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HPV vaccination not tied to risky sexual behavior
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Risk perceptions after HPV vaccination do not appear to lead to the initiation of sex or risky sexual behaviors among adolescent girls and young women, researchers found.
“As clinicians, we understand that there are many key factors driving adolescent decisions about sexual behaviors (individual, contextual, societal) that are overwhelmingly more influential than receiving a vaccine,” Jessica Kahn, MD, a physician in the division of adolescent medicine at Cincinnati Children’s Hospital, told Infectious Disease News. “However, some parents do express concern about the behavioral impact of HPV vaccination, and we can now reassure those parents that several studies have shown no adverse impact at all on sexual behaviors.”
Jessica Kahn
Kahn and colleagues surveyed 339 sexually experienced and inexperienced female adolescents and young adults aged 13 to 21 years following their HPV vaccination. Participants completed questionnaires immediately after vaccination and again at 2 and 6 months. The questionnaires assessed demographic information; knowledge and attitudes about the HPV vaccine and infection; risk perceptions, or beliefs about the risk for acquiring STIs other than HPV and beliefs about the need for safer sexual behaviors after vaccination; and sexual behavior.
According to Kahn, most girls held appropriate risk perceptions (ie, HPV vaccination did not protect against STIs other than HPV and that there was still a need for safer sexual behaviors after vaccination).
Results indicated that among all sexually inexperienced participants (42.5%), perceptions of the risk for acquiring an STI other than HPV and beliefs about the need for safer sexual behaviors after HPV vaccination were not associated with initiating sex. Among a subset of sexually inexperienced females aged 16 to 21 years, those who were under the erroneous impression that there was less risk for acquiring other STIs as a result of getting vaccinated for HPV were actually less likely to initiate sex (OR=0.13; 95% CI, 0.03-0.69).
Moreover, there was no association between baseline risk perceptions and the number of sexual partners or condom use among sexually experienced girls (57.5%). Most sexually experienced girls reported using a condom during their last sexual encounter at 2 (61.8%) and 6 months (62.7%) after HPV vaccination, and a minority of these girls reported two or more sexual partners since their last follow-up (21.8% at 2 months and 34.8% at 6 months).
“Our study also demonstrates that most young women do have appropriate risk perceptions after vaccination; they believe that safer sexual behaviors are still important after vaccination and that HPV vaccination does not protect against other STIs,” Kahn said. “Hopefully this information will help clinicians make stronger recommendations for HPV vaccination, which will be essential to improve vaccination rates.” – John Schoen
Jessica Kahn, MD, can be reached at jessica.kahn@cchmc.org.
Disclosure: Kahn chaired a grant review committee for the Society for Adolescent Health and Medicine evaluating project proposals to improve adolescent vaccination; Merck provided grant funding for this program. The other researchers report no relevant financial disclosures.
Perspective
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Rachel Caskey, MD, MaPP, FAAP, FACP
Unfortunately, concerns regarding HPV vaccination leading to riskier sexual activity among adolescents continue despite a growing body of literature disproving this notion. This study measured perceived risk for acquiring a non-HPV sexually transmitted infection (STI) among girls and young women over a 6-month period after HPV vaccination. The authors found no association between risk perceptions and sexual initiation or sexual behaviors. In other words: vaccinating a girl against HPV does not make her think she is protected from STIs, does not promote sexual activity, but does protect her from a future HPV-related cancer.
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