{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T09:34:47Z","timestamp":1777023287400,"version":"3.51.4"},"reference-count":64,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Center for Human Papillomavirus Research, Indiana University School of Medicine"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: In the United States, adult human papillomavirus (HPV) vaccination coverage remains low at 20\u201350%, depending on age, and cervical cancer (CC) screening rates range from 68 to 76%. Few studies have evaluated characteristics of women who are both HPV vaccinated and up to date (UTD) with screening as an integrated outcome. The purpose of the present study was to classify women into four prevention categories and examine factors associated with being double protected compared to unprotected. Methods: Data were gathered via an online survey from a sample of low-income women (household income &lt; USD 50,000) provided by a research survey company (n = 719). Women were classified into four categories: vaccinated only, screened only, both vaccinated and screened (double protected), or neither (unprotected). Sociodemographic characteristics, healthcare access, and Health Belief Model constructs were assessed. Multivariable logistic regression compared women who were double protected with those unprotected (n = 274). Results: Most women were UTD with screening only (57.8%), while 15.5% were double protected and 22.6% were unprotected. Younger age (Odds Ratio [OR = 0.93; 95% Confidence Interval [CI]: 0.89, 0.98), having \u22651 medical visit in the past year (OR = 4.16; 95% CI: 1.74, 9.95), higher perceived CC risk (OR = 3.65; 95% CI: 1.41, 9.43), greater perceived benefits of CC screening (OR = 1.96; 95% CI: 1.45, 2.66), and higher HPV knowledge (OR = 1.09; 95% CI: 1.01, 1.17) were associated with higher odds of being double protected. Conclusions: A substantial proportion of low-income women lack comprehensive CC prevention. Integrated, bundled prevention strategies that simultaneously promote HPV vaccination and screening may be important to reduce CC disparities.<\/jats:p>","DOI":"10.3390\/vaccines14030251","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T10:16:12Z","timestamp":1773051372000},"page":"251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Correlates of Integrated Human Papillomavirus Vaccination and Cervical Cancer Screening Protection in U.S. Low-Income Women"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6221-5806","authenticated-orcid":false,"given":"Erika B.","family":"Biederman","sequence":"first","affiliation":[{"name":"Department of Community Health Systems, Indiana University School of Nursing, Indianapolis, IN 46202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6153-0713","authenticated-orcid":false,"given":"Victoria L.","family":"Champion","sequence":"additional","affiliation":[{"name":"Department of Community Health Systems, Indiana University School of Nursing, Indianapolis, IN 46202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine J.","family":"Head","sequence":"additional","affiliation":[{"name":"Department of Communication Studies, Indiana University-Indianapolis, Indianapolis, IN 46202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8883-6659","authenticated-orcid":false,"given":"Teresa M.","family":"Imburgia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indianapolis, IN 46202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3835-937X","authenticated-orcid":false,"given":"Gregory D.","family":"Zimet","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, 1625 Sturbridge Road, Indianapolis, IN 46260, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"ref_1","first-page":"10","article-title":"Cancer statistics, 2025","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1158\/1055-9965.EPI-21-0307","article-title":"Reducing Poverty-Related Disparities in Cervical Cancer: The Role of HPV Vaccination","volume":"30","author":"Spencer","year":"2021","journal-title":"Cancer Epidemiol. Biomark. 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