Patterns of HPV vaccination among Latinos: Key factors for consideration Rachel A. Reimer, PhD Chair Department of Public Health Director MPH program Associate Professor Des Moines University

Cervical Cancer Disparities Latinas more likely to contract HPV-associated cervical cancer than Whites Mortality rates disparate – Pap screening rates – Advanced stage of diagnosis

Patterns of HPV Vaccination year olds, NIS-Teen 2014 Females – 60.0 > 1 dose – 39.7 > 3 doses Males – 33.6 > 1 dose – 13.4 > 3 doses

Patterns of HPV vaccination by race / ethnic group White non-HispanicBlack non-HispanicHispanic Females > 1 doses > 3 doses Males > 1 doses > 3 doses

Study 1 Purpose – Examine HPV vaccine uptake among older adolescent girls and women and to examine influence of mother-daughter communication Participants – 972 ISU undergraduate students – Predominantly Caucasian – Typically from middle-class SES backgrounds Roberts, Gerrard, Reimer, & Gibbons. (2010). Mother Daughter communication and Human Papillomavirus Vaccine uptake by college students. Pediatrics,

Study 1 Findings: Logistic Regressions predicting vaccination status Unadjusted logistic regression Adjusted Logistic Regressions BOR (95% CI)B Risky Sexual Behavior (.98 – 1.14)-- HPV knowledge.26*1.30 (1.11 – 1.52) ( ) HPV risk perception.12*(1.22 (1.13 – 1.31).14*1.15 ( ) Communication –sex.39*1.48 (1.25 – 1.75).28*1.32 (1.10 – 1.59) Communication –values ( )-- Mother approval.95*2.57 ( ).84*2.32 (1.90 – 2.83)

Study 2 Purpose – Examine ethnic differences in HPV-associated beliefs and practices Partners – PHC and Mercy family practice clinics Participants – 150 White non-Hispanic, and 159 Latina women

Study 2 Findings: Communication about sex & values

Study 2 Findings: Norms

Study 2 Findings Religiosity

Study 3 Purpose – Examine ethnic and gender differences in key vaccination predictors Participants – Community sample recruited from health care clinics – yr old male and female Hispanic and non-Hispanic Whites

Study 3 Findings HPV awareness – Whites and females reported more awareness HPV knowledge – Hispanics and Males reported lower knowledge Vaccine Status – No males had been vaccinated – White women more likely to be vaccinated Physician Recommendation – Hispanics less likely to receive recommendation – Males less likely to receive recommendation – Hispanic Males least likely to receive a recommendation

Future Practice Recommendations Practice – Consider key sociocultural factors that may affect racial and ethnic groups and genders differently – Collaborate with health care providers to increase awareness – Engage community stakeholders to change norms and perceptions