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Examining the Influence of Religious and Spiritual Beliefs on HPV Vaccine Uptake Among College Women

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The human papillomavirus (HPV) vaccine is an effective mechanism to prevent HPV-associated cancers; however, uptake is low among women aged 18–26. Religiosity/spirituality is associated with sexual health decision-making. This study examined the role of religious/spiritual beliefs on HPV vaccination among college women (N = 307) using logistic regression and mediation analyses. Findings indicate that sexual activity is the main factor associated with HPV vaccination; and sexual activity fully mediates the relationship between religious/spiritual beliefs and HPV vaccination. Health promotion efforts should highlight the importance of HPV vaccination regardless of current sexual activity and may benefit from partnerships with religious/spiritual organizations.

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  • Barnack, J. L., Reddy, D. M., & Swain, C. (2010). Predictors of parents’ willingness to vaccinate for human papillomavirus and physicians’ intentions to recommend the vaccine. Women’s Health Issues,20(1), 28–34.

    Article  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.

    Article  CAS  Google Scholar 

  • Bernat, D. H., Gerend, M. A., Chevallier, K., Zimmerman, M. A., & Bauermeister, J. A. (2013). Characteristics associated with initiation of the human papillomavirus vaccine among a national sample of male and female young adults. Journal of Adolescent Health,53(5), 630–636.

    Article  Google Scholar 

  • Best, A. L., Spencer, S. M., Friedman, D., Hall, I. J., & Billings, D. (2016). The influence of spiritual framing on African American women’s mammography intentions: A randomized trial. Journal of Health Communication.

    Article  PubMed  PubMed Central  Google Scholar 

  • Best, A. L., Spencer, S. M., Hall, I. J., Friedman, D. B., & Billings, D. (2015). Developing spiritually framed breast cancer screening messages in consultation with African American women. Health Communication,30(3), 290–300.

    Article  Google Scholar 

  • Bodson, J., Wilson, A., Warner, E. L., & Kepka, D. (2017). Religion and HPV vaccine-related awareness, knowledge, and receipt among insured women aged 18–26 in Utah. PLoS ONE,12(8), e0183725.

    Article  Google Scholar 

  • Brimeyer, T. M., & Smith, W. L. (2012). Religion, race, social class, and gender differences in dating and hooking up among college students. Sociological Spectrum,32(5), 462–473.

    Article  Google Scholar 

  • Burchell, A. N., Winer, R. L., de Sanjosé, S., & Franco, E. L. (2006). Epidemiology and transmission dynamics of genital HPV infection. Vaccine,24, S52–S61.

    Article  Google Scholar 

  • Burris, J. L., Smith, G. T., & Carlson, C. R. (2009). Relations among religiousness, spirituality, and sexual practices. Journal of Sex Research,46(4), 282–289.

    Article  Google Scholar 

  • Centers for Disease Control and Prevention. (2017). STD facts—Human papillomavirus (HPV). Retrieved from

  • Constantine, N. A., & Jerman, P. (2007). Acceptance of human papillomavirus vaccination among Californian parents of daughters: A representative statewide analysis. Journal of Adolescent Health,40(2), 108–115.

    Article  Google Scholar 

  • Egbert, N., Mickley, J., & Coeling, H. (2004). A review and application of social scientific measures of religiosity and spirituality: Assessing a missing component in health communication research. Health Communication,16(1), 7–27.

    Article  Google Scholar 

  • Ferrer, H. B., Trotter, C., Hickman, M., & Audrey, S. (2014). Barriers and facilitators to HPV vaccination of young women in high-income countries: A qualitative systematic review and evidence synthesis. BMC Public Health,14(1), 700.

    Article  Google Scholar 

  • George Dalmida, S., Aduloju-Ajijola, N., Clayton-Jones, D., Thomas, T. L., Erazo Toscano, R. J., Lewis, R., et al. (2018). Sexual risk behaviors of African American adolescent females: The role of cognitive and religious factors. Journal of Transcultural Nursing,29(1), 74–83.

