title: Racial and ethnic differences in HPV knowledge, attitudes, and vaccination rates among low-income African-American, Haitian, Latina, and Caucasian young adult women.
abstract: OBJECTIVE
  To examine facilitators and barriers to HPV vaccine uptake in African-American, Haitian, Latina, and White women aged 18-22 and to determine vaccination completion rates among participants over 5 years.
  
  
  METHODS
  Using semi-structured interviews and medical record review, we assessed HPV knowledge and attitudes towards HPV vaccination among young women. We then determined their subsequent HPV vaccination initiation and completion rates. We used constructs from the Health Belief Model and methods based in grounded theory and content analysis to identify attitudes towards HPV vaccination cues to initiate vaccination, perception of HPV, and how communication about issues of sexuality may impact vaccine uptake.
  
  
  METHODS
  We enrolled 132 African-American, Haitian, Latina, and White women aged 18-22 years who visited an urban academic medical center and 2 affiliated community health centers between the years 2007 and 2012.
  
  
  METHODS
  Intent to vaccinate and actual vaccination rates.
  
  
  RESULTS
  Of 132 participants, 116 (90%) stated that they were somewhat or very likely to accept HPV vaccination if offered by their physician, but only 51% initiated the vaccination over the next 5 years. Seventy-eight percent of those who initiated vaccination completed the 3 doses of the HPV vaccine series. Forty-five percent (45%, n = 50) of the adolescents who started the series completed 3 doses over a 5-year period: 42% of African-American (n = 16), 33% of Haitian (n = 13), 63% of Latina (n = 10), and 65% of White young women (n = 11) completed the 3-dose series. Despite low knowledge, they reported high levels of trust in physicians and were willing to vaccinate if recommended by their physicians.
  
  
  CONCLUSIONS
  Desire for HPV vaccination is high among older adolescents, physician recommendation, and use of every clinic visit opportunity may improve vaccine uptake in young women. More White young women completed the HPV vaccine series compared with other race and ethnic young women.
authors.affiliation: Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, Boston, MA. Electronic address: napierre@bu.edu.
authors.forename: Natalie
authors.initials: N
authors.lastname: Pierre Joseph
authors.affiliation: Boston University School of Public Health, Boston, MA.
authors.forename: Jack A
authors.initials: JA
authors.lastname: Clark
authors.affiliation: Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, Boston, MA.
authors.forename: Glory
authors.initials: G
authors.lastname: Mercilus
authors.affiliation: Department of Obstetrics and Gynecology, John Hopkins, Baltimore, MD.
authors.forename: MaryAnn
authors.initials: M
authors.lastname: Wilbur
authors.affiliation: Department of Pediatrics, Boston Medical Center and Boston University School of Medicine, Boston, MA.
authors.forename: Jean
authors.initials: J
authors.lastname: Figaro
authors.affiliation: Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Perkins
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D003142:Communication; D005260:Female; D006205:Haiti / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D037141:Mandatory Programs; D053918:Papillomavirus Vaccines; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011203:Poverty; D012725:Sexual Behavior; D035502:Trust; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology; D014611:Vaccination / Q000706:statistics & numerical data*; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccine, Young adult women, HPV, Cervical cancer prevention in young adult women