Disparities in Knowledge and Awareness of Human Papillomavirus and Human Papillomavirus-Related Cancers Among Sexual Minorities in the United States, 2017-2020

Abstract

Introduction: Human Papillomavirus (HPV) is a prevalent STI linked to penile, anal, oral, and cervical cancers. It is a vaccine-preventable infection, but vaccination uptake rates remain low Sexual minorities (LGBTQ+) are less likely to be screened and have a higher risk of contracting HPV and HPV-related cancers; however, they are often overlooked in interventions and research. Knowledge and awareness of HPV and its vaccines can reduce and prevent HPV-related cancers. Methods: A retrospective analysis of HINTS-5 (2017-2020) data assessed the knowledge and awareness of HPV and HPV vaccination among sexual minorities. Poisson regression models estimated the incidence rate ratio (IRR) of HPV awareness, HPV vaccine awareness, and knowledge of HPV- related cancers. Weighted analysis was performed. Results: Awareness of HPV and the HPV vaccine has generally increased over the years, although there was a slight decline in 2020. Men (aIRR=1.15, p<0.001), individuals with less than a high school education (aIRR=1.24, p<0.001), Midwest residents (aIRR=1.06, p=0.002), and those without regular healthcare providers (aIRR=1.05, p=0.005) were more likely to be aware of HPV. Non- Hispanic Blacks (aIRR=1.04, p=0.007) and those with lower education levels (aIRR=1.10, p<0.001) were more knowledgeable about HPV-related oral cancer, while men (aIRR=1.10, p<0.001), Non-Hispanic Blacks (aIRR=1.07, p=0.008), low-income individuals (aIRR=1.09, p=0.001), and those with lower education levels (aIRR=1.25, p<0.001) were more likely to be knowledgeable about HPV-related cervical cancer. Lower rates of HPV awareness were observed among adults aged 18-34 years old, p<0.001. Conclusion: Despite variations in awareness, sexual minorities demonstrated insufficient knowledge regarding HPV-related cancers. Comprehensive education initiatives are warranted to ensure equitable access to information, addressing disparities across populations. Efforts should leverage existing community strengths to enhance HPV prevention and education strategies, fostering inclusivity and effectiveness.