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Health inequities in human papillomavirus prevention, diagnostics and clinical care in the USA: a scoping review
  1. Kimberly Magana1,
  2. Laura Strand1,
  3. Mitchell Love1,
  4. Ty Moore1,
  5. Andriana Peña1,
  6. Alicia Ito Ford1,2,
  7. Matt Vassar1,2
  1. 1Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
  2. 2Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
  1. Correspondence to Kimberly Magana, Oklahoma State University Center for Health Sciences, Tulsa, OK 74107, USA; kimberlymagana13{at}gmail.com

Abstract

Background Human papillomavirus (HPV) represents the most common STI in the USA. HPV inequities in prevention, diagnostics and clinical care persist. We define inequities as systematic, avoidable and unfair differences in health outcomes.

Objectives The objectives of this scoping review are to chart existing data on HPV-related inequities, identify gaps in existing literature and guide future research to reduce these inequities.

Methods We completed a scoping review following guidelines from the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping reviews extension. We performed a literature search on PubMed and Ovid Embase in July 2022 for articles pertaining to HPV and evaluating populations within the USA. We included English language publications from 2018 to 2022 evaluating at least one health inequity outlined by the National Institutes of Health. General publication characteristics and health inequity data were charted in a masked, duplicate fashion using a pilot-tested Google Form. We analysed frequencies of health inequities and summarised main findings from included studies.

Results Our final sample included 170 publications. The most common inequities examined were race/ethnicity (140 studies), sex or gender (97 studies), and income (69 studies). Many historically marginalised racial/ethnic groups had lower rates of HPV-related knowledge, vaccination and worse overall outcomes related to HPV. Compared with women, men had lower rates of HPV vaccination and provider recommendation, and higher rates of HPV-infection. Results regarding income were largely conflicting.

Conclusion Findings from our review demonstrate clear gaps in HPV-related inequity research. Vaccine completion, provider recommendation and intersectionality should continue to be evaluated to implement targeted interventions.

  • Diagnostic Screening Programs
  • Genital Diseases, Female
  • Genital Diseases, Male
  • Papillomaviridae
  • SEXUAL HEALTH

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Footnotes

  • Handling editor Joseph D Tucker

  • Contributors KM and LS collected, analysed and interpreted data, drafted and revised the manuscript, and gave final approval for the version of the manuscript to be published. ML and TM planned the study, drafted and revised the manuscript, and gave final approval for the version of the manuscript to be published. AP planned the study, drafted and revised the manuscript and gave final approval for the version of the manuscript to be published. AF drafted and revised the manuscript, and gave final approval for the version of the manuscript to be published. MV was the primary investigator, planned the study, drafted and revised the manuscript, and gave final approval of the version of the manuscript to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. MV reports receipt of funding from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the US Office of Research Integrity, Oklahoma Center for Advancement of Science and Technology, and internal grants from Oklahoma State University Center for Health Sciences—all outside of the present work. AIF reports receipt of funding from Center for Integrative Research on Childhood Adversity and internal grants from Oklahoma State University Center for Health Sciences—all outside of the present work. All other authors have nothing to report.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.