Cervical Cancer Prevention Services at College Health Centers: Historically Black Colleges and Universities (HBCUs) Compared to Predominantly White Institutions (PWIs)

Abstract

Abstract Cervical cancer (CC) incidence and mortality rates are increased among African American women. We sought to examine the availability of CC prevention services, such as the HPV vaccine and Pap tests, at college health centers among Historically Black Colleges and Universities (HBCUs) compared to Predominantly White Institutions (PWIs). Methods: We analyzed data from a sample of colleges and universities identified using the National Center for Education Statistics' College Navigator tool. Identified HBCUs were matched with a randomly selected four year PWI within the same state, resulting in an analytic sample of 162 colleges and universities. We collected data on health services and institutional characteristics via the institutions' websites, the College Navigator Tool, and by telephone interviews with health centers. We examined whether institutions provided HPV vaccine or Pap tests to students and identified correlates of each using logistic regression. Results: A total of 131 (81%) colleges and universities had operating health centers, of which 121 (92%) were successfully contacted via telephone. HBCUs were less likely than PWIs to offer the HPV vaccine (21% vs.46%; p-value < 0.05) or Pap tests (49% vs. 67%; p-value <0.05). However, in multivariate logistic regression models, the difference was no longer statistically significant. Significant variables were setting (non- rural vs. rural) and enrollment size. Institutions in a non-rural setting (OR = 4.42; 95% CI, 1.01–19.42) were more likely to offer the HPV vaccine, and institutions with higher enrollments (per every 1,000 increase) were more likely to offer the HPV vaccine (OR = 1.24; 95% CI, 1.10–1.39) or Pap tests (OR = 1.18; 95% CI, 1.0–1.39) to students. Conclusion: Many colleges and universities are not offering the HPV vaccine or Pap tests to students. Student enrollment size and non-rural setting of the institution are important determinants of whether a college or university offers CC prevention services. Given that HBCUs support a large concentration of minority students who are at risk of cervical cancer, a greater effort should be employed at these smaller institutions to increase the availability of CC prevention services.