An Integrative Theoretical Framework for HPV Vaccine Promotion Among Male Sexual Minorities.
The objective of the current study was to quantify the behavioral intentions of young adult male sexual minorities (MSM) to initiate human papillomavirus (HPV) vaccination and test an integrative model of HPV vaccine decision making. Participants were 575 MSM who were residing in the United States and were between ages 18 and 26 years. Standard direct and indirect measures of attitudes, perceived norms, and perceived behavioral control were employed to explain variation in behavioral intention. Additional background factors-such as concealment of one's sexual identity, suspicion of health care provider competence in LGBT health issues, perceived threat, and information orientation-were also included in the model. The final model fit the data well and identified a set of salient attitudinal and control beliefs as the strongest determinants of intention ( R2= .38). Perceived threat and information orientation were positively correlated with HPV-related beliefs. Perceived threat was higher among men infected with HIV and lower among men in monogamous relationships. Self-efficacy, as an indirect measure of perceived behavioral control, was inversely related to the general tendency to conceal aspects of one's sexual orientation and a suspicion of health care providers. Bisexual identified men were more likely to conceal their sexual orientation and be more suspicious of health care providers. In this study, a number of modifiable determinants of HPV vaccine intentions-both psychosocial and environmental-were identified and have implications for targeted and tailored behavioral interventions to promote HPV vaccination among MSM.
1 University of South Florida, Tampa, FL, USA.
Christopher W
CW
Wheldon
1 University of South Florida, Tampa, FL, USA.
Ellen M
EM
Daley
2 San Diego State University, San Diego, CA, USA.
Eric R
ER
Walsh-Buhi
3 Northern Arizona University, Flagstaff, AZ, USA.
Julie A
JA
Baldwin
4 University of Texas, Houston, TX, USA.
Alan G
AG
Nyitray
5 H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Anna R
AR
Giuliano
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003657:Decision Making; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D020380:Needs Assessment; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012307:Risk Factors; D000072339:Sexual and Gender Minorities / Q000523:psychology / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States; D014611:Vaccination / Q000523:psychology; D055815:Young Adult
D053918:Papillomavirus Vaccines
health education; health promotion and disease prevention; public health; sexual identity; sexually transmitted diseases/infections