    Article  Google Scholar 

  • Harris, S. K., Aalsma, M. C., Weitzman, E. R., Garcia-Huidobro, D., Wong, C., Hadland, S. E., et al. (2017). Research on clinical preventive services for adolescents and young adults: Where are we and where do we need to go? Journal of Adolescent Health,60(3), 249–260.

    Article  Google Scholar 

  • Lefkowitz, E. S., Gillen, M. M., Shearer, C. L., & Boone, T. L. (2004). Religiosity, sexual behaviors, and sexual attitudes during emerging adulthood. Journal of Sex Research,41(2), 150–159.

    Article  Google Scholar 

  • Luquis, R. R., Brelsford, G. M., & Rojas-Guyler, L. (2012). Religiosity, spirituality, sexual attitudes, and sexual behaviors among college students. Journal of Religion and Health,51(3), 601–614.

    Article  Google Scholar 

  • Markowitz, L. E., Liu, G., Hariri, S., Steinau, M., Dunne, E. F., & Unger, E. R. (2016). Prevalence of HPV after introduction of the vaccination program in the United States. Pediatrics,137, e20151968.

    Article  Google Scholar 

  • Martinez, G., Chandra, A., Febo-Vazquez, I., & Mosher, W. (2013). Use of family planning and related medical services among women aged 1544 in the United States: National Survey of Family Growth, 20062010 (no. 2013). US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.

  • Miller, M. A. (1995). Culture, spirituality, and women’s health. Journal of Obstetric, Gynecologic, and Neonatal Nursing,24, 257–264.

    Article  CAS  Google Scholar 

  • Moyer, V. A. (2012). Screening for cervical cancer: US preventive services task force recommendation statement. Annals of Internal Medicine,156(12), 880–891.

    Article  Google Scholar 

  • Nicholson, W. (2016). Reproductive life planning to reduce unintended pregnancy. Obstetrics and Gynecology,127(2), E66–E69.

    Article  Google Scholar 

  • Pew Research Center. (2015a). America’s changing religious landscape. Retrieved from

  • Pew Research Center. (2015b). US public becoming less religious. Retrieved from

  • Rambout, L., Tashkandi, M., Hopkins, L., & Tricco, A. C. (2014). Self-reported barriers and facilitators to preventive human papillomavirus vaccination among adolescent girls and young women: A systematic review. Preventive Medicine,58, 22–32.

    Article  Google Scholar 

  • Shelton, R. C., Snavely, A. C., De Jesus, M., Othus, M. D., & Allen, J. D. (2013). HPV vaccine decision-making and acceptance: Does religion play a role? Journal of Religion and Health,52(4), 1120–1130.

    Article  Google Scholar 

  • Thompson, E. L., Best, A. L., Vamos, C. A., & Daley, E. M. (2017). “My mom said it wasn’t important”: A case for catch-up human papillomavirus vaccination among young adult women in the United States. Preventive Medicine,105, 1–4.

    Article  Google Scholar 

  • Walker, T. Y., Elam-Evans, L. D., Singleton, J. A., Yankey, D., Markowitz, L. E., Fredua, B., et al. (2017). National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2016. MMWR: Morbidity and Mortality Weekly Report,66(33), 874.

    PubMed  PubMed Central  Google Scholar 

  • Wigfall, L., Rawls, A., Sebastian, N., Messersmith, A., Pirisi-Creek, L., Spiryda, L., et al. (2012). HPV high risk and protective behaviors: The effects of religious affiliation. Journal of Religion and Health,51(4), 1325–1336.

    Article  Google Scholar 

  • Williams, W. W. (2017). Surveillance of vaccination coverage among adult populations—United States, 2015. MMWR. Surveillance Summaries, 66.

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This study was funded by an Interdisciplinary Research Grant from the USF College of Public Health awarded to Dr. Cheryl Vamos (co-author on the manuscript).

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Correspondence to Alicia L. Best.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Best, A.L., Thompson, E.L., Adamu, A.M. et al. Examining the Influence of Religious and Spiritual Beliefs on HPV Vaccine Uptake Among College Women. J Relig Health 58, 2196–2207 (2019).

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