Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States.
Area-based socioeconomic factors and Human Papillomavirus (HPV) vaccination among teen boys in the United States.
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DOI：
10.1186/s12889-017-4567-2
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发表时间：
2017-07-14
影响因子：
4.5
通讯作者：
Kepka D
中科院分区：
文献类型：
--
作者：
Henry KA;Swiecki-Sikora AL;Stroup AM;Warner EL;Kepka D
这项研究首次考察了美国男孩中几个基于地区的社会经济因素与人乳头瘤病毒（HPV）疫苗摄取之间的关系。分析2012-2013年国家免疫调查-青少年限制使用数据的数据，以检查13-17岁（N = 19,518）男孩中HPV疫苗接种开始（接受≥1剂）和系列完成（接受3剂）与几个个人水平和邮政编码表区（ZCTA）普查措施的关系。采用多变量logistic回归分别估计HPV疫苗接种开始和系列完成的几率。在2012-2013年，大约27.9% （95% CI 26.6%-29.2%）的男孩开始接种HPV疫苗，10.38% （95% CI 9.48%-11.29%）的男孩完成了HPV疫苗系列。以地区为基础的贫困与开始接种HPV疫苗没有统计学上的显著关联。然而，它与系列完成有关，生活在高贫困地区的男孩（≥20%生活在贫困以下的居民）完成系列的几率高于低贫困地区的男孩（0-4.99%）（AOR 1.22, 95% CI 1.01-1.48）。种族/民族与邮政编码水平贫困之间的相互作用表明，生活在高贫困地区的西班牙裔男孩接种HPV疫苗的几率（AOR 1.43, 95% CI 1.03-1.97）和完成疫苗接种的几率（AOR 1.56, 95% CI 1.05-2.32）在统计学上显著高于低贫困地区的西班牙裔男孩。高贫困地区的非西班牙裔黑人男孩比低贫困地区的非西班牙裔黑人男孩有更高的开始（AOR 2.23, 95% CI 1.33-3.75）和完成（AOR 2.61, 95% CI 1.06-6.44）的几率。农村/城市居住和人口密度也是重要因素，来自城市或人口稠密地区的男孩与生活在非城市、人口较少地区的男孩相比，开始和完成学业的几率更高。城市地区和高度贫困地区的种族/少数民族的人乳头瘤病毒疫苗接种率较高，可能是由于疫苗接受程度、保健做法以及他们通过儿童疫苗方案获得人乳头瘤病毒疫苗等因素，该方案向没有保险和保险不足的儿童提供免费疫苗。鉴于美国男孩的HPV疫苗接种率较低，这些结果为告知公共卫生干预措施以增加HPV疫苗接种提供了重要证据。
This study is the first to examine associations between several area-based socioeconomic factors and human papillomavirus (HPV) vaccine uptake among boys in the United States (U.S.). Data from the 2012-2013 National Immunization Survey-Teen restricted-use data were analyzed to examine associations of HPV vaccination initiation (receipt of ≥1 dose) and series completion (receipt of three doses) among boys aged 13-17 years (N = 19,518) with several individual-level and ZIP Code Tabulation Area (ZCTA) census measures. Multivariable logistic regression was used to estimate the odds of HPV vaccination initiation and series completion separately. In 2012-2013 approximately 27.9% (95% CI 26.6%-29.2%) of boys initiated and 10.38% (95% CI 9.48%-11.29%) completed the HPV vaccine series. Area-based poverty was not statistically significantly associated with HPV vaccination initiation. It was, however, associated with series completion, with boys living in high-poverty areas (≥20% of residents living below poverty) having higher odds of completing the series (AOR 1.22, 95% CI 1.01-1.48) than boys in low-poverty areas (0-4.99%). Interactions between race/ethnicity and ZIP code-level poverty indicated that Hispanic boys living in high-poverty areas had a statistically significantly higher odds of HPV vaccine initiation (AOR 1.43, 95% CI 1.03-1.97) and series completion (AOR 1.56, 95% CI 1.05-2.32) than Hispanic boys in low-poverty areas. Non-Hispanic Black boys in high poverty areas had higher odds of initiation (AOR 2.23, 95% CI 1.33-3.75) and completion (AOR 2.61, 95% CI 1.06-6.44) than non-Hispanic Black boys in low-poverty areas. Rural/urban residence and population density were also significant factors, with boys from urban or densely populated areas having higher odds of initiation and completion compared to boys living in non-urban, less densely populated areas. Higher HPV vaccination coverage in urban areas and among racial/ethnic minorities in areas with high poverty may be attributable to factors such as vaccine acceptance, health-care practices, and their access to HPV vaccines through the Vaccines for Children Program, which provides free vaccines to uninsured and under-insured children. Given the low HPV vaccination rates among boys in the U.S., these results provide important evidence to inform public health interventions to increase HPV vaccination.
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