Racial Disparities in HPV-related Knowledge, Attitudes, and Beliefs Among African American and White Women in the USA

Abstract

The objective of this study was to assess the differences in HPV-related knowledge, attitudes, and beliefs among African American and non-Hispanic white women and to determine their communication preferences for cancer-related information. Data was obtained from the National Cancer Institute's (NCI) 2014 Health Interview National Trends Survey (HINTS), a cross-sectional survey of US adults 18 years of age or older. Descriptive statistics, bivariate, and multivariate logistic regression were used to identify differences in awareness and knowledge. Data was collected in 2014 and analyzed in 2016. HPV awareness (71 vs. 77%) and knowledge that HPV causes cervical cancer (64 vs. 81%) were significantly lower among blacks. Additionally, there were significant disparities in awareness of the HPV vaccine (66 vs. 79%), with only 25% of Black women indicating that they or a family member was recommended the HPV vaccine by a health care professional. There were also differences in cancer communication preferences. Blacks were more likely than Whites to trust cancer information from family (OR 2.7, confidence interval [CI] 0.725-10.048), television (OR 3.0, 95% [CI] 0.733-12.296), government health agencies (OR 5.8, [CI] 0.639-52.818), and religious organizations (OR 6.4, 95% [CI] 1.718-23.932). Study results indicate that racial/ethnic differences exist in HPV knowledge/awareness and cancer communication preferences. These results highlight the need to increase HPV prevention and education efforts using methods that are tailored to Black women. To address HPV/cervical cancer disparities, future interventions should utilize preferred communication outlets to effectively increase HPV knowledge and vaccine awareness.

Community members trusted by African American parents for vaccine advice

“…Inclusion of community figures who are not medical authorities may be particularly useful in vaccination campaigns for reaching parents who are more vaccine hesitant given that vaccine hesitant parents and refusers may have lower levels of trust in, and more negative experiences with the medical system. [28][29][30] Our study suggests that like parents of other races, 10,31,32 African American parents trust medical authorities for vaccine advice. Nonetheless, qualitative studies have repeatedly demonstrated that though this may be true, African Americans' attitudes toward vaccination are multi-faceted and often impacted by deep-seated fears of experimentation.…”

“…Finally, similar to other surveys, trust in community figures for vaccine advice was assessed using a single item. 31,40,41 Future studies whose aim is to fine tune the assessment of trust in vaccine advisors may develop and test a scale to possibly assess this construct more precisely.…”

“…The included community figures were selected based on previous studies' findings of people potentially influential in parents' vaccination decisions. 5,6,31,40,42 Parents were shown labelled images of the figures in a stereotypical pose (e.g., school nurse in scrubs examining a child, pastor in church, school principal in a classroom, pediatrician in a white coat examining a child, mother/father hugging a child, disease survivor at a rally, and scientist with a microscope). We first pilot tested the survey with ten parents who met inclusion criteria, and interviewed them for feedback after the survey.…”

Analysis of community-based studies related with knowledge, awareness, attitude, and behaviors towards HPV and HPV vaccine published in Turkey: A systematic review

“…In information and awareness studies on HPV and the HPV vaccine that were conducted in developed countries, it was reported that HPV knowledge and awareness were at low-tomoderate levels, and vaccination rates (26%-55%) were not at desired levels, although the willingness for vaccination was high (17,(28)(29)(30)(31)(32)(33)(34). In studies conducted in developing countries, it was reported that HPV knowledge and awareness and willingness for vaccination were at low-to-moderate levels, and HPV vaccination rates were quite low (13.3%-16.1%) (35)(36)(37)(38)(39)(40)(41).…”

“…Although HPV immunization willingness was high, various barriers made it difficult to raise vaccination rates to the desired level. HPV vaccination barriers in developed countries were listed as doubts about vaccine safety and efficiency, adverse effect concerns, lack or inconsistency of information about HPV and the HPV vaccine, and the price of the HPV vaccine (29,32,34). In developing countries, HPV vaccine barriers were the lack of awareness of the vaccine, doubting the safety and efficiency of the vaccine, finding it embarrassing to buy the vaccine for sexually transmitted infections, and people thinking that they were not at risk for HPV (35,37,41).…”