Rural U.S. populations experience high rates of cancers related to HPV, including cervical, oropharyngeal, and anal cancer (three of the six types of cancer caused by HPV). There is a persistent geographic disparity in HPV vaccination, with rural areas having among the lowest vaccination rates in the country. Increasing the uptake of the HPV vaccine in rural areas is an urgent public health priority.

The stigma around HPV infection is widespread and serves as a barrier to the uptake of HPV vaccination across a variety of populations. Stigma impacts health-seeking behaviors through pathways such as fear of disclosure and discrimination, which can lead to avoidance and underutilization of health services. HPV-related stigma stems partly from early vaccine messages focused on HPV as a sexually transmitted infection. Negative stereotypes surrounding HPV infection, prejudice, and discrimination are common drivers of HPV-related stigma and contribute to negative attitudes toward the vaccine. These include parental fears that HPV vaccination will increase early sexual activity and promiscuity among vaccinated adolescents.

Stigma is correlated with low levels of knowledge regarding the risks associated with HPV infection. Similarly, a lack of knowledge regarding the vaccine’s benefits is correlated with low vaccine acceptance. Increasing knowledge and revising messaging around HPV infection are promising ways to decrease the stigma surrounding HPV and increase vaccine acceptability. For example, social media platforms can raise awareness and knowledge around the HPV vaccine, and targeted messaging can emphasize cancer prevention rather than sexual transmission, routinize the vaccine for all adolescents, and highlight the risks of HPV infection.

Addressing HPV-related stigma is critical to overcoming vaccine hesitancy and increasing vaccine uptake to reduce the unacceptably high rates of HPV-related cancer in rural U.S. populations.

We invite guest contributors to share information on how they are working to improve HPV vaccination in rural areas. If you are interested in contributing or learning more about our efforts to improve HPV vaccination within rural communities, please email us at PreventHPV@stjude.org

Caryn Peterson, PhD is a Research Assistant Professor of Epidemiology in the Division of Epidemiology & Biostatistics at the School of Public Health, University of Illinois Chicago (UIC). Her work has demonstrated the effects of individual- and community-level socioeconomic variables on ovarian cancer survival, differences in socio-cultural and behavioral characteristics and barriers to receiving care, and the increased risk of HPV-positive head and neck squamous cell carcinomas associated with higher area-level socioeconomic status. Dr. Peterson’s current work explores clinical and community-based solutions to improve HPV vaccination and cervical cancer screening rates in the U.S. and French West Africa.