Sexual Orientation Identity Disparities in Awareness and Initiation of the Human Papillomavirus Vaccine Among US Women and Girls A National Survey

Background: Lesbians and bisexual women are at risk for human papillomavirus (HPV) infection from female and male sexual partners. Objective: To examine the association between sexual orientation identity and HPV vaccination among U.S. women and girls. Design: Cross-sectional, using 2006-2010 National Survey of Family Growth data. Setting: U.S.civilian noninstitutionalized population. Participants: The 2006-2010 National Survey of Family Growth used stratified cluster sampling to establish a national probability sample of 12 279 U.S. women and girls aged 15 to 44 years. Analyses were restricted to 3253 women and girls aged 15 to 25 years who were asked about HPV vaccination. Measurements: Multivariable logistic regression was used to obtain prevalence estimates of HPV vaccine awareness and initiation adjusted for sociodemographic and health care factors for each sexual orientation identity group. Results: Among U.S. women and girls aged 15 to 25 years, 84.4% reported having heard of the HPV vaccine; of these, 28.5% had initiated HPV vaccination. The adjusted prevalence of vaccine awareness was similar among heterosexual, bisexual, and lesbian respondents. After adjustment for covariates, 8.5% (P = 0.007) of lesbians and 33.2% (P = 0.33) of bisexual women and girls who had heard of the vaccine had initiated vaccination compared with 28.4% of their heterosexual counterparts. Limitation: Self-reported, cross-sectional data, and findings may not be generalizable to periods after 2006 to 2010 or all U. S. lesbians aged 15 to 25 years (because of the small sample size for this group). Conclusion: Adolescent and young adult lesbians may be less likely to initiate HPV vaccination than their heterosexual counterparts. Programs should facilitate access to HPV vaccination services among young lesbians.