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Cancer Causes & Control

, Volume 27, Issue 10, pp 1187–1196 | Cite as

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

  • Madina AgénorEmail author
  • Sarah M. Peitzmeier
  • Allegra R. Gordon
  • Brittany M. Charlton
  • Sebastien Haneuse
  • Jennifer Potter
  • S. Bryn Austin
Original paper

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.

Keywords

Human papillomavirus vaccination Health disparities Sexual orientation Gender Young adults 

Notes

Acknowledgments

AR Gordon is supported by National Institutes of Health R01HD066963. BM Charlton is supported by National Institutes of Health F32HD084000, Society of Family Planning SHPRF9-18, and the Lesbian Health Fund. S Haneuse is supported by the National Cancer Institute. SB Austin is supported by National Institutes of Health R01HD057368, National Institutes of Health R01HD066963, and Maternal and Child Health Bureau T71MC00009 and T76MC00001. The authors thank National Health Interview Survey participants and staff for the data used in these analyses.

References

  1. 1.
    Dunne EF, Markowitz LE, Saraiya M et al (2014) CDC grand rounds: reducing the burden of HPV-associated cancer and disease. MMWR 63:69–72PubMedGoogle Scholar
  2. 2.
    Satterwhite CL, Torrone E, Meites E et al (2013) Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis 40:187–193CrossRefPubMedGoogle Scholar
  3. 3.
    Hariri S, Unger ER, Sternberg M et al (2011) Prevalence of genital human papillomavirus among females in the United States, the National Health and Nutrition Examination Survey, 2003–2006. J Infect Dis 204:566–573CrossRefPubMedGoogle Scholar
  4. 4.
    Markowitz L, Hariri S, Lin C et al (2013) Reduction in human papillomavirus (HPV) prevalence among young women following HPV vaccine introduction in the United States, National Health and Nutrition Examination Survey, 2003–2010. J Infect Dis 208:385–393CrossRefPubMedGoogle Scholar
  5. 5.
    Jemal A, Simard EP, Dorell C et al (2013) Annual report to the nation on the status of cancer, 1975–2009, featuring the burden and trends in human papillomavirus (HPV)-associated cancers and HPV vaccination coverage levels. J Natl Cancer Inst 105:175–201CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Markowitz L, Dunne EF, Saraiya M et al (2014) Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 63:1–30PubMedGoogle Scholar
  7. 7.
    Williams WW, Lu PJ, O’Halloran A et al (2016) Surveillance of vaccination coverage among adult populations—United States, 2014. MMWR 65:1–19CrossRefPubMedGoogle Scholar
  8. 8.
    Centers for Disease Control and Prevention (2015) Immunization and infectious diseases. Healthy People 2020. U.S. Department of Health and Human Services. www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases/objectives. Accessed 16 Dec 2015
  9. 9.
    Centers for Disease Control and Prevention (2015) National and state vaccination coverage among adolescents aged 13–17 years—United States, 2014. MMWR 64:784–792Google Scholar
  10. 10.
    Gorgos LM, Marrazzo JM (2011) Sexually transmitted infections among women who have sex with women. Clin Infect Dis 53:S84–S91CrossRefPubMedGoogle Scholar
  11. 11.
    Marrazzo JM, Gorgos LM (2012) Emerging sexual health issues among women who have sex with women. Curr Infect Dis Rep 14:204–211CrossRefGoogle Scholar
  12. 12.
    McNair R (2005) Risks and prevention of sexually transmissible infections among women who have sex with women. Sex Health 2:209–217CrossRefPubMedGoogle Scholar
  13. 13.
    Lindley LL, Walsemann KM, Carter JV (2013) Invisible and at risk: STDs among young adult sexual minority women in the United States. Perspect Sexual Reprod Health 45:66–73CrossRefGoogle Scholar
  14. 14.
    Everett BG (2013) Sexual orientation disparities in sexually transmitted infections: examining the intersection between sexual identity and sexual behavior. Arch Sex Behav 42:225–236CrossRefPubMedGoogle Scholar
  15. 15.
