School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Prev Sci. 2020 Oct;21(7):937-948. doi: 10.1007/s11121-020-01131-5.
Little is known about human papillomavirus (HPV) vaccination uptake among youth experiencing homelessness (YEH), who may be at higher risk for HPV than their housed counterparts. We examined the prevalence and associations of HPV vaccination initiation and completion among YEH. Guided by the Behavioral Model for Vulnerable Populations, we analyzed cross-sectional data collected from YEH (N = 1074; ages 18-26) in seven U.S. cities to assess HPV vaccination prevalence and to identify predisposing, enabling, and need factors associated with HPV vaccination status. Due to timing differences in the release of HPV vaccine recommendations, we conducted separate logistic regression analyses for men (n = 673) and women (n = 401). Approximately 19% of men and 37% of women had initiated and completed HPV vaccination. Several factors among men (i.e., older age, Latinx ethnicity, San Jose or St. Louis residence compared with New York City, never having had sex, and not previously being tested for STIs) and women (i.e., lower education level, San Jose or Houston residence compared with New York City, and never having had sex) were associated with lower odds of HPV vaccination initiation, completion, or both. Gay men had higher odds of initiating and completing the vaccination series than their heterosexual counterparts. Our findings reveal that HPV vaccination uptake is low among YEH and that there are vaccination disparities among subgroups of YEH. HPV vaccination strategies and resources that are easy-to-understand, facilitate point-of-care services, and address societal and system-level vaccination barriers encountered by YEH are needed.
人们对无家可归的青年（YEH）人群中人类乳头瘤病毒（HPV）疫苗接种的了解甚少，与有房者相比，他们可能面临更高的 HPV 感染风险。我们研究了 YEH 人群中 HPV 疫苗接种起始和完成的流行情况及其相关性。我们以易受伤害人群行为模型为指导，分析了来自美国七个城市的 YEH（N=1074；年龄 18-26 岁）的横断面数据，以评估 HPV 疫苗接种的流行情况，并确定与 HPV 疫苗接种状况相关的倾向、促成和需求因素。由于 HPV 疫苗推荐发布的时间不同，我们对男性（n=673）和女性（n=401）分别进行了逻辑回归分析。大约 19%的男性和 37%的女性已经开始并完成了 HPV 疫苗接种。男性（例如，年龄较大、拉丁裔、与纽约市相比，圣何塞或圣路易斯的居住者、从未发生过性行为、之前未进行性传播感染检测）和女性（例如，教育程度较低、与纽约市相比，圣何塞或休斯顿的居住者、从未发生过性行为）中的一些因素与 HPV 疫苗接种起始、完成或两者都较低的几率相关。男同性恋者比女同性恋者开始和完成疫苗接种系列的几率更高。我们的研究结果表明，YEH 人群中的 HPV 疫苗接种率较低，而且 YEH 人群中的疫苗接种存在差异。需要制定针对 YEH 的简单易懂、促进护理点服务以及解决社会和系统层面疫苗接种障碍的 HPV 疫苗接种策略和资源。
