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Role of Race/Ethnicity, Language, and Insurance in Use of Cervical Cancer Prevention Services Among Low-Income Hispanic Women, 2009–2013
ORIGINAL RESEARCH — Volume 15 — February 22, 2018
PEER REVIEWED
Both uninsured Hispanic women and non-Hispanic white women had lower odds of receiving at least 1 HPV vaccine dose than insured non-Hispanic white women (Hispanic women, OR: 0.31; 95% CI, 0.17–0.55; and non-Hispanic white women: OR, 0.24; 95% CI, 0.12–0.48). Insured Hispanic women barely differed from insured non-Hispanic white women in receiving at least 1 HPV vaccine dose (OR, 0.7; 95% CI, 0.5–0.99). Uninsured and insured Hispanic women had higher odds of completing an HPV vaccine regimen than insured non-Hispanic white women (uninsured, OR: 2.7; 95% CI, 0.8–8.7; insured: OR, 1.8; 95% CI, 0.9–3.6). Uninsured non-Hispanic white women had lower odds of completing an HPV regimen (OR, 0.7; 95% CI, 0.2–3.6). None of the differences for completing an HPV vaccine regimen was significant.
Figure.
Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of receiving at least 1 dose of human papillomavirus (HPV) vaccine compared with adjusted odds ratio of completing an HPV vaccine series among women aged 21 to 29 years, by race/ethnicity and insurance status, Oregon, 2009–2013. Multivariable logistic regression was used to estimate odds of receiving at least 1 HPV vaccine dose, by race/ethnicity and insurance status relative to insured non-Hispanic white women (x-axis; n = 6,346). Then, among those who initiated an HPV regimen, we performed another multivariable logistic regression to estimate odds of completing a HPV regimen by race/ethnicity and insurance status relative to insured non-Hispanic white women (y-axis; n = 268). Both models adjusted for pregnancy and number of health center visits (1, 2–5, >5) during the study period. For both models, we estimated 95% confidence intervals using robust Huber–White sandwich estimators of the standard error to account for clustering of patients within home clinic (the community health center that the patient visited most often). Abbreviation: NHW, non-Hispanic white.
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