title: Correlates to Human Papillomavirus Vaccination Status and Willingness to Vaccinate in Low-Income Philadelphia High School Students.
abstract: BACKGROUND
  Little is known about the correlates of human papillomavirus (HPV) vaccination or willingness to be vaccinated in urban, minority adolescents.
  
  
  METHODS
  Using responses to the 2013 Youth Risk Behavior Survey in Philadelphia, a random sample of high schools provided weighted data representing 20,941 9th to 12th graders. Stratified by either having had or willingness to have the vaccine, bivariate analysis with sexual behavior, preventive health behaviors, mental health, substance use, and demographic characteristics were examined and then multivariable regression models were developed to estimate significant correlates.
  
  
  RESULTS
  Respondents were 52.3% female, 84.4% non-White, and 65.9% ≥16 years; 43% reported having had the HPV vaccine, and of those not vaccinated, 66% reported willingness to be vaccinated. Logistic regression models indicate that females (odds ratio [OR] = 3.12, p < .01) and those reporting human immunodeficiency virus (HIV) testing (OR = 2.10, p < .01) were more likely to be vaccinated. Those reporting condom use during last intercourse (OR = 0.40; p = .05) and current marijuana use (OR = 0.37; p = .03) were less likely to indicate willingness to be vaccinated.
  
  
  CONCLUSIONS
  Important areas for intervention include addressing misconceptions or feelings of "immunity," especially for those using condoms. Understanding the correlation between HIV testing and HPV vaccination is also an important intervention opportunity for schools hoping to increase adolescent vaccination rates.
authors.affiliation: Department of Public Health, Temple University, 1301 Cecil B. Moore Avenue, 9th Floor, Philadelphia, PA 19122. sbass@temple.edu.
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Bass
authors.affiliation: Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, 834 Chestnut Street, Suite 314, Philadelphia, PA 19107. amy.leader@jefferson.edu.
authors.forename: Amy
authors.initials: A
authors.lastname: Leader
authors.affiliation: Department of Public Health, Temple University, 1301 Cecil B. Moore Avenue, 9th floor, Philadelphia, PA 19122. mshwarz@temple.edu.
authors.forename: Michelle
authors.initials: M
authors.lastname: Shwarz
authors.affiliation: Department of Public Health, Temple University, 1301 Cecil B. Moore Avenue, 9th floor, Philadelphia, PA 19122. judith.greener@temple.edu.
authors.forename: Judith
authors.initials: J
authors.lastname: Greener
authors.affiliation: Department of Public Health, Temple University, 1301 Cecil B. Moore Avenue, 9th floor, Philadelphia, PA 19122. fredap@temple.edu.
authors.forename: Freda
authors.initials: F
authors.lastname: Patterson
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology; D001741:Black or African American / Q000706:statistics & numerical data; D040343:Behavioral Risk Factor Surveillance System; D063425:Binge Drinking / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology; D008603:Mental Health; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D015143:Philadelphia / Q000453:epidemiology; D011204:Poverty Areas; D017678:Sex Distribution; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology; D059020:Suicidal Ideation
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV; HPV vaccination: Youth Risk Behavior Survey; adolescent health; human papillomavirus; sexual health