Race and Sexual Behavior Predict Uptake of the Human Papillomavirus Vaccine

Objective: To identify predictors of human papillomavirus (HPV) vaccination initiation by girls at high risk for HPV infection. Method: Participants were 2,098 girls enrolled in the ongoing Pittsburgh Girls Study, who were between the ages of 12 and 15 years in 2008, and their primary caregivers. The study was conducted in the 2 years after the deployment of the first HPV vaccine approved by the U. S. Food and Drug Administration. Primary caregivers were asked about HPV vaccine uptake. Girls were interviewed about pubertal development and sexually intimate behavior. Results: Approximately 60% of the girls had initiated the HPV vaccine in the past year. Among the hypothesized predictors of initiation, African-American race decreased the likelihood and level of sexually intimate behavior in the previous year increased the likelihood of uptake. Controlling for receipt of public assistance, African-American girls were close to 40% less likely to be vaccinated than European-American girls. Conclusion: Racial disparities in use of preventive interventions such as the HPV vaccine exist. Lack of information about public financing of the vaccine, timing of vaccination relative to sexual activity, and perceptions of preventive value may limit uptake among those at highest risk for infection and negative sequelae from infection. Further research to probe knowledge and attitudes toward HPV vaccination and the impact of the media on vaccine initiation and uptake may reveal specific targets of intervention.