Purpose To examine the association between race/ethnicity and HPV vaccine initiation and to determine how access to healthcare influences this relationship. Methods We used nationally representative data from the National Survey of Family Growth to assess HPV vaccine initiation in 2,168 females aged 15–24. A series of regression analyses were performed to determine the independent effect of race/ethnicity on HPV vaccine initiation after controlling for socio-demographic variables and healthcare access measures. Age-stratified regression analyses were also performed to assess whether the relationship between race/ethnicity and HPV vaccine initiation differed between females aged 15–18 and 19–24. Results There were significant racial/ethnic disparities in HPV vaccination with US-born Hispanics, foreign-born Hispanics, and African-Americans less likely to have initiated vaccination than whites (p<0.001). Adjusting for socio-demographic characteristics attenuated the disparity for both US-born and foreign-born Hispanics (adjusted odds ratio (AOR): 0.76; 95% confidence interval (CI): 0.50–1.16 and AOR: 0.67; 95% CI: 0.37–1.19) but not for African-Americans (AOR: 0.47; 95% CI: 0.33–0.66). Adding healthcare access measures further attenuated the disparity for US-born and foreign-born Hispanics (AOR: 0.85; 95% CI: 0.54–1.34 and AOR: 0.84; 95% CI: 0.45–1.55). African-Americans, however, remained less likely than whites to have initiated vaccination (AOR: 0.49; 95% CI: 0.36–0.68). These racial/ethnic trends were similar for females aged 15–18 and 19–24. Conclusions Lower rates of HPV vaccination among African-American females do not appear to be explained by differential access to healthcare. More research is necessary to elucidate factors contributing to HPV vaccination in this population.

Hispanic and black women have significantly lower levels of HPV awareness than white women. Targeted educational efforts will be important to improve HPV awareness and associated preventive health measures to avoid HPV-related morbidity and mortality.

CONTEXT Abortion stigma may cause psychological distress in women who are considering having an abortion or have had one. This phenomenon has been relatively underexplored in low-income women, who may already be at an increased risk for poor abortion-related outcomes because of difficulties accessing timely and safe abortion services. METHODS A qualitative study conducted between 2010 and 2013 used semistructured interviews to explore pregnancy intentions among low-income women recruited from six reproductive health clinics in Western Pennsylvania. Transcripts from interviews with 19 participants who were planning to terminate a pregnancy or had had an abortion in the last two weeks were examined through content analysis to identify the range of attitudes they encountered that could contribute to or reflect abortion stigma, the sources of these attitudes and women’s responses to them. RESULTS Women commonly reported that partners, family members and they themselves held antiabortion attitudes. Such attitudes communicated that abortion is morally reprehensible, a rejection of motherhood, rare and thus potentially deviant, detrimental to future fertility and an irresponsible choice. Women reacted to external and internal negative attitudes by distinguishing themselves from other women who obtain abortions, experiencing negative emotions, and concealing or delaying their abortions. CONCLUSIONS Women’s reactions to antiabortion attitudes may perpetuate abortion stigma. Further research is needed to inform interventions to address abortion stigma and improve women’s abortion experiences.

Extranasal colonization is increasingly recognized as an important reservoir for Staphylococcus aureus among high-risk populations. We conducted a cross-sectional study of multiple body site colonization among 173 randomly selected STD clinic patients in Baltimore, Maryland. Staphylococcal carriage at extranasal sites, including the oropharynx, groin, rectum, and genitals, was common among study subjects. The USA300 clone was particularly associated with multiple sites of colonization compared with non-USA300 strains (p = .01). Given their high burden of multi-site colonization and confluence of established staphylococcal risk factors, STD clinic patients may represent a community-based reservoir for S. aureus and be well suited for innovative infection control initiatives.

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