Racial/Ethnic Differences in HPV Prevalence, Risk Factors, and Knowledge Among Patients in Federally Qualified Health Centers (FQHCs)

Background: Little is known about differences in human papillomavirus (HPV) positivity by race/ethnicity. Nearly all cervical cancers are causally related to infection with HPV. Risk factors for acquisition and persistence of HPV infection include early age at first sexual intercourse, number of lifetime sexual partners, history of sexually transmitted diseases (STDs), and smoking. This study assessed racial/ethnic differences in the prevalence of HPV infection, risk factors, and HPV knowledge among underserved women in Federally Qualified Health Centers (FQHCs).

Methods: Data were collected from 984 low income women aged 30 - 60 years across Illinois from 2009 to 2011. Participants completed a baseline survey assessing demographics, risk factors, and HPV knowledge. HPV test results were also collected after routine screening. Age-adjusted logistic regression and linear regression were used to examine the association of race/ethnicity with HPV prevalence, risk factors, and HPV knowledge.

Results: The sample consisted of 384 (39.0%) white, 312 (31.7%) Hispanic, and 254 (25.8%) black women. Hispanic women had a significantly lower prevalence of HPV infection (4.2%) than white (9.1%) or black women (8.7%) (p<0.05). Hispanic women were also less likely to report risky behaviors (first sexual intercourse before age 15, multiple sexual partners in lifetime, history of STDs, and smoking cigarettes) than white and black women. White and black women were more likely to report three or more risk factors for contracting HPV compared to Hispanic women; however, Hispanic women had lower levels of HPV knowledge than white and black women.

Conclusions: As compared to white and black women, Hispanic women had the lowest levels of HPV prevalence, risk factors, and knowledge in this underserved population in Illinois. In this population of women with similar socioeconomic characteristics, there is still variability across subgroups suggesting that a more personalized approach to education and clinical care may be warranted.