HPV Literacy in Adult Minnesotans: Informing Targeted Intervention Strategies to Promote HPV-Associated Cancer Equity

Background: Human papillomavirus (HPV) is a set of viruses that affects both men and women and is transmitted through vaginal, anal, or oral sex. With 14 million new cases diagnosed annually and 80%-90% of individuals having the virus at some point in their lives, HPV is the most common sexually transmitted infection (STI) in the United States Previous studies have shown that higher HPV literacy, such as knowledge about the disease and how it can be prevented, increases the likelihood of getting the HPV vaccine, which prevents the spread of HPV). Therefore, predictors related to HPV literacy level need to be identified. The present study aimed to investigate the level of HPV literacy and the associated factors with HPV literacy among adults in Minnesota.

Methods: With the approval of the University of Minnesota Institutional Review Board (IRB), a survey on HPV literacy and health behaviors was conducted at the 2016 Minnesota State Fair. In this survey, data of 733 adults aged over 18 years old were collected, including 299 males and 434 females. Under the application of Andersen’s Behavioral Model of Health Services Use, predisposing factors (age, gender, race/ethnicity, and marital status), enabling factors (educational level, employment, monthly household income, health check-up, and health insurance), and need factors (self-reported health status, family cancer history, and activities of daily life difficulties) were identified and included in the analyses. The conduction of a multiple regression analysis helped examined the factors associated with HPV literacy.

Results: The mean score of HPV literacy of participants was 6.05 (SD = 1.50) out of a total possible 8 points. Around half of the participants (52.8%) answered correctly on the statement, “Pap tests will almost always detect HPV.” Less than half of participants (44.7%) answered correctly on the statement, “A negative test for HPV means that you do not have HPV.” HPV literacy was .264 points lower among older groups compared to those between 18 and 40 years old (b = -.131, p < 0.05). Participants who were non-Latino White (b = .114, p < 0.05) or had a bachelor’s degree (b = .187, p < 0.001) had higher levels of HPV literacy, .359 points and .583 points respectively. Interestingly, HPV literacy was 1.045 points higher among participants with insurance coverage compared to those without it (b = .120, p < 0.05) and .529 points lower for participants who rated their health status as good or excellent (b = -.134, p < 0.05).

Conclusions and Implications: This study indicated age and race/ethnicity disparities regarding HPV literacy. Education, health insurance coverage, and self-reported health status significantly predicted HPV literacy. Future efforts are needed to improve HPV literacy among those who have lower education levels and lacking insurance coverage. Additionally, lower scores on specific HPV literacy items suggest that health education should target more specific knowledge aiming to improve general HPV literacy.