Sexual orientation identity disparities in human papillomavirus vaccination initiation and completion among young adult US women and men
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To examine the association between sexual orientation identity and human papillomavirus (HPV) vaccination initiation and completion among both women and men.
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).
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.
Interventions are needed to promote HPV vaccination among all US women and men, regardless of sexual orientation identity.
KeywordsHuman papillomavirus vaccination Health disparities Sexual orientation Gender Young adults
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.
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