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Master of Public Health

Regional variation in HPV Knowledge and Awareness among American Indians and Alaska Natives: an analysis of the Health Information National Trends Survey, 2011-2020

AUTHORS

Sherman BM , Islam JY , Gartner D , . Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2023 8 22; ().

ABSTRACT

BACKGROUND: American Indian and Alaskan Native (AIAN) people experience a disproportionately high incidence of HPV-related cancers and mortality, and these rates vary across geographic regions. To address the unexplained regional differences among AIAN people, we describe regional variations and socio-demographic correlates of HPV-related knowledge and HPV vaccination awareness indicators.

METHODS: A cross-sectional study was implemented with data for 866 AIAN respondents pooled from eight cycles of the Health Information National Trends Survey (HINTS). We used chi-square tests to determine if there were regional differences in the indicators and then used multivariable, modified Poisson regression to explore associations between socio-demographic characteristics and HPV-related knowledge and vaccination awareness measures.

RESULTS: Of the 13 indicators, just one demonstrated regional variation. However, we observed a high level of uncertainty regarding HPV and HPV-vaccine-related knowledge and experience. We also observed that women were more likely than men to have heard of HPV (aPR 1.29, 95%CI:1.03-1.63), the HPV vaccine (aPR 1.59, 95%CI: 1.15-2.22), and to have discussed it with their providers (aPR 3.69, 95%CI: 1.47-9.28). There were also differences by age, education, and insurance status.

CONCLUSIONS: High levels of uncertainty and lack of regional variation in indicators suggest that there may be missed opportunities across Indian Country for engagement between healthcare providers and AIAN in HPV-related conversations.

IMPACT: Efforts towards improving HPV knowledge and vaccination should target all at-risk sexes (and genders), age groups, and education levels. Moreover, AIAN-serving healthcare providers should be empowered with sufficient understanding, so they are prepared for discussions with at-risk patients.

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