title: HPV vaccine readiness among American Indian college students.
abstract: BACKGROUND
  Young adults experience high rates of human papillomavirus (HPV) infection. This article reports on American Indian (AI) university students' HPV vaccine readiness and female vaccine decision-making.
  
  
  METHODS
  Eight focus groups were held with AI students attending four universities. A questionnaire was also administered. Fifty-seven students, 23 males and 34 females, aged 19 to 26 participated. Audio-recorded sessions were transcribed. Common themes were coded and categorized following grounded theory procedures. Statistical tests included chi-square and two sample independent t tests.
  
  
  RESULTS
  A significant difference was observed between sexes and HPV risk status (P=.008). Females perceived a higher risk and were more knowledgeable about HPV and the vaccine than males, however, they did not know where to seek information and were less likely to recommend the vaccine to friends. Fifty-two percent of males reported perceived low risk of contracting HPV. Six explanatory factors were identified: low knowledge, access barriers, fear of side effects, culture, adverse historical events, and poor risk perception.
  
  
  CONCLUSIONS
  American Indian female college students are not at a stage of readiness to comply with HPV vaccine recommendations, and need improved access to the HPV vaccine.
authors.affiliation: University of California at Los Angeles School of Nursing, Los Angeles, CA 90095, USA. fhodge@sonnet.ucla.edu
authors.forename: Felicia S
authors.initials: FS
authors.lastname: Hodge
authors.forename: Tracy
authors.initials: T
authors.lastname: Itty
authors.forename: Briana
authors.initials: B
authors.lastname: Cardoza
authors.forename: Christine
authors.initials: C
authors.lastname: Samuel-Nakamura
mesh_terms: D000328:Adult; D001130:Arizona; D002140:California; D016009:Chi-Square Distribution; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007198:Indians, North American / Q000208:ethnology / Q000523:psychology*; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control*; D012307:Risk Factors; D013334:Students / Q000523:psychology*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014611:Vaccination / Q000523:psychology*; D055815:Young Adult