Human papillomavirus: trends in human papillomavirus rates, vaccine uptake, and factors driving intention to vaccinate

Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States. It is also the primary cause of cervical cancer as well as other cancers. Fortunately, there are safe and effective vaccines to prevent HPV that are recommended for both men and women ages 9-26 years old. Unfortunately, vaccine uptake is considered low, leaving a need to increase HPV vaccine uptake across the U.S. This study examines trends in high-risk HPV positivity rates over the past 10 years using large-scale laboratory test data, factors associated with vaccination in the published literature, and factors associated with intention to vaccinate in women age 18- 26 years old in Utah. Findings showed that HPV infection rates are likely falling, but at a rate that indicates less-than-optimal vaccination rates (consistent with CDC data). The trends in the published literature also indicate that intention to vaccinate is not increasing over time, and may actually be decreasing. Additionally, studies find physicians play a key role in influencing vaccination and are more likely to recommend to older woman. In Utah, physician's recommendation, age, religious practices, relationship status, and education level were associated with vaccine intention. The results of this study can be used to inform future programs targeted at increasing HPV vaccination in Utah and perhaps in other low-vaccination states. For example, despite Advisory Committee on Immunization Practices (ACIP) recommendations for initiating HPV vaccination series in females aged 11 or 12 years, iv and catch-up vaccination for females aged 13 through 26 years, we found that physicians are more likely to recommend vaccination at later ages. Additionally, our findings indicate that a strong physician recommendation significantly increases vaccination intention. These findings indicate the potential usefulness of a physician-focused intervention.