    Llata E, Stenger M, Bernstein K et al (2014) Prevalence of genital warts among sexually transmitted disease clinic patients—sexually transmitted disease surveillance network, United States, January 2010 to December 2011. Sex Transm Dis 41:89–93CrossRefPubMedGoogle Scholar
  16. 16.
    Machalek DA, Poynten M, Jin F et al (2012) Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: a systematic review and meta-analysis. Lancet Oncol 13:487–500CrossRefPubMedGoogle Scholar
  17. 17.
    Rosario M, Corliss HL, Everett BG et al (2014) Sexual orientation disparities in cancer-related risk behaviors of tobacco, alcohol, sexual behaviors, and diet and physical activity: pooled Youth Risk Behavior Surveys. Am J Public Health 104:245–254CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Boehmer U, Miao X, Linkletter C et al (2012) Adult health behaviors over the life course by sexual orientation. Am J Public Health 102:292–300CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Cochran SD, Mays VM, Bowen D et al (2001) Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women. Am J Public Health 91:591–597CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Coker AL, Hopenhayn C, DeSimone CP et al (2009) Violence against women raises risk of cervical cancer. J Womens Health 18:1179–1185CrossRefGoogle Scholar
  21. 21.
    McCauley HL, Silverman JG, Decker MR et al (2015) Sexual and reproductive health indicators and intimate partner violence victimization among female family planning clinic patients who have sex with women and men. J Womens Health 24:621–628CrossRefGoogle Scholar
  22. 22.
    Agénor M, Krieger N, Austin SB, Hanuese S, Gottlieb BR (2014) Sexual orientation disparities in Papanicolaou test use among US women: the role of sexual and reproductive health services. Am J Public Health 104:e68–e73CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Agénor M, Krieger N, Austin SB, Haneuse S, Gottlieb BR (2014) At the intersection of sexual orientation, race/ethnicity, and cervical cancer screening: assessing Pap test use disparities by sex of sexual partners among black, Latina, and white U.S. women. Soc Sci Med 116:110–118CrossRefPubMedGoogle Scholar
  24. 24.
    Charlton BM, Corliss HL, Missmer SA et al (2011) Reproductive health screening disparities and sexual orientation in a cohort study of U.S. adolescent and young adult females. J Adolesc Health 49:505–510CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Marrazzo JM, Koutsky LA, Kiviat NB et al (2001) Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women. Am J Public Health 91:947–952CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Tracy JK, Lydecker AD, Ireland L (2010) Barriers to cervical cancer screening among lesbians. J Women’s Health 19:229–237CrossRefGoogle Scholar
  27. 27.
    Daling JR, Madeleine MM, Johnson LG et al (2004) Human papillomavirus, smoking, and sexual practices in the etiology of anal cancer. Cancer 101:270–280CrossRefPubMedGoogle Scholar
  28. 28.
    Dunne EF, Nielson CM, Stone KM et al (2006) Prevalence of HPV infection among men: a systematic review of the literature. J Infect Dis 194:1044–1057CrossRefPubMedGoogle Scholar
  29. 29.
    Goldstone S, Palefsky JM, Giuliano AR et al (2011) Prevalence of and risk factors for human papillomavirus (HPV) infection among HIV-seronegative men who have sex with men. J Infect Dis 203:66–74CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Reiter PL, McRee AL, Katz ML, Paskett ED (2015) Human papillomavirus vaccination among young adult gay and bisexual men in the United States. Am J Public Health 105:96–102CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Meites E, Markowitz LE, Paz-Bailey G, Oster AM (2014) HPV vaccine coverage among men who have sex with men—national HIV Behavioral Surveillance System, United States, 2011. Vaccine 32:6356–6359CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    McRee A, Katz ML, Paskett ED, Reiter PL (2014) HPV vaccination among lesbian and bisexual women: findings from a national survey of young adults. Vaccine 32:4736–4742CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Agénor M, Peitzmeier S, Gordon AR, Potter J, Haneuse S, Austin SB (2015) Sexual orientation identity disparities in awareness and initiation of the human papillomavirus vaccine among U.S. women and girls: a national survey. Ann Intern Med 163:99–106CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Agénor M, McCauley HL, Peitzmeier SM, Haneuse S, Gordon AR, Potter J, Austin SB (2016) Sex of sexual partners and human papillomavirus vaccination among U.S. girls and women. Am J Prev Med 50:318–327CrossRefPubMedGoogle Scholar
