ASPO Abstracts
Association between Marital Status and HPV Vaccination Recommendation: A National Survey of Obstetrician/Gynecologists
Category: Behavioral Science & Health Communication
Conference Year: 2021
Abstract Body:
Purpose: To evaluate differences in obstetrician/gynecologists' (OB/GYN) recommendation of HPV vaccination for
postpartum patients by patient age, parity, and marital status.
Methods: U.S. OB/GYNs completed a survey that included 8 clinical vignettes featuring a postpartum patient
eligible for HPV vaccine. The case studies were identical except for patient age (23/33 years old), parity (1st/3rd
child), and relationship status (married/unmarried). Providers were asked how likely they were to recommend HPV
vaccine to each patient from 0 (definitely would not) to 100 (definitely would).
Results: The 224 providers were 69% White, 56% male, and 55% practiced in suburban clinics. Providers were
more likely to recommend HPV vaccine to younger vs older patients. The highest recommendation was for the 23
year-old, unmarried patient having her 1st child (m=84.6/100), with the lowest score for the 33 year-old married
patient having her 3rd child (m=53.1/100). However, providers were significantly more likely to recommend HPV
vaccine to an unmarried patient than to a married patient, regardless of age/parity. The largest difference was for a
23 year-old having her 1st child. If that patient was unmarried, the recommendation score was 83.1, compared to
64.5 if that same patient was married (p<0.0001). This held true across age groups. For those having their 1st
child, there was no difference between a married 23 year-old and an unmarried 33 year-old (68.5 vs. 69.4;
p=0.90). Similarly, for those having their 3rd child, there was no difference between a married 23-year old and an
unmarried 33 year-old (64.5 vs. 68.2; p=0.45).
Conclusions: When examining these findings, it is important to note that the 23-year-old patient is recommended
for catch-up HPV vaccination and the 33-year-old is not. While providers in our study recommended the vaccine
more for younger patients, marital status was a more important driver of recommendation. Providers may be using
marital status as a proxy for risk of HPV infection, basing their recommendation on perceptions of a patient's risk
of exposure. However, marital status may not be a good indicator of whether a woman would benefit from HPV
vaccine. Additional education and training on HPV vaccination guidelines may be beneficial for OB/GYNS.
Keywords: human papillomavirus vaccines; cancer prevention; obstetrics/gynecology