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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Presentation 5 - Head and Neck Surgery

HPV Vaccination and Sexual Behaviors Among Middle-Aged US Adults

Monday, October 13, 2025
1:36 PM - 1:42 PM EDT
Location: 127
Disclosure(s):
Albert Y. Li:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Given the expansion of HPV vaccination to adults aged 27-45 and the continued rising incidence of HPV+ oropharyngeal cancer, this study seeks to elucidate the relationship between middle-aged adults, sexual behaviors, and HPV vaccination status.

Methods: Data from 2022-2023 National Survey of Family Growth – a cross-sectional CDC survey – was utilized. Adults aged 27-45 were included. Primary outcome was self-reported HPV vaccination status. Vaccination rates, timing, and cohort characteristics were described. Multivariable logistic regression was utilized to assess factors associated with any vaccination and vaccination after age 26. Survey weighting was utilized for all analyses.

Results: Among a cohort of 6,014 individuals aged 27-45 (weighted n=82,803,050), 21.2% [95% CI: 19.4-23.1] were vaccinated. Among vaccinated individuals in this group, 14.1% [95% CI: 11.9-16.6%] received vaccination after age 26. Among those with multiple sexual partners in the past year, 75.6% [95% CI: 70.2-80.3%] were unvaccinated, representing approximately 5,465,000 individuals. Upon multivariable logistic regression of factors associated with HPV vaccination, factors most strongly associated with vaccination included female gender (OR: 4.21 [95% CI: 3.48-5.09]), higher than undergraduate education (OR: 2.70 [95% CI: 1.69-4.30]), and annual income above $100,000 (OR: 1.54 [95% CI: 1.03-2.30]). Factors most strongly associated with new vaccination after age 26 included greater than undergraduate education (OR: 3.36 [95% CI: 1.77-6.35]), female gender (OR: 2.15 [95% CI: 1.42-3.23]), and being unmarried but cohabitating (OR: 2.07 [95% CI: 1.33-3.22]). Having multiple sexual partners in the past year was also associated with new HPV vaccination after age 26 (OR: 1.91 [95% CI: 1.07-3.41]), though not as strongly as other factors.

Conclusions: Despite risk of new exposure to HPV being the primary indication for vaccination among individuals aged 27-45, several other factors were more strongly correlated with new vaccination. This suggests a need for improved publicity and adherence to HPV vaccination guidelines.

    Presenting Author(s)

  • Albert Y. Li

    Medical Student
    Keck School of Medicine of USC
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Tyler J. Gallagher, MD MPH

    Resident Physician
    Caruso Department of Otolaryngology-Head and Neck Surgery, University of Southern California
    Monterey Park, CA, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • DK

    Daniel I. Kwon, MD

    Associate Professor of Head and Neck Surgery
    University of Southern California
    Los Angeles, California, United States

    Disclosure information not submitted.