Sexual orientation identity disparities in human papillomavirus vaccination initiation and completion among young adult US women and men

Abstract

Purpose To examine the association between sexual orientation identity and human papillomavirus (HPV) vaccination initiation and completion among both women and men. Methods Using data from the 2013 and 2014 National Health Interview Survey, we estimated logistic regression models for the association between sexual orientation identity and HPV vaccination initiation (≥1 dose) and completion (≥3 doses) among US women and men in relation to sociodemographic and healthcare factors. Analyses were restricted to individuals for whom the HPV vaccine was recommended at some point in their lives, namely women aged 18–34 years (n = 9,734) and men aged 18–31 years (n = 6,812). Results Among all women, bisexual women had higher adjusted odds of HPV vaccination initiation [(odds ratio) 1.71; (95 % confidence interval) 1.20–2.45] and completion (1.59; 1.05–2.42) than heterosexual women. No difference was observed in the odds of HPV vaccination initiation or completion between lesbian and heterosexual women. Among women who had initiated HPV vaccination, lesbians had lower adjusted odds of completion than heterosexual women (0.41; 0.19–0.90). Among all men, gay men had higher adjusted odds of initiating (2.07; 1.17–3.52) and completing (3.90; 1.68–9.06) HPV vaccination than heterosexual men. No difference was observed in the odds of HPV vaccination initiation or completion between bisexual and heterosexual men. Among men who had initiated HPV vaccination, gay (4.36; 1.28–14.83) and bisexual (20.92; 2.34–186.73) men had higher adjusted odds of completion than heterosexual men, although these results are unreliable and should be interpreted with caution. Conclusions Interventions are needed to promote HPV vaccination among all US women and men, regardless of sexual orientation identity.

Comparing Receipt of Cervical Cancer Screening and Completion of Human Papillomavirus Vaccination Using a New Construct of Sexual Orientation: A Serial Cross-Sectional Study

“…The two prior studies that have investigated this outcome have yielded mixed results, with one finding no statistically significant difference in completion of the vaccine series by sexual orientation identity, 26 and the other finding a higher odds of vaccine series completion among bisexual-identified women, but a lower odds of series completion among lesbian-identified women, compared with heterosexual women. 27 Our study, which differs in methodology as it examined vaccine completion by reported sexual partners, adds to these mixed findings.…”

Sexual Orientation Disparities in Human Papillomavirus Vaccination in a Longitudinal Cohort of U.S. Males and Females

“…47 Another recent study using nationally representative National Health Interview Survey data documented that heterosexual men were about half as likely to initiate and complete HPV vaccination compared to gay men. 31 Finally, ACIP recommends that men who have sex with men get catch-up vaccination for five additional years compared to all other males, giving them more uptake opportunities. 7 Two previous studies documenting sexual orientation disparities in HPV vaccination among girls and women used cross-sectional data from the National Survey of Family Growth (NSFG).…”

“…Data include a simultaneous examination of different dimensions of sexual orientation among both females and males, which is novel in the sexual orientation literature, as are data on both HPV vaccination initiation and completion. 31 We hypothesized that, compared to their sexual minority peers, heterosexual females would be more likely and heterosexual males less likely to receive HPV vaccination.…”

Sociodemographic Characteristics and Health Outcomes Among Lesbian, Gay, and Bisexual U.S. Adults UsingHealthy People 2020Leading Health Indicators

“…8 This inclusion has enabled researchers to begin analysis of sexual minority (i.e., not heterosexual) demographics, deleterious health behaviors, and preventive health measures. [9][10][11][12] Founded in 1979, Healthy People is a federal, sciencebased, national, health promotion and disease prevention initiative that aims to improve American health. 13 The 2020 version (released in 2010) included ''LGBT Health'' as a topic area for the first time.…”