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Preventive medicine · Nov 2022
Low human papillomavirus vaccine uptake among women engaged in HIV care in Ontario, Canada.
- Catharine Chambers, Jennifer Gillis, Joanne Lindsay, Anita C Benoit, Claire E Kendall, Abigail Kroch, Ramandip Grewal, Mona Loutfy, Ashley Mah, Kristen O'Brien, Gina Ogilvie, Janet Raboud, Anita Rachlis, Beth Rachlis, Anna Yeung, Mark H Yudin, Ann N Burchell, and OHTN Cohort Study Team.
- University of Toronto, Toronto, Canada; St. Michael's Hospital, Unity Health Toronto, Toronto, Canada.
- Prev Med. 2022 Nov 1; 164: 107246107246.
AbstractWomen living with HIV are at higher risk for human papillomavirus (HPV)-related dysplasia and cancers and thus are prioritized for HPV vaccination. We measured HPV vaccine uptake among women engaged in HIV care in Ontario, Canada, and identified socio-demographic, behavioural, and clinical characteristics associated with HPV vaccination. During annual interviews from 2017 to 2020, women participating in a multi-site, clinical HIV cohort responded to a cross-sectional survey on HPV vaccine knowledge and receipt. We used logistic regression to derive age-adjusted odds ratios and 95% confidence intervals (CI) for factors associated with self-reported vaccine initiation (≥1 dose) or series completion (3 doses). Among 591 women (median age = 48 years; interquartile range = 40-56 years), 13.2% (95%CI = 10.5-15.9%) had received ≥1 dose. Of those vaccinated, 64.6% had received 3 doses. Vaccine initiation (≥1 dose) was significantly higher among women aged 20-29 years at 31.0% but fell to 13.9% in those aged 30-49 years and < 10% in those aged ≥50 years. After age adjustment, vaccine initiation was significantly associated with being employed (vs. unemployed but seeking work), income $40,000-$59,999 (vs. <$20,000), being married/common-law (vs. single), living with children, immigrating to Canada >5 years ago (vs. immigrating ≤5 years ago), never smoking (vs. currently smoking), and being in HIV care longer (per 10 years). Similar factors were identified for series completion (3 doses). HPV vaccine uptake remains low among women living with HIV in our cohort despite regular engagement in care. Recommendations for improving uptake include education of healthcare providers, targeted community outreach, and public funding of HPV vaccination.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.
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