• Jennifer C Spencer, Lisa P Spees, Caitlin B Biddell, Olufeyisayo O Odebunmi, Anna A Ilyasova, Juan Yanguela, LichKristen HassmillerKHDepartment of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America., Sarah D Mills, Colleen R Higgins, Sachiko Ozawa, and Stephanie B Wheeler.
• Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, TX, United States of America. Electronic address: jennifer_spencer@austin.utexas.edu.
• Prev Med. 2024 May 1; 182: 107941107941.

ObjectiveModels simulating the potential impacts of Human Papillomavirus (HPV) vaccine have been used globally to guide vaccination policies and programs. We sought to understand how and why marginalized populations have been incorporated into HPV vaccine simulation models.MethodsWe conducted a systematic search of PubMed, CINAHL, Scopus, and Embase to identify studies using simulation models of HPV vaccination incorporating one or more marginalized population through stratification or subgroup analysis. We extracted data on study characteristics and described these overall and by included marginalized groups.ResultsWe identified 36 studies that met inclusion criteria, which modeled vaccination in 21 countries. Models included men who have sex with men (MSM; k = 16), stratification by HIV status (k = 9), race/ethnicity (k = 6), poverty (k = 5), rurality (k = 4), and female sex workers (k = 1). When evaluating for a marginalized group (k = 10), HPV vaccination was generally found to be cost-effective, including for MSM, individuals living with HIV, and rural populations. In studies evaluating equity in cancer prevention (k = 9), HPV vaccination generally advanced equity, but this was sensitive to differences in HPV vaccine uptake and use of absolute or relative measures of inequities. Only one study assessed the impact of an intervention promoting HPV vaccine uptake.DiscussionIncorporating marginalized populations into decision models can provide valuable insights to guide decision making and improve equity in cancer prevention. More research is needed to understand the equity impact of HPV vaccination on cancer outcomes among marginalized groups. Research should emphasize implementation - including identifying and evaluating specific interventions to increase HPV vaccine uptake.Copyright © 2024 Elsevier Inc. All rights reserved.

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