Nativity status and genital HPV infection among adults in the U.S.

Abstract

Over 43 million immigrants live in the United States (U.S.). Foreign-born populations experience multiple disparities related to human papillomavirus (HPV), including higher cervical cancer mortality rates, yet little research has examined the prevalence of genital HPV infection among this population. We used data from 1,822 women and 1,622 men ages 20-59 in the U.S. who participated in the 2013-2014 National Health and Nutrition Examination Survey (NHANES). Participants reported their nativity status (foreign-vs. U.S.-born) and provided biospecimens for HPV testing. We assessed nativity differences in the prevalence of three HPV infection outcomes (any HPV type, high-risk HPV type, and vaccinepreventable HPV type) using weighted logistic regression. Overall, 40% of women and 46% of men tested positive for any type of HPV. Compared to women born in the U.S., foreign-born women had a lower prevalence of infection with any HPV type (32% vs. 42%, p < .01). Compared to men born in the U.S., foreign-born men had a lower prevalence of all HPV infection outcomes (any type: 39% vs. 48%; high-risk: 22% vs. 34%; vaccine-preventable: 12% vs. 16%; all p < .05). Multivariable models attenuated several of these differences, though foreign-born men had lower odds of infection with a high-risk HPV type (OR = 0.75; 95% CI: 0.60-0.93, p < .01) after adjusting for covariates. Although lower than among their U.S.-born counterparts, HPV infection is prevalent among foreign-born women and men in the U.S. Findings can help inform strategic communication campaigns and targeted HPV vaccination and cervical cancer screening efforts for immigrant populations.

Differences in human papillomavirus (HPV) vaccine uptake by nativity status among men aged 18–34 years

“…There is a huge burden of HPV infection among foreign-born in the US. For example, Bhattacharya et al recently reported the rate of any HPV infection to be 39%, high risk infection to be 22%, and vaccine preventable infection to be 12% among foreign-born men in the US (Bhattacharya et al, 2019). HPV-associated anal cancers in males are higher in Asia (India and China) than in the US, while HPV-associated penile cancers are higher in Latin America and Asia (India and China) than in the US (de Martel et al, 2017).…”

Health inequities in human papillomavirus prevention, diagnostics and clinical care in the USA: a scoping review

“…Except for Hispanic patients, historically marginalised racial/ethnic groups had disproportionately lower rates of vaccination and decreased knowledge of HPV (online supplemental table 2). Additionally, these populations had lower physician recommendation for vaccination,20–22 higher prevalence of HPV infections23–32 and were less likely to undergo primary surgery as treatment for HPV-associated cancer 33–35. Although vaccination rates among Hispanic patients were relatively high, all historically marginalised racial/ethnic populations had higher rates of HPV-associated cancer36 and worse cancer-related outcomes compared with white patients 37…”

Dietary Vitamin K Intake and HPV-Infection Status Among American Women: A Secondary Analysis From National Health and Nutrition Examination Survey Data From 2003 to 2016

“…Based on the factors associated with HPV-infection that are reported in the previous study [32][33][34][35][36][37][38][39][40][41][42][43], we use these factors as the covariates. So these covariates involved in this analysis consist of vitamin K intake data, sociodemographic data, experimental data, questionnaire data, and data from a physical examination.…”