Changing HPV vaccination rates in bisexual and lesbian women
Historically, a mistaken belief within the lesbian community was that they were at lower risk for human papillomavirus (HPV) transmission and associated cancers resulting in preventable disease and lower rates of HPV vaccination (Waterman & Voss, 2015). This mistaken belief may contribute to the higher rates of HPV infection in lesbian and bisexuals compared to heterosexual women (Reiter & McRee, 2017). Additionally, members of the lesbian and bisexual community have been reluctant to share their sexual orientation with healthcare providers (Munson & Cook, 2016). In response to these concerns, and HPV vaccination rates below national targets in the general population, provider‐based educational programs and public health efforts to increase the rates of HPV vaccination were undertaken. These efforts demonstrated increases in many state‐level vaccination rates but were less effective in lesbian and bisexual women when compared to heterosexual women (McRee, Gilkey, & Dempsey, 2014a). More recent reports note vaccination rates have remained below target rates (Printz, 2015). Additionally, reports of vaccination rates that have included sexual orientation status, included females as young as 15 years of age, who received, refused, or were not offered the HPV vaccine (Agénor et al., 2015). Reports which include adolescents may be confounded by parental involvement. Parental involvement in the vaccination process in preteen and the younger adolescent female may obscure the relationship between sexual orientation and vaccination acceptance.
To address the gap in our knowledge about the relationship between sexual orientation and HPV vaccination acceptance, this study characterized current rates of HPV vaccination uptake in lesbian, bisexual, and heterosexual women. The overarching aim of this study was to characterize at‐risk groups to support nurse practitioner (NP) vaccination efforts as they are a critical component of decreasing morbidity and mortality associated with HPV in sexual minority women and providing vaccinations.