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

  • Monideepa B. BecerraEmail author
  • Robert M. Avina
  • Salome Mshigeni
  • Benjamin J. Becerra



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.


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.


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.


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


HPV Asian Americans Immigrants Social determinants Health literacy 


Compliance with Ethical Standards

This study followed all guidelines for public access data.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Board Approval

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


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Copyright information

© W. Montague Cobb-NMA Health Institute 2020

Authors and Affiliations

  • Monideepa B. Becerra
    • 1
    Email author
  • Robert M. Avina
    • 1
  • Salome Mshigeni
    • 1
  • Benjamin J. Becerra
    • 2
  1. 1.Department of Health Science and Human Ecology, Center for Health EquityCalifornia State UniversitySan BernardinoUSA
  2. 2.School of Allied Health ProfessionsLoma Linda UniversityLoma LindaUSA

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