human papillomavirus; HPV screening; race/ethnicity; age; women


Community Health | Epidemiology | Health Services Research | Public Health Education and Promotion | Women's Health


Many studies have demonstrated disparities in awareness of and knowledge about human papillomavirus (HPV) among young, immigrant, and minority populations. Yet, there is a lack of existing research that has investigated the role of race/ethnicity and HPV screening, and how it varies by age. The purpose of this study was to evaluate this association using 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. This study included 120,646 women who self-reported information on race/ethnicity, HPV screening, and age. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CIs). A stratified analysis was conducted to determine if age modified the race/ethnicity and HPV screening association. After adjustment, non-Hispanic Black and Multiracial women had statistically significant increased odds of receiving HPV screening as compared to non-Hispanic white women (OR 1.20; 95% CI 1.11, 1.29 and OR 1.58; 95% CI 1.33, 1.88, respectively). There was no association between Hispanic race/ethnicity and HPV screening (OR 1.02; 95% CI 0.95, 1.09). The findings of this study provide evidence that age modifies the association between race/ethnicity and HPV screening. Among the oldest categories of women, non-Hispanic Black, Multiracial, and Hispanic women had increased odds of HPV screening. Conversely, among the youngest categories of women, non-Hispanic Other and Hispanic had decreased odds of HPV screening. Public health interventions and health care providers may need to focus on specific minority subgroups to increase HPV screening in certain sub age categories.


This study protocol was determined to be exempt by UNC Charlotte’s Institutional Review Board. The authors have no known conflicts of interest and the contents of this manuscript have not been published elsewhere. Additionally, all authors have met all criteria for authorship.