HPV Literacy and Its Link to Initiation and Completion of HPV Vaccine Among Young Women in Minnesota

Background and Purposes: Human papillomavirus, commonly known as HPV, is the most common sexually transmitted infection in the United States (Weinstock, Berman, & Cates, 2004; American Sexual Health Association. Statistics, 2017). Fortunately, vaccines exist to prevent contraction of HPV (National Cancer Institute, 2015). These vaccines are most effective in preventing new cases of HPV (National Cancer Institute, 2015; Schiller, Castellsague, & Garland, 2016) and for that reason, it is especially important to focus HPV prevention efforts on adolescents and younger adults. There is a dearth of research, however, on what intervenable factors are associated with HPV vaccine initiation and completion among young women. Knowing those would help to target interventions to increase vaccination rates and, ultimately, to prevent the spread of HPV and associated negative outcomes. This paper aims to identify whether, and how, HPV literacy and predisposing, enabling, and need factors are associated with HPV vaccine initiation and completion among young women in Minnesota.

Methods: Using a cross-sectional survey research method, the current study was conducted at the 2016 Minnesota State Fair. 100 young women aged between 18 and 26 living in Minnesota was recruited with a convenience sampling strategy and self-administered questionnaires were used as a data collection method. HPV literacy was measured by a 7-item questionnaire condensed from McPartland et al.’s 16-item scale regarding HPV disease and prevention (McPartland, Weaver, Lee, & Koutsky, 2005). Andersen’s Health Behavioral Model (Andersen, 1995) guided the study theoretically. We used logistic regression models to identify factors associated with HPV vaccination initiation and completion, including HPV literacy, adjusting for relevant predisposing, enabling, and need factors.

Results: Findings revealed that participants who initiated HPV vaccine reported a lower level of HPV literacy than those who have completed HPV vaccine. Consistent with national estimates, we found relatively low rates of HPV vaccination initiation (56%) and completion (47%). While not being married/partnered and having an annual check-up were significantly associated with higher rates of initiation of HPV vaccine, not being married/partnered and having a higher level of HPV literacy were related to higher odds of HPV vaccine completion.

Conclusions: Findings revealed that young women who did not complete HPV vaccine series had lower HPV and HPV vaccine knowledge as compared to those who have completed HPV vaccination. This finding indicates an urgent need for developing intervention program that aims to improve HPV literacy for women in this age. When developing intervention program, we should consider the importance of annual check-up for initiation and HPV and HPV vaccine literacy for completion as intervenable factors. Public health programs, policy-makers, and healthcare providers can use these results to increase HPV vaccination rates by making concerted efforts to improve HPV vaccination literacy through individual and public education campaigns and by improving access to annual check-ups.