Sexual Orientation Identity Disparities in Awareness and Initiation of the Human Papillomavirus Vaccine Among U.S. Women and Girls

Abstract

Background Lesbians and bisexual women are at risk of human papillomavirus (HPV) from female and male sexual partners throughout the life course. Objective To examine the association between sexual orientation identity and HPV vaccination among U.S. women. Design We used cross-sectional data 2006–2010 National Survey of Family Growth (NSFG) data. Setting U.S. civilian noninstitutional population. Participants The NSFG used stratified cluster sampling to establish a national probability sample of 12,279 U.S. women aged 15–44 years. Analyses were restricted to the 3,253 women and girls aged 15–25 years who were asked about HPV vaccination. Measurements Multivariable logistic regression was used to obtain HPV vaccine awareness and initiation prevalence estimates adjusted for socio-demographic and health care factors for each sexual orientation identity group. Results Eighty-four percent of U.S. women and girls aged 15–25 years reported having ever heard of the HPV vaccine; of these, 28.5% had initiated HPV vaccination. The adjusted prevalence of HPV vaccine awareness was similar among heterosexual, bisexual, and lesbian respondents. Among those who had heard of the vaccine, 8.5% (p = 0.007) of lesbians and 33.2% (p = 0.33) of bisexual women and girls had initiated HPV vaccination compared to 28.4% of their heterosexual counterparts, adjusting for covariates. Limitations Self-report, cross-sectional data. Findings may not be generalizable to time periods after 2006–2010 or all U.S. lesbians aged 15–25 years (small sample size for this group). Conclusions Adolescent and young adult lesbians may be less likely to initiate HPV vaccination compared to their heterosexual counterparts. Programs should facilitate access to and utilization of HPV vaccination among young lesbians, a marginalized and underserved population. Primary Funding Source National Cancer Institute Cancer Education Program grant 3R25CA057711.

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

“…The present study’s finding that lesbians were no less likely to initiate HPV vaccination than heterosexual women differs from that of our prior study, which found that lesbians aged 15–25 years were significantly less likely than their heterosexual counterparts to have initiated HPV vaccination [33]. The two studies’ disparate findings may be due to the fact that our prior study used data from the 2006–2010 NSFG, which were collected before the implementation of the Affordable Care Act (ACA).…”

“…In order to address this notable gap in the literature, we recently examined the association between two dimensions of sexual orientation [35], sexual orientation identity and sex of sexual partners, and HPV vaccination initiation among US women and girls using 2006–2010 National Survey of Family Growth (NSFG) data [33, 34]. However, our previous studies did not examine sexual orientation disparities in HPV vaccination completion, which the NSFG did not assess and may be most relevant to the prevention of cervical and other HPV-related cancers.…”

Sexual Orientation Identity Disparities in Awareness and Initiation of the Human Papillomavirus Vaccine

“…Our analyses suggest that lesbian women and girls aged 15–25 years who had heard of the HPV vaccine were significantly less likely to have initiated HPV vaccination compared to their heterosexual counterparts. However, we found no difference in HPV vaccination initiation between bisexual and heterosexual women and girls (1). …”

Sexual orientation and its impact on sexual behaviour of young people aged 15‐29: a cross‐sectional study

“…Accordingly, bisexual and lesbian adolescents in the USA have a high risk of contracting an STI because they tend to practice unprotected sex (Agénor et al . ). On the other hand, in Mexico, women, regardless of their sexual orientation, have the same probability of condom use though condom use is more frequent in bisexual women and less frequent in lesbians (Frómeta & Ponce ).…”