University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
J Adolesc Health. 2013 Dec;53(6):756-62. doi: 10.1016/j.jadohealth.2013.07.002. Epub 2013 Aug 27.
To examine the association between race/ethnicity and human papillomavirus (HPV) vaccine initiation and to determine how access to health care influences this relationship.
We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15-24 years. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for sociodemographic variables and health care access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed among females aged 15-18 and 19-24 years.
There were significant racial/ethnic disparities in HPV vaccination; United States (US)-born Hispanics, foreign-born Hispanics, and African-Americans were less likely to have initiated vaccination than were whites (p < .001). Adjusting for sociodemographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio [AOR], .76; 95% confidence interval [CI], .50-1.16; and AOR, .67; 95% CI, .37-1.19) but not for African-Americans (AOR, .47, 95% CI, .33-.66). Adding health care access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR, .85, 95% CI, .54-1.34; and AOR, .84, 95% CI, .45-1.55). However, African-Americans remained less likely than whites to have initiated vaccination (AOR, .49, 95% CI, .36-.68). These racial/ethnic trends were similar for females aged 15-18 and 19-24 years.
Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to health care. More research is necessary to elucidate factors contributing to HPV vaccination in this population.
探讨种族/民族与人类乳头瘤病毒（HPV）疫苗接种启动之间的关联，并确定医疗保健可及性如何影响这种关系。
我们使用全国代表性数据，即国家家庭增长调查，评估了 2168 名 15-24 岁女性 HPV 疫苗接种启动情况。进行了一系列回归分析，以确定在控制社会人口统计学变量和医疗保健可及性措施后，种族/民族对 HPV 疫苗接种启动的独立影响。还进行了年龄分层回归分析，以评估种族/民族与 HPV 疫苗接种启动之间的关系在 15-18 岁和 19-24 岁女性中是否存在差异。
HPV 疫苗接种存在显著的种族/民族差异；与白人相比，美国出生的西班牙裔、外国出生的西班牙裔和非裔美国人接种疫苗的可能性较低（p<0.001）。调整社会人口统计学特征后，美国出生和外国出生的西班牙裔之间的差异减弱（调整后的优势比 [AOR]，0.76；95%置信区间 [CI]，0.50-1.16；和 AOR，0.67；95%CI，0.37-1.19），但非裔美国人之间的差异并未减弱（AOR，0.47，95%CI，0.33-0.66）。进一步增加医疗保健可及性措施后，美国出生和外国出生的西班牙裔之间的差异进一步减弱（AOR，0.85，95%CI，0.54-1.34；和 AOR，0.84，95%CI，0.45-1.55）。然而，非裔美国人接种疫苗的可能性仍低于白人（AOR，0.49，95%CI，0.36-0.68）。这些种族/民族趋势在 15-18 岁和 19-24 岁的女性中相似。
非裔美国女性 HPV 疫苗接种率较低，这似乎并非是由于医疗保健可及性的差异所致。需要进一步研究阐明导致该人群 HPV 疫苗接种的因素。