  35. 35.
    Sell RL (2007) Defining and measuring sexual orientation for research. In: Meyer IH, Northridge ME (eds) The health of sexual minorities: public health perspectives on lesbian, gay, bisexual, and transgender populations. Springer, New York, pp 355–374CrossRefGoogle Scholar
  36. 36.
    Parsons VL, Moriarity C, Jonas K, Moore TF, Davis KE, Tompkins L (2014) Design and estimation for the National Health Interview Survey, 2006–2015. Vital Health Stat Ser 2 Data Eval Methods Res 165:1–53Google Scholar
  37. 37.
    National Center for Health Statistics (2014) 2013 National Health Interview Survey (NHIS) public use data release survey description. Centers for Disease Control and Prevention. ftp://ftp.cdc.gov/pub/Health_statistics/NCHS/Dataset_Documentation/NHIS/2013/srvydesc.pdf. Accessed 1 Feb 2016
  38. 38.
    National Center for Health Statistics (2015) 2014 National Health Interview Survey (NHIS) public use data release survey description. Centers for Disease Control and Prevention. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/Dataset_Documentation/NHIS/2014/srvydesc.pdf. Accessed 1 Feb 2016
  39. 39.
    Centers for Disease Control and Prevention (2010) FDA licensure of quadrivalent human papillomavirus vaccine (HPV4, Gardasil) for use in males and guidance from the Advisory Committee on Immunization Practices (ACIP). MMWR 59:630–632Google Scholar
  40. 40.
    Markowitz LE, Dunne EF, Saraiya M, Lawson HW, Harrell Chesson H, Unger ER (2007) Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 56:1–24PubMedGoogle Scholar
  41. 41.
    Petrosky E, Bocchini JA Jr, Hariri S, Chesson H, Curtis CR, Saraiya M, Unger ER, Markowitz LE (2015) Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the Advisory Committee on Immunization Practices. MMWR 64:300–304PubMedGoogle Scholar
  42. 42.
    Krieger N (2001) A glossary for social epidemiology. J Epidemiol Commun Health 55:693–700CrossRefGoogle Scholar
  43. 43.
    Krieger N (2001) Theories for social epidemiology in the 21st century: an ecosocial perspective. Int J Epidemiol 30:668–677CrossRefPubMedGoogle Scholar
  44. 44.
    Krieger N (2011) Epidemiology and the people’s health: theory and context. Oxford University Press, New YorkCrossRefGoogle Scholar
  45. 45.
    Tornello SL, Riskind RG, Patterson CJ (2014) Sexual orientation and sexual and reproductive health among adolescent young women in the United States. J Adolesc Health 54:160–168CrossRefPubMedGoogle Scholar
  46. 46.
    Klesse C (2005) Bisexual women, non-monogamy and differentialist anti-promiscuity discourses. Sexualities 8:445–464CrossRefGoogle Scholar
  47. 47.
    Kerr DL, Ding K (2013) Thompson AJ (2013) A comparison of lesbian, bisexual, and heterosexual female college undergraduate students on selected reproductive health screenings and sexual behaviors. Women’s Health Issues 23:e347–e355CrossRefPubMedGoogle Scholar
  48. 48.
    Charlton BM, Corliss HL, Missmer SA, Frazier AL, Rosario M, Kahn JA et al (2011) Reproductive health screening disparities and sexual orientation in a cohort study of U.S. adolescent and young adult females. J Adolesc Health 29:505–510CrossRefGoogle Scholar
  49. 49.
    Koh HK, Sebelius KG (2010) Promoting prevention through the Affordable Care Act. N Engl J Med 363:1296–1299CrossRefPubMedGoogle Scholar
  50. 50.
    Department of Health and Human Services. Preventive services covered under the Affordable Care Act. http://www.hhs.gov/healthcare/facts/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforChildren. Accessed 17 March 2014
