Human Papillomavirus Vaccination Initiation and Completion among Youth Experiencing Homelessness in Seven U.S. Cities
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Human Papillomavirus Vaccination Initiation and Completion among Youth Experiencing Homelessness in Seven U.S. Cities Kathryn R. Gallardo 1 & Diane Santa Maria 2 & Sarah Narendorf 3 & Christine M. Markham 1 & Michael D. Swartz 1 & Hsun-Ta Hsu 4 & Anamika Barman-Adhikari 5 & Kimberly Bender 5 & Jama Shelton 6 & Kristin Ferguson 7
# Society for Prevention Research 2020
Abstract Little is known about human papillomavirus (HPV) vaccination uptake among youth experiencing homelessness (YEH), who may be at higher risk for HPV than their housed counterparts. We examined the prevalence and associations of HPV vaccination initiation and completion among YEH. Guided by the Behavioral Model for Vulnerable Populations, we analyzed cross-sectional data collected from YEH (N = 1074; ages 18–26) in seven U.S. cities to assess HPV vaccination prevalence and to identify predisposing, enabling, and need factors associated with HPV vaccination status. Due to timing differences in the release of HPV vaccine recommendations, we conducted separate logistic regression analyses for men (n = 673) and women (n = 401). Approximately 19% of men and 37% of women had initiated and completed HPV vaccination. Several factors among men (i.e., older age, Latinx ethnicity, San Jose or St. Louis residence compared with New York City, never having had sex, and not previously being tested for STIs) and women (i.e., lower education level, San Jose or Houston residence compared with New York City, and never having had sex) were associated with lower odds of HPV vaccination initiation, completion, or both. Gay men had higher odds of initiating and completing the vaccination series than their heterosexual counterparts. Our findings reveal that HPV vaccination uptake is low among YEH and that there are vaccination disparities among subgroups of YEH. HPV vaccination strategies and resources that are easy-to-understand, facilitate point-of-care services, and address societal and systemlevel vaccination barriers encountered by YEH are needed. Keywords Youth experiencing homelessness . Homeless youth . Young adults . Human papillomavirus vaccination . HPV vaccine . Immunization
* Kathryn R. Gallardo [email protected] 1
School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
2
Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA
3
Graduate College of Social Work, University of Houston, Houston, TX, USA
4
School of Social Work, University of Missouri, Columbia, MO, USA
5
Graduate School of Social Work, University of Denver, Denver, CO, USA
6
Silberman School of Social Work at Hunter College, New York, NY, USA
7
School of Social Work, Arizona State University, Phoenix, AZ, USA
Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the USA, accounting for 71% of STIs (Satterwhite et al. 2013), and disproportionately affects adolescents and young adults. Prior to the introduction of HPV vaccination, it was estimated
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