title: Racial and ethnic differences in human papillomavirus positivity and risk factors among low-income women in Federally Qualified Health Centers in the United States.
abstract: Reasons for racial/ethnic disparities in HPV infection are unclear. This study assessed racial/ethnic differences in and risk factors for HPV positivity among low-income women. Data were collected from 984 low-income women visiting Federally Qualified Health Centers across Illinois (2009-2011). Pearson chi square and Logistic regression analyses were used to examine associations with HPV positivity. Our results showed Mexican-born Hispanics had the lowest HPV positivity (16%), followed by non-Hispanic whites (29%), US-born Hispanics (35%), and non-Hispanic blacks (39%). Mexican-born Hispanics reported fewer risk behaviors for HPV positivity, including first sexual intercourse before age 16 years (9% versus 27%), multiple sexual partners in lifetime (48% versus 90%), and current cigarette smoking status (10% versus 35%) when compared to non-Hispanic whites (p<0.001). In multivariate-adjusted logistic regression, being non-Hispanic black, first sexual intercourse before age 16 years, increasing numbers of recent or lifetime sexual partners and current cigarette smoking status were associated with a higher likelihood of HPV positivity. Our findings highlight racial/ethnic differences in HPV positivity and risk factors in a population of women with similar socioeconomic characteristics. When measuring HPV risk factors within the Hispanic population, foreign-born status and other mediating factors, such as social norms and cultural characteristics, may be relevant to assess the intragroup heterogeneity.
authors.affiliation: Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Lavinia
authors.initials: L
authors.lastname: Lin
authors.affiliation: Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States. Electronic address: vdb9@cdc.gov.
authors.forename: Vicki B
authors.initials: VB
authors.lastname: Benard
authors.affiliation: Division of Health and Analytics, Battelle Memorial Institute, Seattle, WA, United States.
authors.forename: April
authors.initials: A
authors.lastname: Greek
authors.affiliation: Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Nikki A
authors.initials: NA
authors.lastname: Hawkins
authors.affiliation: Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Roland
authors.affiliation: Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Mona
authors.initials: M
authors.lastname: Saraiya
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000208:ethnology*; D011203:Poverty; D044469:Racial Groups / Q000706:statistics & numerical data; D012307:Risk Factors
keywords: Ethnicity; Hispanics; Human papillomavirus; Risk behaviors