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Low Human Papillomavirus Literacy Among Asian-American Women in California: an Analysis of the California Health Interview Survey

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Abstract

Background

Asian-Americans are one of the fastest growing minority groups in the USA, and the literature notes high rates of human papillomavirus (HPV). In this study, we aimed to address whether key social determinants of health, especially health literacy, in combination with English language proficiency, and immigration status, were key factors in HPV knowledge and awareness among Asian-Americans.

Methods

The data was collected from the California Health Interview Survey (CHIS). The study population consisted of Asian adult females from 18 to 65 years of age, with a sample size of 2050 representing a population of 1,552,710. Survey-weighted descriptive, bivariate, and multivariable Poisson regression were conducted with alpha less than .05 to denote significance.

Results

Nearly 45% of the population reported that they never heard of HPV, while 14% reported thinking HPV can cause AIDS, and 13% reported that HPV can go away on its own. HPV knowledge, however, was varied by Asian-American ethnicity as well as being foreign-born. Survey-weighted multivariable robust Poisson regression results show that, when compared with Japanese subgroup, Chinese, South Asians, and Koreans were less likely to have heard of HPV. Having heard of HPV was 31% lower among Asian-Americans who were foreign-born, as compared with those who were US-born. Foreign-born Asian-Americans were 196% more likely to think HPV causes AIDS. Ever having heard of HPV was also associated with low English language proficiency (70% lower), low health literacy (45% lower), and a combination of both (55%). While, those with low English language proficiency understood HPV is a sexually transmitted infection, a substantially high number associated it with AIDS.

Conclusion

Interventions towards increasing health literacy among Asian Americans are imperative in order increase HPV vaccination rates to reduce cervical cancer rates/deaths.

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Correspondence to Monideepa B. Becerra.

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The study was approved by Institutional Review Board as exempt as there are no human subject participants in secondary analysis.

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Summary

Nearly half of Asian-Americans never heard of HPV, with 14% thinking that HPV can cause AIDS. Around 13% also thought HPV goes away by itself. HPV knowledge was even lower among Asian-Americans who were not born in the USA or had low English language proficiency. These differences in HPV health literacy should be considered when working with the Asian-American population.

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Becerra, M.B., Avina, R.M., Mshigeni, S. et al. Low Human Papillomavirus Literacy Among Asian-American Women in California: an Analysis of the California Health Interview Survey. J. Racial and Ethnic Health Disparities 7, 678–686 (2020). https://doi.org/10.1007/s40615-020-00698-7

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