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.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
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.
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.
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.
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. https://doi.org/10.1080/10810730.2015.1114055.
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.
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.
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.
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.
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.
Centers for Disease Control and Prevention. (2017). STD facts—Human papillomavirus (HPV). Retrieved from https://www.cdc.gov/std/hpv/stdfact-hpv.htm.
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.
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.
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.
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.
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.
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.
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.
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.
Martinez, G., Chandra, A., Febo-Vazquez, I., & Mosher, W. (2013). Use of family planning and related medical services among women aged 15–44 in the United States: National Survey of Family Growth, 2006–2010 (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.
Moyer, V. A. (2012). Screening for cervical cancer: US preventive services task force recommendation statement. Annals of Internal Medicine,156(12), 880–891.
Nicholson, W. (2016). Reproductive life planning to reduce unintended pregnancy. Obstetrics and Gynecology,127(2), E66–E69.
Pew Research Center. (2015a). America’s changing religious landscape. Retrieved from http://www.pewforum.org/2015/05/12/americas-changing-religious-landscape/.
Pew Research Center. (2015b). US public becoming less religious. Retrieved from http://www.pewforum.org/2015/11/03/u-s-public-becoming-less-religious/.
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.
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.
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.
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.
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.
Williams, W. W. (2017). Surveillance of vaccination coverage among adult populations—United States, 2015. MMWR. Surveillance Summaries, 66.
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).
Conflict of interest
The authors declare that they have no conflict of interest.
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.
Informed consent was obtained from all individual participants included in the study.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
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). https://doi.org/10.1007/s10943-019-00890-y
- Human papillomavirus (HPV)
- HPV vaccination
- Sexual health
- College students