title: Identification of potential missed opportunities for human papillomavirus (HPV) vaccination in women referred to an academic colposcopy clinic for evaluation of abnormal cervical cytology.
abstract: To identify possible predictors of missed opportunities for human papillomavirus (HPV) counseling and vaccination prior to presentation at an academic colposcopy clinic.
  
  
  
  We examined the characteristics of 638 vaccinated and 1,024 unvaccinated age-eligible patients using data from a patient registry of women presenting for colposcopic evaluation between 2/26/2007 and 3/10/2014 who were aged 26 or less at presentation. Demographics, smoking history, pregnancy history, sexually transmitted infections (STIs), sexual history, contraception use, immunosuppression, and medical problems were compared between HPV vaccinated and unvaccinated women. Multivariable logistic regression models included age, race, language, marital status, insurance type, lifetime number of sexual partners, other medical illnesses, number of pregnancies, contraception use, history of STIs, and smoking history to determine predictors of HPV vaccination.
  
  
  
  In multivariable analysis, race, marital status, and language were not significantly associated with HPV vaccination. Women with fewer pregnancies were more likely to be vaccinated (p-trend <0 .0001). Vaccinated women were more likely to have other medical illnesses (OR=1.44, 95% CI=1.13-1.83) and be aware of their HPV status (OR=1.75, 95% CI= 1.40-2.18).
  
  
  
  In this study, greater number of pregnancies was associated with lower vaccination rates as compared to women who had never been pregnant. Reproductive health visits, such as postpartum and family planning visits, represent an ideal opportunity to educate women about HPV and the importance of vaccination, and should be an area of focus to improve current HPV vaccination rates.
authors.affiliation: a Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Dorton
authors.affiliation: a Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: Allison F
authors.initials: AF
authors.lastname: Vitonis
authors.affiliation: a Brigham and Women's Hospital , Boston , MA , USA.|b Dana Farber Cancer Institute , Boston , MA , USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Feldman
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D015331:Cohort Studies; D003127:Colposcopy; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000150:complications / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines
keywords: abnormal cervical cytology; cervical cancer; colposcopy; human papillomavirus vaccination; provider counseling
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