The Association of Health Seeking Behaviors With Human Papillomavirus Vaccination Status Among High-Risk Urban Youth.
Vaccination is the primary strategy to reduce the burden of human papillomavirus (HPV) related diseases in the United States. Unvaccinated youth are at risk for HPV infection and associated diseases, and limited research has explored factors associated with HPV vaccination among those who are disadvantaged and at high risk, including lesbian, gay, bisexual, transgender and queer and/or homeless.



A retrospective electronic medical record review was conducted at an urban, homeless, and lesbian, gay, bisexual, transgender and queer focused health center in northeastern US logistic regression models examined the associations between HPV vaccination and demographic/social characteristics and health behaviors.



A total of 1211 men and 1326 women (gender at birth) records were reviewed from patients (ages 13-26 years) who presented for care between January 2010 and June 2013. The sample was diverse, and about half identified as heterosexual and reported stable/secure housing. Approximately 8% of men and 29% of women had obtained ≥ 1 HPV vaccine dose. The strongest predictors of vaccine initiation were health-related behaviors: having an annual examination, obtaining a non-HPV vaccine, and engaging in oral sex. Additionally, for women only, having had a Pap test or a sexually transmitted infection visit were also associated with an increase in odds, whereas identifying as transmale decreased the odds of vaccination. Having private insurance was the only predictor of 3-dose completion (women only).



Among a high-risk adolescent sample, primarily health-seeking behaviors increased the odds of HPV vaccination, reinforcing the importance of providers using various routine preventative visits as opportunities/cues to vaccine.
From the *Boston College, W.F. Connell School of Nursing, Chestnut Hill; †The Fenway Institute; ‡Sidney Borum Jr. Health Center, Fenway Health, Boston MA; and §SRI International, SRI Education, Center for Learning & Development, Menlo Park, CA.
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D000293:Adolescent; D000328:Adult; D002648:Child; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D027383:Papillomaviridae / Q000276:immunology*; D030361:Papillomavirus Infections / Q000517:prevention & control* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care; D012189:Retrospective Studies; D000072339:Sexual and Gender Minorities; D014481:United States; D014504:Urban Health; D014611:Vaccination; D055815:Young Adult
D053918:Papillomavirus Vaccines