STI Vaccination: What Do Adult Women Want?

Background: As US licensure of HPV vaccine for women over 26 years of age is under consideration, it is important to understand preferences regarding HPV/STI vaccination.

Objectives: To identify vaccination preferences of adult women.

Methods: Mothers accompanying adolescents to medical appointments completed surveys. 9 items assessed vaccine acceptability. Each described a unique scenario defined in terms of four dimensions: mode of transmission (STI; non-STI), vaccine efficacy (50%; 70%, 90%), infection severity (acute, chronic, fatal), and availability of behavioral prevention (yes/no). Each vaccine was rated on a 0-100 scale. Conjoint analysis generated part-worth utilities (PWUs), which reflected relative preferences across dimensions.

Results: Respondents were 258 women of diverse racial/ethnic background, ages 27-55 (M=39). The highest rated vaccine (M=86) was: non-STI; 90% efficacious; prevents fatal infection; no behavioral means of prevention. The lowest rated vaccine (M=74) was: non-STI vaccine; 50% efficacious; prevents chronic infection; behavioral prevention available. Severity of infection strongly contributed to ratings with a relative preference for a vaccine that prevents fatal infection (PWU=6.5) compared to one that prevents chronic (PWU=-2.4) or acute infection (PWU=-4.0). Efficacy also strongly influenced ratings with a relative preference for a 90% efficacious vaccine (PWU=3.9) compared to a 70% (PWU=.2) or 50% (PWU=-4.1) efficacious vaccine. Availability of behavioral protection and mode of transmission had minimal effects on ratings.

Conclusions: These results suggest that many adult women are interested in vaccination and do not distinguish between STI and non-STI vaccines. Prevention of a potentially fatal infection, like HPV, and high vaccine efficacy were the main drivers of preference ratings.

Implications for Programs, Policy, and/or Research: This research suggests that HPV vaccination should be highly acceptable to many adult women. Further, it indicates that information emphasizing the high efficacy of HPV vaccines and the morbidity/mortality associated with HPV infection may encourage adult women to get vaccinated.