One Size Does Not Fit All: Differences in HPV Knowledge between Haitian and African American Women

Abstract

Background: Historically, all black persons, regardless of ancestry or country of origin, have been categorized as one group for cancer research and control efforts. This practice likely masks variability in exposure to determinants of disease, as well as in risk of cancer incidence and mortality. The current study examines potential differences in knowledge of human papilloma virus (HPV) between Haitian women living in Little Haiti, Miami, Florida, and a national sample of predominately African American women.Methods: Data for Haitian women were collected in 2007 as part of an ongoing community-based participatory research initiative in Little Haiti. For purposes of comparison, we used data from a largely African American subsample of the 2007 Health Information National Trends Survey (HINTS). These data sources used identical items to assess HPV knowledge, providing a unique opportunity to examine how this outcome may vary between two very distinct populations who are often grouped together for research and disease surveillance.Results: Relative to the HINTS sample, Haitian women were far less likely to have heard about HPV. Conclusions: Study data highlight important differences in Haitian and African American women's knowledge of HPV, a known determinant of cervical cancer risk. Such findings suggest that continuing to classify persons of similar phenotype but different cultural backgrounds and lifetime exposures as one group may preclude opportunity to understand, as well as attenuate, health disparity. Cancer Epidemiol

Knowledge, Attitudes, and Beliefs Regarding HPV Vaccination: Ethnic and Cultural Differences Between African-American and Haitian Immigrant Women

“…Based on data from this study, it seems that providers may need to deliver targeted messages to specific ethnic groups. Strategies that incorporate ethnic diversity within messaging are likely to be more effective than 'one-sizefits-all' approaches (Kobetz et al, 2010). Based on our findings, messages targeting African Americans may need to focus on vaccine safety, whereas messages targeting Haitians should focus on the role of parents' in their daughters' vaccination against HPV, and the appropriate time to vaccinate their daughters.…”

“…Because most existing research in this area has been conducted without differentiating ethnic groups that belong to the same race (Constantine & Jerman, 2007;Dinh et al, 2007;Noel et al, 2007), addressing barriers specific to subgroups of populations who self-identify as "Black" may help to achieve high penetrance of HPV vaccination in minority adolescents (Kobetz et al, 2010).…”

“…Our study and others indicate that Haitian women are less informed about HPV than African-American womendin fact, many Haitians do not understand the role of HPV in the development of cervical cancer. Most, however, report that a physician recommendation would be a reason for them to vaccinate their daughters against HPV (Kobetz et al, 2010;Kobetz et al, 2011). Failing to acknowledge ethnic, cultural, and socioeconomic differences within a racially homogenous group can prevent a full understanding of a health disparity.…”

Human Papillomavirus Awareness in Haiti: Preparing for a National HPV Vaccination Program

“…9 Much of the research has been conducted with Haitian immigrants in the U.S. Studies have shown that Haitian immigrants have varying levels of HPV and HPV vaccine awareness. 10–12 HPV awareness is a necessary antecedent of behavior change, 13–15 according to several leading stage theories of health behavior. 16–18 Given the dearth of information on HPV awareness in Haiti, we sought to examine levels of HPV awareness and predictors of HPV awareness among healthcare-seeking adults in Port-au-Prince and Léogâne, Haiti.…”

Cultural Values Influencing Immigrant Haitian Mothers’ Attitudes Toward Human Papillomavirus Vaccination for Daughters

“…However, as cultures are never static, it is important to continuously examine how sociohistorical and contextual experiences shape various health outcomes (Castro & Farmer, 2005; Stephens et al, 2012). For example, Haitian communities in the United States have been described as transnational because their cultural beliefs are negotiated via an American and Haitian lens of health (Kobetz et al, 2010). For this reason, it is important to consider how recently immigrated Haitian mothers negotiate various health afflictions and concerns through their own cultural values and current experiences within American contexts.…”