Human Papillomavirus Knowledge and Attitude among Homeless Women of New York City Shelters.
BACKGROUND
Human papillomavirus (HPV) has not been studied among homeless women in the United States. We assessed knowledge and attitudes regarding HPV infection and the HPV vaccine among homeless women.


METHODS
We enrolled 300 homeless women age 19 to 65 residing in multiple New York City shelters from 2012 to 2014. We used a national survey to collect HPV data.


RESULTS
Mean age was 44.7 ± 12.16 years. The majority were Black, heterosexual, and single; 50.6% were smokers. Almost all HPV knowledge and attitudes data were considerably below the national averages; 41.9% never heard of HPV. Only 36.5% knew that HPV is a sexually transmitted disease; 41.5% knew that HPV causes cervical cancer; and only 19.5% and 17.3% received provider counseling regarding HPV testing and vaccine, respectively. Among participants, 65.4% reported that they would vaccinate their eligible daughters for HPV. Lower rates of up-to-date Pap tests were associated with a lack of knowledge regarding relationship between HPV and abnormal Pap test (p < .01).


CONCLUSIONS
We recommend improved HPV counseling by providers during any clinical encounter to reduce missed opportunities, coupled with employing patient teaching coach or navigators to improve health literacy and to connect patients to services regarding HPV and cervical cancer.
Department of Population Health, New York University School of Medicine, New York, New York; Department of Medicine, New York University School of Medicine, New York, New York. Electronic address: ramin.asgary@caa.columbia.edu.
Ramin
R
Asgary
Community Medicine Program, NYU Lutheran Family Health Centers, New York, New York.
Analena
A
Alcabes
Department of Obstetrics and Gynecology, The Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Rebecca
R
Feldman
Community Medicine Program, NYU Lutheran Family Health Centers, New York, New York.
Victoria
V
Garland
Department of Medicine, New York University School of Medicine, New York, New York.
Ramesh
R
Naderi
Department of Population Health, New York University School of Medicine, New York, New York; Department of Medicine, New York University School of Medicine, New York, New York.
Gbenga
G
Ogedegbe
Community Medicine Program, NYU Lutheran Family Health Centers, New York, New York.
Blanca
B
Sckell
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000517:prevention & control / Q000523:psychology*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000523:psychology*