Nativity Differences in Behaviors Associated with High-Risk HPV Infection Among Hispanic Women in Houston, Texas, USA

Abstract

While Hispanics in the U.S. are a population with significant within-group heterogeneity, epidemiologic studies often aggregate Hispanics into one homogenous group without considering differences by nativity. The objective of this study is to evaluate nativity differences in the risk behavior profile associated with prevalent high risk human papillomavirus (HR-HPV) among U.S.- and foreign-born Hispanic women. Using a clinical trial dataset, we compare risk behavior and HR-HPV infection patterns among U.S.- and foreign-born participants and assess factors associated with infection in each group. While the prevalence of HR-HPV infection was similar among U.S.- and foreign-born participants, U.S.-born cases had a higher HR-HPV risk profile. The similar prevalence of HR-HPV despite foreign-born women's lower risk profile suggests a role for unmeasured risk factors among foreign-born Hispanics. More importantly, nativity differences in behavioral risk factors associated with HR-HPV suggest the need to further research cervical cancer risk factors among disaggregated Hispanic subgroups.

Racial and ethnic differences in human papillomavirus positivity and risk factors among low-income women in Federally Qualified Health Centers in the United States

“…Our results showed that Mexican-born Hispanics had the lowest HPV positivity and engaged in a fewer number of HPV risk behaviors, including early age at first sexual intercourse, multiple sexual partnerships, and current cigarette smoking, when compared to US-born Hispanics and other racial groups. These findings are consistent with other studies (Escarce et al, 2006; Giuliano et al, 1999; Montealegre et al, 2013), suggesting that Mexican-born Hispanics retain protective factors associated with foreign-born status for health risk behaviors. The protective factors for risk behaviors are likely due to unmeasured factors, such as social norms and cultural characteristics in the country of birth, which have been found to diminish with increased acculturation and time in the US (Escarce et al, 2006; Ward et al, 2010).…”

“…Evidence has shown that the sexual networks of black persons are more racially segregated and have higher rates of concurrent sexual partnerships as well as sexual mixing between high- and low-risk groups, which may facilitate the spread of STI within the community (Adimora and Schoenbach, 2005). Differences in country of birth in HPV infection among Hispanic populations have also been observed due to intragroup heterogeneity related to demographic variables and acculturation; however, epidemiological studies have not produced consistent findings (Giuliano et al, 1999; Montealegre et al, 2013; Ward et al, 2010). …”

Health Disparity among Latina Women: Comparison with Non-Latina Women

“…19 Preventative education included in the health-care plan should be increased and expanded to include males, as risk of cervical cancer is associated with the sexual behavior of males, and condom use is lower among foreign-born Latino males. 20 Cardiovascular and cerebrovascular diseases are other main health issues facing Latinas today. Cardiovascular health disparities in the Latina population exist due to income barriers, language barriers, and health education barriers.…”

“…19 Preventative education included in the health-care plan should be increased and expanded to include males, as risk of cervical cancer is associated with the sexual behavior of males, and condom use is lower among foreign-born Latino males. 20…”