being sexually naïve, those that had ever had oral and vaginal sex were more likely to have initiated (aOR=2.18, 95% CI: 1.41–3.39) the HPV vaccinations; however, no difference was observed for completion. Other factors associated with lower odds of HPV vaccination initiation included younger age (aOR=0.90, 95% CI: 0.85–0.95), male sex (aOR=0.33, 95% CI: 0.23–0.45), rural residence (aOR=0.67, 95% CI: 0.47–0.96), and freshman/sophomore academic level (aOR=0.55, 95% CI: 0.31–0.95). Only gender was associated with vaccination completion where male students were 74% less likely to have completed the series compared to female students. Conclusions: We show that 1-in-5 students were sexually naïve, and that 4-in-10 had initiated the HPV vaccination but only 16% had completed the series. Sexual naivety was an independent predictor of HPV vaccine initiation, with sexually naïve students less likely to have initiated the vaccination. Since sexually naïve students may benefit the most from receiving the HPV vaccination, targeted interventions should be implemented towards this population to help increase vaccination rates and prevent HPV-associated diseases.
Citation Format: Eric Adjei Boakye, Stacey L. McKinney, Maria C. Franca, Kelli D. Whittington, Valerie E. Boyer, Minjee Lee, Richard C. McKinnies, Sandra K. Collins. Association between sexual naivety and human papillomavirus (HPV) vaccination initiation and completion [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-244.