Dissertations & Theses (Open Access)

Date of Award

Summer 8-2019

Degree Name

Master of Public Health (MPH)

Advisor(s)

Paula M. Cuccaro, Phd

Second Advisor

Angelica M. Roncancio, Phd

Abstract

Background: Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STI) in the United States (US). Certain HPV strains have the potential to develop into cervical, anal, penile, vulvar, and throat cancers. Latinos in the U.S. have the highest rates of cervical and penile cancers compared to non-Hispanic Whites. Despite the availability of HPV9v, uptake of the vaccine is suboptimal in the Latino community. Previous research has found factors such as provider recommendation and communication are important in HPV vaccine series initiation and completion. Discrimination in the medical setting is linked to poorer health outcomes and delayed receipt of preventaive health services. Little is known about the effect of perceived discrimination in the medical setting and HPV vaccination uptake.

Aims: (1) Assess factors associated with initiation and completion of the HPV vaccine series among Latino children using the Aday-Andersen model; (2) Determine whether maternal perceived discrimination plays a role in HPV vaccine initiation; (3) Determine whether maternal perceived discrimination plays a role in HPV vaccine completion.

Methods: Data from parent study Por Amor a Ellos were used for binomial regression analysis. The sub-sample used for analysis included 166 Latina mothers with a child aged 10 17, who answered items pertaining to perceived discrimination, offer of HPV vaccine by medical provider, marital status, acculturation, self-efficacy to initiate the HPV vaccine series, and perceived child health.

Results: Latina mothers who were married were more likely to initiate the HPV vaccine series at follow-up (odds ratio [OR]: 0.233, 95% confidence interval [CI]: 0.088-0.615). Perceived discrimination was not associated with HPV vaccine series initiation, but was associated with HPV vaccine series completion (OR: 1.120, 95% CI: 1.007-1.247). Having the HPV vaccine offered by a doctor or nurse was related to HPV vaccine series initiation, but did not reach significance.

Conclusion: More information is needed to determine if perceived discrimination in the medical setting plays a role in HPV vaccination uptake. Further research should explore the relationship between perceived discrimination and mother’s relationship with their child’s provider.

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