HPV vaccine coverage and acceptability among a national sample of sexual minority women ages 18–45

Background: Sexual minority women (lesbian, bisexual, and other women who have sex with women) are at risk for human papillomavirus (HPV) infection and HPV-related disease, demonstrating the importance of HPV vaccination for these women. Methods: We conducted an online survey of sexual minority women ages 18–45 from the United States (n = 505) in October 2019, about two months after HPV vaccine recommendations were expanded to include ages 27–45. Multivariable Poisson regression identified correlates of HPV vaccine initiation (i.e., receipt of at least one HPV vaccine dose). Results: Overall, 65% of participants ages 18–26 and 33% of participants ages 27–45 had initiated the HPV vaccine series. Among participants ages 18–26, initiation was more common among those who had received a healthcare provider recommendation (RR = 2.19, 95% CI: 1.64–2.93) or had disclosed their sexual orientation to their primary healthcare provider (RR = 1.33, 95% CI: 1.07–1.65). Among initiators ages 27–45, a large majority (89%) reported receiving their first dose before turning age 27. Initiation was more common among participants ages 27–45 who had received a healthcare provider recommendation (RR = 3.23, 95% CI: 2.31–4.53) or who reported greater perceived social support for HPV vaccination (RR = 1.22, 95% CI: 1.05–1.40). Several reasons for not yet getting HPV vaccine differed by age group (ages 18–26 vs. ages 27–45; all p < 0.05). Conclusions: Many sexual minority women, particularly those ages 27–45, remain unvaccinated against HPV. Findings provide early insight into HPV vaccine coverage among adult women and highlight key leverage points for increasing vaccination among this population.