Human papillomavirus vaccine-related risk perceptions and subsequent sexual behaviors and sexually transmitted infections among vaccinated adolescent women |
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| Affiliation: | 1. Division of Adolescent and Transition Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave MLC 4000, Cincinnati, OH 45229, USA;2. University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH 45267, USA;3. Division of Adolescent Medicine, Indiana University, 410 West 10th Street, HS 1001, Indianapolis, IN 46202, USA;4. Departments of Pediatrics and Psychiatry, Columbia University and New York Presbyterian Morgan Stanley Children’s Hospital, 622 West 168 Street, Vanderbilt Clinic 4th Floor – Room 402, New York, NY 10032, USA;5. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave MLC 5041, Cincinnati, OH 45229, USA;1. Department of Health Administration and Policy, George Mason University, 4400 University Drive, Fairfax, VA 22030, United States;2. Department of Global and Community Health, George Mason University, 4400 University Drive, Fairfax, VA 22030, United States;3. Department of Public Policy, University of North Carolina, Chapel Hill, 103 Abernethy Hall, Chapel Hill, NC 27599-3435, United States;1. Field Epidemiology Training Program (FETP), National Institute of Infectious Diseases, Tokyo, Japan;2. Department of Epidemiology for Infectious Diseases, Osaka University, Graduate School of Medicine, Japan;3. Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan;4. Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan;1. Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands;2. The Great Influenza Survey/Science in Action BV, PO Box 1786, 1000 BT Amsterdam, The Netherlands;1. Mayo Clinic Vaccine Research Group, Mayo Clinic, Rochester, MN 55905, USA;2. Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, MN 55905, USA |
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| Abstract: | ObjectiveTo examine the association between risk perceptions after human papillomavirus (HPV) vaccination and sexual behaviors and sexually transmitted infection (STI) diagnosis over 30 months following vaccination.MethodsParticipants included 112 sexually experienced girls aged 13–21 years who were enrolled at the time of first HPV vaccination and completed ⩾2 of 4 follow-up visits at 2, 6, 18, 30 months and including 30 months. At each visit, participants completed surveys assessing risk perceptions (perceived need for safer sexual behaviors, perceived risk of STIs other than HPV) and sexual behaviors. STI testing was done at 6, 18, and 30 months. Outcomes were condom use at last intercourse with main male partner, number of sexual partners since last study visit, and STI diagnosis. Associations between risk perceptions and sexual behaviors/STIs were examined using generalized linear mixed models.ResultsMean age was 17.9 years; 88% were Black; 49% had a history of STI at baseline. Scale scores for perceived need for safer sexual behaviors did not change significantly over time. Scale scores for perceived risk of STIs other than HPV significantly changed (p = 0.027), indicating that girls perceived themselves to be more at risk of STIs other than HPV over 30 months following vaccination. Multivariable models demonstrated that greater perceived need for safer sexual behaviors following vaccination was associated with condom use (p = 0.002) but not with number of partners or STI diagnosis. Perceived risk of STIs other than HPV was not associated with the three outcomes.ConclusionsThe finding that perceived risk for STIs other than HPV was not associated with subsequent sexual behaviors or STI diagnosis is reassuring. The association between perceived need for safer sexual behaviors and subsequent condom use suggests that the HPV vaccination visit is an important opportunity to reiterate the importance of safer sexual behaviors to sexually experienced girls. |
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| Keywords: | Papillomavirus vaccines Adolescent Sexual behavior Longitudinal study Survey study Sexually transmitted infections (STIs) |
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