背景:超过60%的美国成年人报告不良的童年经历(ACE),这与危险的健康行为和医疗保健预防措施的低利用率相关,在以后的生活中可能导致慢性疾病。
目的:本研究调查了美国全国成人样本中ACEs与人乳头瘤病毒(HPV)疫苗接种之间的关系。
方法:我们使用了2019年收集的疾病控制和预防中心行为危险因素监测系统中选定州的数据(密西西比州,南卡罗来纳州,和田纳西州),2020(格鲁吉亚,密西西比州,北达科他州,南卡罗来纳州),2021年(密西西比州),和2022(阿肯色州)(N分别为3578、4392、904和810)。
方法:我们进行了描述性的,单变量,并使用SAS9.4进行多元回归分析。独立和因变量是ACE和HPV疫苗接种,分别。
结果:具有≥4个ACE的个人,与没有ACE相比,在2019年,2020年和2021年报告HPV疫苗接种的可能性显着增加(OR分别为1.40、1.77、2.80,所有p<0.05),2022年除外(OR=1.54,p=0.165)。2019年,特定的ACE类型,情感虐待,家庭精神疾病与HPV疫苗接种有关,而在2021年,情感虐待,家庭精神疾病,被监禁的家庭成员,和家庭中的药物滥用,2022年,情绪虐待与HPV疫苗接种相关.
结论:我们发现ACE与HPV疫苗接种之间大多呈正相关,特别是在最初的三年。然而,2022年的调查结果并不重要,除了情感虐待。观察到ACEs与HPV疫苗接种之间关系的不同模式,强调ACEs和HPV疫苗接种数据收集需要一致性,包括疫苗接种时间,更好地了解这些人群中预防HPV相关癌症的潜在机制和干预计划。
BACKGROUND: Over 60 % of U.S. adults report adverse childhood experience (ACE), which correlate with risky health behaviors and lower utilization of healthcare preventive measures, potentially leading to chronic diseases in later life.
OBJECTIVE: This study investigates the relationship between ACEs and human papillomavirus (HPV) vaccination in a national U.S. adult sample.
METHODS: We used data from selected states from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System collected in years 2019 (Mississippi, South Carolina, and Tennessee), 2020 (Georgia, Mississippi, North Dakota, South Carolina), 2021 (Mississippi), and 2022 (Arkansas) (N = 3578, 4392, 904, and 810, respectively).
METHODS: We conducted descriptive, univariate, and multivariable regression analysis using SAS 9.4. Independent and dependent variables were ACEs and HPV vaccination, respectively.
RESULTS: Individuals with ≥4 ACEs, versus no ACEs, were significantly more likely to report HPV vaccination in 2019, 2020, and 2021 (OR = 1.40, 1.77, 2.80, all p < 0.05 respectively), except in 2022 (OR = 1.54, p = 0.165). In 2019, specific ACE types, emotional abuse, and household mental illness were associated with HPV vaccination, whereas in 2021, emotional abuse, household mental illness, incarcerated household member, and substance abuse in household, and in 2022, emotional abuse was associated with HPV vaccination.
CONCLUSIONS: We found mostly positive association between ACEs and HPV vaccination, particularly in initial three years. However, findings in 2022 were not significant, except for emotional abuse. Diverse patterns in relationship between ACEs and HPV vaccination was observed overtime, highlighting the need for consistency in ACEs and HPV vaccination data collection, including vaccination timing, to better understand the underlying mechanisms and plan for interventions to prevent HPV-related cancers among these populations.