Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
Institute for Global Health, University College London, London, United Kingdom.
JAMA Netw Open. 2023 Nov 1;6(11):e2343325. doi: 10.1001/jamanetworkopen.2023.43325.
Understanding disparities in human papillomavirus (HPV) awareness is crucial, given its association with vaccine uptake.
To investigate differences in HPV awareness by educational attainment, race, ethnicity, and their intersectionality.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used the Health Information National Trends Survey (HINTS) 5 cycles 1 to 4 data (January 26, 2017, to June 15, 2020). The data were analyzed from December 12, 2022, to June 20, 2023. A sample of the noninstitutionalized civilian US population 18 years or older was included in the analysis.
Weighted prevalence of HPV awareness, HPV vaccine awareness, and knowledge that HPV causes cancer, stratified by educational attainment and by race and ethnicity. Interaction between educational attainment and race and ethnicity was assessed using a Wald test.
A total of 15 637 participants had educational attainment data available; of these, 51.2% were women, and the median age was 58 (IQR, 44-69) years. A total of 14 444 participants had race and ethnicity information available; of these, 4.6% were Asian, 13.9% were Black, 15.3% were Hispanic, 62.6% were White, and 3.6% were of other race or ethnicity (including American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, and more than 1 race or ethnicity). Awareness of HPV by educational attainment ranged from 40.4% for less than high school to 78.2% for college or higher; awareness by race and ethnicity ranged from 46.9% among Asian individuals to 70.2% among White individuals. Awareness of HPV vaccines across educational attainment ranged from 34.7% among those with less than high school to 74.7% among those with a college degree or higher and by race and ethnicity from 48.4% among Asian individuals to 68.2% among White individuals. Among adults who were aware of HPV, knowledge that HPV causes cervical cancer differed by educational attainment, ranging from 51.7% among those with less than high school to 84.7% among those with a college degree or higher, and by race and ethnicity, ranging from 66.0% among Black individuals to 77.9% among Asian individuals. The interaction between educational attainment and race and ethnicity on HPV awareness and HPV vaccine awareness was not significant; however, within each educational attainment level, awareness differed by race and ethnicity, with the lowest awareness consistently among Asian individuals regardless of educational attainment. Within each racial and ethnic group, HPV awareness and HPV vaccine awareness significantly decreased with decreasing educational attainment.
Disparities in HPV awareness were evident across social factors, with the lowest awareness among Asian individuals and individuals with lower educational attainment. These results emphasize the importance of considering social factors in HPV awareness campaigns to increase HPV vaccination.
鉴于人乳头瘤病毒（HPV）意识与其疫苗接种率相关，了解 HPV 意识方面的差异至关重要。
调查受教育程度、种族和族裔以及它们的相互作用对 HPV 意识差异的影响。
设计、地点和参与者：本横断面研究使用了健康信息国家趋势调查（HINTS）5 个周期 1 至 4 数据（2017 年 1 月 26 日至 2020 年 6 月 15 日）。数据分析于 2023 年 6 月 20 日从 2022 年 12 月 12 日开始。分析包括 18 岁或以上的非机构化美国平民人口样本。
根据受教育程度和种族和族裔分层，HPV 意识、HPV 疫苗意识和 HPV 导致癌症的知识的加权流行率。使用 Wald 检验评估受教育程度与种族和族裔之间的交互作用。
共有 15637 名参与者提供了受教育程度数据；其中 51.2%为女性，中位年龄为 58（IQR，44-69）岁。共有 14444 名参与者提供了种族和族裔信息；其中 4.6%为亚洲人，13.9%为黑人，15.3%为西班牙裔，62.6%为白人，3.6%为其他种族或族裔（包括美洲印第安人或阿拉斯加原住民、夏威夷原住民或其他太平洋岛民以及多种族或族裔）。受教育程度不同的 HPV 意识范围从不到高中的 40.4%到大学或更高学历的 78.2%；种族和族裔之间的 HPV 意识范围从亚洲人 46.9%到白人 70.2%。受教育程度不同的 HPV 疫苗意识范围从不到高中的 34.7%到大学学历或更高的 74.7%，种族和族裔之间的 HPV 疫苗意识范围从亚洲人 48.4%到白人 68.2%。在 HPV 意识方面，在知道 HPV 会导致宫颈癌的成年人中，受教育程度不同，从不到高中的 51.7%到大学学历或更高的 84.7%不等，种族和族裔之间的知识差异，从黑人的 66.0%到亚洲人的 77.9%不等。受教育程度和种族和族裔对 HPV 意识和 HPV 疫苗意识的交互作用不显著；然而，在每个受教育程度水平内，种族和族裔之间的意识存在差异，亚洲人始终处于最低水平，而不论其受教育程度如何。在每个种族和族裔群体中，HPV 意识和 HPV 疫苗意识随着受教育程度的降低而显著降低。
HPV 意识方面存在明显的社会因素差异，亚洲人和受教育程度较低的人群的意识最低。这些结果强调了在 HPV 意识宣传活动中考虑社会因素的重要性，以提高 HPV 疫苗接种率。