  51. 51.
    Durso LE, Baker K, Cray A (2013) LGBT communities and the Affordable Care Act: findings from a national survey. Center for American Progress. https://cdn.americanprogress.org/wp-content/uploads/2013/10/LGBT-ACAsurvey-brief1.pdf. Accessed 1 Feb 2016
  52. 52.
    National Conference of State Legislatures (2014) Affordable Care Act Medicaid expansion. http://www.ncsl.org/research/health/affordable-care-act-expansion.aspx. Accessed 22 Sept 2014
  53. 53.
    Sonfield A, Frost JJ, Gold RB (2011) Estimating the impact of expanding Medicaid eligibility for family planning services: 2011 update. Guttmacher Institute. https://www.guttmacher.org/pubs/Medicaid-Family-Planning-2011.pdf. Accessed 1 Feb 2016
  54. 54.
    Department of Health and Human Services (2012) The Affordable Care Act and Immunization. http://www.hhs.gov/healthcare/facts-and-features/fact-sheets/aca-and-immunization/index.html. Accessed 2 Feb 2016
  55. 55.
    Ponce NA, Cochran SD, Pizer JC, Mays VM (2010) The effects of unequal access to health insurance for same-sex couples in California. Health Aff 29:1539–1548CrossRefGoogle Scholar
  56. 56.
    Buchmueller T, Carpenter CS (2010) Disparities in health insurance coverage, access, and outcomes for individuals in same-sex versus different-sex relationships, 2000–2007. Am J Public Health 100:489–495CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Gonzales G, Blewett LA (2014) National and state-specific health insurance disparities for adults in same-sex relationships. Am J Public Health 104:e95–e104CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Ward BW, Dahlhamer JM, Galinsky AM, Joestl SS (2013) Sexual orientation and health among U.S. adults: National Health Interview Survey, 2013. Natl Health Stat Rep 77:1–10Google Scholar
  59. 59.
    Conron KJ, Mimiaga MJ, Landers SJ (2010) A population-based study of sexual orientation identity and gender differences in adult health. Am J Public Health 100:1953–1960CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    Courtenay WH (2000) Constructions of masculinity and their influence on men’s well-being: a theory of gender and health. Soc Sci Med 50:1385–1401CrossRefPubMedGoogle Scholar
  61. 61.
    Markowitz L, Dunne EF, Saraiya M, Lawson HW, Chesson H, Unger ER (2007) Quadrivalent human papillomavirus vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 56:1–24PubMedGoogle Scholar
  62. 62.
    National Cancer Institute (2015) HPV and cancer. About cancer: causes and prevention. http://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet. Accessed 18 Aug 2015
  63. 63.
    Centers for Disease Control and Prevention (2006) Evolution of HIV/AIDS prevention programs—United States, 1981–2006. MMWR 55:597–603Google Scholar
  64. 64.
    Centers for Disease Control and Prevention (2015) CDC programs at-a-glance. Gay and bisexual men’s health. http://www.cdc.gov/msmhealth/msm-programs.htm. Accessed 2 Feb 2016

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Madina Agénor
    • 1
    Email author return OK on get
  • Sarah M. Peitzmeier
    • 2
  • Allegra R. Gordon
    • 3
    • 4
  • Brittany M. Charlton
    • 3
    • 4
  • Sebastien Haneuse
    • 5
  • Jennifer Potter
    • 6
    • 7
    • 8
  • S. Bryn Austin
    • 1
    • 3
    • 4
  1. 1.Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonUSA
  2. 2.Department of Population, Family and Reproductive HealthJohns Hopkins School of Public HealthBaltimoreUSA
  3. 3.Division of Adolescent and Young Adult MedicineBoston Children’s HospitalBostonUSA
  4. 4.Department of PediatricsHarvard Medical SchoolBostonUSA
  5. 5.Department of BiostatisticsHarvard T.H. Chan School of Public HealthBostonUSA
  6. 6.Department of MedicineHarvard Medical SchoolBostonUSA
  7. 7.Division of General Medicine and Primary CareBeth Israel Deaconess Medical CenterBostonUSA
  8. 8.The Fenway InstituteFenway HealthBostonUSA

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