All ETDs from UAB

Advisory Committee Chair

Edmond K Kabagambe

Advisory Committee Members

Gerald McGwin

John Waterbor

Julia Gargano

Elizabeth Unger

Mark Beasley

Document Type

Dissertation

Date of Award

2012

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

Although the literature is quite extensive with regard to the human papillomavirus (HPV) among many racial/ethnic populations, there continues to be a paucity of information regarding the prevalence of HPV types as well as of cervical intraepithelial neoplasia (CIN among Latinas, specifically foreign-born Latinas. Some studies have reported prevalence of HPV among Latinas, but very few have differentiated between US- and foreign-born Latinas. This nuance is essential to understanding the true effect contributed by each group to HPV and CIN incidence and prevalence rates. Therefore, this dissertation aimed to assess differences in the prevalence of high- and low-risk types and CIN (0-3) between US-born Latina (USBL) and foreign-born Latina (FBL) women, with additional comparisons to US-born non-Latina black (NLB) and US-born non- Latina white women (NLW). Cross-sectional data from the Early Detection Network II cohort (2004-2009) was obtained for these analyses. The sample was comprised of a total of 1876 women: 499 FBLs, 378 USBLs, 687 NLB, and 312 NLW women. Women were enrolled in Texas and Michigan. This study showed that the prevalence of HPV vaccine types in FBL was similar to that in USBLs. The similar prevalence of HPV vaccine types between foreign- and USBLs is reassuring for HPV vaccine implementation efforts. FBLs differed from USBLs with regard to CIN stage in analyses after adjustment for age, smoking history, and condom use. Given the known barriers to access to health, this finding is contrary to our expectation and perhaps indicative that a longitudinal study may be more appropriate for elucidating on this question further. Finally, our third study demonstrated that compared to other racial/ethnic groups studied, foreign-born Latinas were more likely to be retained in prospective studies on HPV and CIN. Although these findings are contrary to what we expected given cultural, social and structural barriers unique to FBLs, it gives an opportunity to inform researchers of the feasibility of including FBLs in prospective research studies. Given the paucity of information on the epidemiology of HPV and CIN among foreign-born Latinas this study is useful in improving our understanding of HPV/CIN epidemiology in foreign-born Latinas.

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