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ORIGINAL RESEARCH article

Front. Public Health

Sec. Infectious Diseases: Epidemiology and Prevention

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1604954

Nativity and racial/ethnic differences in HPV infection among U.S. adults, NHANES 2007-2016

Provisionally accepted
Leslie  CofieLeslie Cofie1*Lei  XuLei Xu2Breanna  AlligoodBreanna Alligood3Nikhil  BhagatNikhil Bhagat4Sarah  ManessSarah Maness1Mi Hwa  LeeMi Hwa Lee5Alice  RichmanAlice Richman1
  • 1Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, United States
  • 2East Carolina University, Greenville, United States
  • 3Weill Cornell Medicine, Cornell University, New York, New York, United States
  • 4Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States
  • 5School of Social Work, East Carolina University, Greenville, United States

The final, formatted version of the article will be published soon.

Although Human Papillomavirus (HPV) is the most common sexually transmitted infection globally, data on the rate of infection among immigrant populations in the U.S. is limited This study examined changes in HPV infection prevalence overtime by foreign-born status, sex, and race/ethnicity, as well as race/ethnic differences in HPV infection among foreign-born individuals. The 2007-2016 National Health and Nutrition Examination Survey (NHANES) data on adults, 18-34 years (N=4,523) were analyzed. The outcome measures included any HPV infection and vaccine-type infection. Independent measures were foreign-birth status, sex and race/ethnicity. Differences in HPV infection prevalence were assessed using chi-square test, and multivariate binary logistic regression analyses were used to examine the relationship between race/ethnicity and HPV infection among foreign-born individuals. Overall prevalence of any HPV infection was 43% and vaccine-type HPV infection was 8%. Foreign-born individuals had significantly lower HPV infection, vaccine-type infection, and vaccination initiation rates compared to US-born adults (p < .001). Among foreign-born adults, the odds of HPV infection were higher for Black individuals compared to White individuals (aOR = 3.38; 95% CI: 1.3-8.6), after adjusting for survey cycle, sociodemographic covariates and sexual partners; and also higher among Hispanic females (aOR = 2.99; 95% CI: 1.26-7.11) and Black females (aOR = 5.27; 95% CI: 1.51-18.41) compared to White females. No significant associations were observed among foreign-born males. The implementation of public health measures to increase vaccination rates, which can effectively prevent HPV infections, should target foreign-born Black and Hispanic adults.

Keywords: HPV infection1, HPV vaccination2, Foreign-born individuals3, Race/ethnicity4, National Health Surveillance5

Received: 02 Apr 2025; Accepted: 20 Aug 2025.

Copyright: © 2025 Cofie, Xu, Alligood, Bhagat, Maness, Lee and Richman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Leslie Cofie, Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, 27858-4353, North Carolina, United States

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