Factors Associated with HPV Vaccine Adherence among Latino/a Adolescents in a Rural, Texas-Mexico Border County

Abstract

Objective: Completion of human papil­lomavirus (HPV) vaccine series among Texas Hispanic adolescents is low compared to national data. We examined the associa­tion between HPV vaccine initiation and completion among Hispanic adolescents in a rural, Texas-Mexico border county and specific individual and neighborhood-level characteristics.Design: Cross-sectional analysis of data from a broader cancer prevention program.Setting: Underserved colonias communities in a Texas-Mexico border county.Participants: Hispanic mothers or caregiv­ers (n=712) and adolescents aged 11-17 years (n=1120) linked to publicly available data about their neighborhood.Methods: Logit and multi-level mixed-effects logistic regression of individual- and neighborhood-level data.Main Outcome Measures: HPV vaccine adherence (ie, initiation and completion) as reported in either the Texas Immunization Registry or adolescents’ electronic medical records, measured at the end of the cancer prevention program.Results: Factors associated with HPV vac­cine initiation and completion were female gender (P<.01), adolescent insurance status (P<.001), and receipt of required vaccines (P<.001). After controlling for neighbor­hood-level characteristics, only receipt of required vaccines remained significant (P<.001).Conclusions: Findings indicate a relation­ship between Hispanic adolescents’ receiv­ing the required vaccine series for school admission and HPV vaccine initiation and completion. In resource-limited settings like federally qualified health centers, further efforts should focus on implementing best practices at both the provider level (eg, education on bundled vaccine recommen­dation) and practice-level (eg, outreach and support by trained immunization navigators). Ethn Dis. 2022;32(4):275-284; doi:10.18865/ed.32.4.275