HPV VACCINE UPTAKE AND INFECTION AMONG FOREIGN-BORN ADULTS IN THE US

Abstract

Background: Although human papillomavirus (HPV) vaccination reduces the risk of HPV infection, foreign-born individuals are less likely to receive physician recommendation for vaccine uptake. Also, little is known about differences in genital HPV prevalence by nativity. This study examines HPV infections and vaccine uptake by nativity and gender in US adults. Methods: The 2007-2016 National Health and Nutrition Examination Survey (NHANES) data on genital HPV samples (18-34 years, N=4967) were analyzed. “Vaccine-type” HPV included participants positive for HPV types 6, 11, 16, or 18. Changes in infection and vaccination across five survey cycles (2-year intervals) were examined by calculating weighted vaccine-type HPV prevalence change by nativity (US-born and foreign-born) and gender. Multivariable binary logistic regression was used to evaluate associations between nativity and HPV prevalence after controlling for survey cycle, HPV vaccination, number of lifetime sexual partners, gender, race/ethnicity and age. Results: Overall prevalence of vaccine-type HPV was 8.70% and HPV vaccine uptake was 20.60%. Vaccination increased 18.9% among US-born and 9.6% among foreign-born adults (p<0.05). Vaccine-type HPV infection decreased 9.55% among US-born and 5.89% among foreign-born adults. After controlling for survey cycle, HPV vaccination, gender, race/ethnicity and age, odds of HPV infection were lower in foreign-born adults (aOR=0.63, 95% CI: 0.43-0.92). However, this relationship was insignificant (aOR=0.90, 95% CI: 60-1.33) after accounting for lifetime sexual partners. Conclusion: Vaccine-type HPV infection was lower among foreign-born adults, but decreases in prevalence were greater among US-born adults over time. Increasing vaccination among foreign-born adolescents is pertinent to preventing disparities in HPV-related diseases.