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Objective To examine facilitators and barriers to HPV vaccine uptake in African-American, Haitian, Latina, and White women ages 18–22 and to determine vaccination completion rates among participants over 5 years. Design Using semi-structured interviews and medical record review, we assessed HPV knowledge and attitudes towards HPV vaccination among young women. We then determined their subsequent HPV vaccination initiation and completion rates. We used constructs from the Health Belief Model and methods based in grounded theory and content analysis to identify attitudes towards HPV vaccination cues to initiate vaccination, perception of HPV, and how communication about issues of sexuality may impact vaccine uptake. Participants We enrolled 132 African-American, Haitian, Latina, and White women aged 18–22 years who visited an urban academic medical center and two affiliated community health centers between the years 2007 and 2012. Main Outcome Measures Intent to vaccinate and actual vaccination rates Results Of 132 participants, 116 (90%) stated that they were somewhat or very likely to accept HPV vaccination if offered by their physician, but only 51% initiated the vaccination over the next 5 years. Seventy-eight percent of those who initiated vaccination completed the 3 doses of the HPV vaccine series. Forty-five percent (45%, n=50) of the adolescents who started the series completed three doses over a five year period: forty-two percent African-American (n=16), thirty-three percent Haitian (n=13), sixty-three percent Latina (n=10), and sixty-five White young women (n=11) completed the three-dose series. Despite low knowledge, they reported high levels of trust in physicians and were willing to vaccinate if recommended by their physicians. Conclusion Desire for HPV vaccination is high among older adolescents, physician recommendation and use of every clinic visit opportunity may improve vaccine uptake in young women. More White young women completed the HPV vaccine series compared with other race and ethnic young women.