The “Digital Divide”: Differences in Internet Access and Disparities in HPV Vaccine Knowledge

Background:  The internet offers considerable promise as a health promotion and education tool.  However, the fact that many U.S. adults (~30%) are not accessing the internet – a phenomenon often referred to as the “Digital Divide” – remains an unresolved challenge.  One projected consequence of the Digital Divide is perpetuation of health information knowledge gaps.  The knowledge-gap hypothesis conceptualizes health information as a valued resource vulnerable to disparities in access where individuals with access to desirable health information gain knowledge advantages.  The Digital Divide could, it seems, be one factor contributing to potential disparities in knowledge about the Human Papillomavirus (HPV) and the HPV vaccine.

Objectives:  To explore this issue, we compared assessments of HPV and HPV vaccine knowledge among individuals reporting internet access or not.

Methods:  Data were from the 2007 Health Information National Trends Survey (HINTS, n=7,658).  A single item assessed Internet access.  Three questions assessed knowledge about HPV, the HPV vaccine, and HPV as a cause of cervical cancer.  All responses were dichotomously coded with “no” as referent.  Logistic models, accommodating the HINTS survey design and adjusting for demographics (e.g., age, income, sex), were computed.

Results:  Respondents accessing the internet (n=5,075; 66.3%) -- compared to those not accessing the internet (n=2,583; 33.7%) -- were significantly more likely to report having heard about HPV (adjusted OR 2.55, 95% CI 2.09-3.12), having heard about a vaccine to prevent cervical cancer (adjusted OR 2.53, 95% CI 2.12-3.03), and to think that HPV can cause cervical cancer (adjusted OR 1.71, 95% CI 1.04-2.81).

Conclusions:  The findings are consistent with the notion of a “digital divide” and the knowledge-gap hypothesis.  Disparities in knowledge about HPV and the HPV vaccine were linked with having internet access or not.  Respondents not accessing the internet reported significantly poorer HPV and HPV vaccine knowledge.