ASPO Abstracts
Higher levels of HPV vaccine hesitancy among Hispanic, male, and non-binary rural young adults in the western U.S., 2020-2021
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: Assess differences in HPV vaccine hesitancy by rurality, gender, and ethnicity among young adults in the western United States. Methods: A cross-sectional survey was conducted among young adults (YAs) ages 18-26 years living in rural and urban areas in 12 western U.S. states (Oct. 2020 – Apr. 2021). Participants (N=2937) answered HPV vaccine hesitancy and healthcare questions. Factor analysis evaluated n=27 items to create individual coarse scores for three scales of vaccine hesitancy (n, Cronbach's alpha): HPV vaccine confidence (n=6, α=0.71[95%CI: 0.69-0.73]), HPV complacency (n=11, α=0.73[95%CI: 0.71-0.75]), and HPV vaccine complacency (n=3, α=0.81[95%CI: 0.78-0.82]). Differences were examined by rurality, gender, and ethnicity, as well as rurality among Hispanic YAs and rurality among gender groups (female, male, and other). Logistic regression estimated odds (ORs). Directed acyclic graphs (DAGs) identified scientifically meaningful and minimally sufficient covariates. Results: Hispanic YAs had significantly higher odds of HPV vaccine hesitancy across all HPV scales: confidence (1.55 [95%CI:1.23-1.96]), complacency (1.53 [95%CI:1.22-1.93]), and HPV vaccine complacency (1.28 [95%CI:1.01-1.61]). Similarly, male YAs had significantly greater odds of high vaccine hesitancy compared to female YAs: confidence (2.01 [95%CI:1.66-2.44]), complacency (2.14 [95%CI:1.77-2.60]), and HPV vaccine complacency (1.30 [95%CI:1.07-1.57]). We observed significantly higher HPV vaccine complacency among non-Binary YAs (2.24 [1.06-5.17]). Significantly higher HPV vaccine hesitancy among rural YAs was observed in the dimensions of vaccine confidence (1.66 [95%CI: 1.37, 2.01]) and HPV vaccine complacency (1.79 [95%CI:1.48-2.17]) scales, compared to urban YAs. We observed similar differences by rurality among gender and ethnic groups, which was most pronounced among Hispanic YAs; strong and significantly higher odds of hesitancy among rural Hispanic YAs for HPV vaccine confidence (OR=2.13 [95%CI:1.33-3.49]) and HPV vaccine complacency (OR=2.11 [95%CI:1.33-3.40]) compared to urban Hispanic YAs. Conclusions: Rural interventions, tailored for gender and ethnicity, are needed to decrease HPV vaccine hesitancy among rural YAs to decrease risk for HPV- related cancers.
Keywords: HPV vaccination hesitancy, rural, Hispanic, gender