African American women are less likely to receive the HPV vaccine, which reduces the risk of cervical cancer, than white women even though they have the same access to health care, a new study from the University of Pittsburgh School of Medicine shows. Published in the Journal of Adolescent Health, the findings suggest a need for health care providers to increase HPV vaccine recommendations and address the negative attitudes toward the vaccine in this vulnerable population of patients.

HPV is a sexually transmitted infection that contributes to almost all cervical cancer diagnoses. According to the Centers for Disease Control and Prevention, about 12,000 cases of HPV associated cervical cancer are diagnosed every year in the United States. In the past decade, two HPV vaccines have been made available to adolescents and young adults between the ages of 11 and 26 to reduce infection risk. The vaccine is given in a three-step process and costs around $400 without insurance coverage.

“The HPV vaccine is a first line of defense to protect against cervical cancer,” said Sonya Borrero, M.D., M.S., assistant professor of medicine, Pitt School of Medicine, and senior author of the study. “Given that cervical cancer is more common and associated with higher mortality in African-American and Hispanic women than in white women, it is especially important to understand the barriers to HPV vaccination for these populations.”

Researchers used data from the National Survey of Family Growth (2006-2010) to examine the effect of race and ethnicity on HPV vaccine initiation in adolescent girls and young women to determine if health care access influenced the relationship.

“Our findings in African-Americans suggest that there are other unmeasured patient- or provider-level factors contributing to under-vaccination and that alternate strategies need to be identified to increase HPV vaccination among African-Americans,” said Dr. Borrero.

Even though data was limited, a negative attitude toward the vaccine could be one of the critical barriers. Also, African Americans are less likely to receive recommendation for the vaccine from their health care providers.

“Further efforts are needed to understand how to overcome the patient-, parent- and provider-level barriers that hamper widespread uptake for this effective and safe vaccine,” Dr. Borrero added.

Past studies have shown higher rates of vaccine initiation among adolescents from racial and ethnic minorities, noted Dr. Borrero, but this could be a result of differences in survey methods or reflect changes in HPV vaccination patterns over time.