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Human Papillomavirus Vaccination Initiation and Completion among Youth Experiencing Homelessness in Seven U.S. Cities

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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 system-level vaccination barriers encountered by YEH are needed.

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Acknowledgments

We would like to thank the youth who participated in the HYRRS study, and the REALYST.org study team and community partners. We would also like to thank Lionel Santibáñez for his editorial assistance.

Funding

This work was partially supported by the Greater Houston Community Foundation Funders Together to End Homelessness; and the Arizona State University Institute for Social Science Research.

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Authors and Affiliations

  1. School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA

    Kathryn R. Gallardo, Christine M. Markham & Michael D. Swartz

  2. Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA

    Diane Santa Maria

  3. Graduate College of Social Work, University of Houston, Houston, TX, USA

    Sarah Narendorf

  4. School of Social Work, University of Missouri, Columbia, MO, USA

    Hsun-Ta Hsu

  5. Graduate School of Social Work, University of Denver, Denver, CO, USA

    Anamika Barman-Adhikari & Kimberly Bender

  6. Silberman School of Social Work at Hunter College, New York, NY, USA

    Jama Shelton

  7. School of Social Work, Arizona State University, Phoenix, AZ, USA

    Kristin Ferguson

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  1. Kathryn R. Gallardo
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  2. Diane Santa Maria
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Correspondence to Kathryn R. Gallardo.

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Gallardo, K.R., Santa Maria, D., Narendorf, S. et al. Human Papillomavirus Vaccination Initiation and Completion among Youth Experiencing Homelessness in Seven U.S. Cities. Prev Sci 21, 937–948 (2020). https://doi.org/10.1007/s11121-020-01131-5

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