Is HPV Vaccine Awareness Associated with HPV Knowledge Level?: Findings from Hints Data

Background and Purpose: Human papillomavirus (HPV) is recognized as a leading cause in multiple types of cancer (i.e., cervical cancer, anal cancer, penile cancer, and oropharynx cancer) (Prue et al., 2016). The US witnessed around 42,000 new cases of HPV-associated cancers each year, of which 24,400 were women (Centers for Disease Control and Prevention, 2019). This study proposed to examine the level of HPV knowledge and associated factors, especially HPV vaccine awareness, with HPV knowledge across four race/ethnicity groups including Non-Hispanic White, Non-Hispanic African American, Hispanic, and Non-Hispanic Asian.

Methods: The present study used a cross-sectional data merged from Cycle 1 and Cycle 2 of Health Information National Trends Survey 5 (HINTS5, Cycle 1 and Cycle 2, N = 3,648). Univariate analysis was conducted to obtain descriptive information of sociodemographic characteristics (i.e., age, gender, race/ethnicity, marital status, and educational attainment), health care resources (i.e., regular health care provider, frequency of visiting health care providers, and health insurance coverage), caregiver of children, number of children in household, English proficiency, self-reported health status, and family cancer history. Conduction of the bivariate analysis including t-test (for two-categorical variables) and ANOVA (for variables with more than two categories) examined the relationship between each variable and HPV knowledge. Multiple linear regression across race/ethnicity was proceeded on all variables to explore the associated factors with HPV knowledge.

Findings: HPV knowledge level among overall participants was low (Mean = 1.68; SD = 1.44; range 0-4). Most respondents (77.8%) answer correctly when asked “Do you think HPV can cause cervical cancer?”, while less than 30% answered correctly to other three items regarding HPV can cause penile cancer/anal cancer/ oral cancer. Regression analysis reported that age (b=-.046, p<.05), educational attainment (b=.082, p<.001), regular health care provider (b=.054, p<.005), head of HPV vaccine (b=.181, p<.001), and family cancer history (b=.040, p<.05) were associated with HPV knowledge level for all participants. Heard of HPV vaccine was the only factor related to HPV knowledge for all race/ethnicity groups including Non-Hispanic White (b=.188, p<.001), Non-Hispanic African American (b=.138, p<.05), Hispanic (b=.169, p<.01), and Non-Hispanic Asian (b=.356, p<.05). Education was the only factor significant beside heard of HPV Vaccine for Non-Hispanic White (b=.061, p<.05). Additionally, age (b=-.136, p<.05), education (b=.143, p<.05) and regular health care provider (b=.126, p<.05) were significant for Non-Hispanic African American, while education (b=.171, p<.01), English proficiency (b=-.184, p<.01) and family cancer history (b=.154, p<.01) were significant for Hispanic, and being a caregiver of children (b=-.301, p<.05) was significant for Non-Hispanic Asian.

Conclusions and Implications: The result of low HPV knowledge level suggests that future health education on HPV knowledge is needed. Specific interventions should target on knowledge about other cancers besides cervical cancer that are also caused by HPV. In addition, it is necessary for practitioners to pay attention to different associated factors with HPV knowledge across different race/ethnicity groups.