Nativity and racial/ethnic differences in HPV infection among U.S. adults, NHANES 2007-2016

Although Human Papillomavirus (HPV) is the most common sexually transmitted infection globally, data on the rate of infection among immigrant populations in the U.S. is limited This study examined changes in HPV infection prevalence overtime by foreign-born status, sex, and race/ethnicity, as well as race/ethnic differences in HPV infection among foreign-born individuals.

The 2007-2016 National Health and Nutrition Examination Survey (NHANES) data on adults, 18-34 years (N = 4,523) were analyzed. The outcome measures included any HPV infection and vaccine-type infection. Independent measures were foreign-birth status, sex, and race/ethnicity. Differences in HPV infection prevalence were assessed using chi-square test, and multivariate binary logistic regression analyses were used to examine the relationship between race/ethnicity and HPV infection among foreign-born individuals.

Overall prevalence of any HPV infection was 43% and vaccine-type HPV infection was 8%. Foreign-born individuals had significantly lower HPV infection, vaccine-type infection, and vaccination initiation rates compared to US-born adults (p < 0.001). Among foreign-born adults, the odds of HPV infection were higher for Black individuals compared to White individuals (aOR = 3.38; 95% CI: 1.3-8.6), after adjusting for survey cycle, sociodemographic covariates and sexual partners; and also higher among Hispanic females (aOR = 2.99; 95% CI: 1.26-7.11) and Black females (aOR = 5.27; 95% CI: 1.51-18.41) compared to White females. No significant associations were observed among foreign-born males.

The implementation of public health measures to increase vaccination rates, which can effectively prevent HPV infections, should target foreign-born Black and Hispanic adults.