Adolescent Perceptions of Risk and Need for Safer Sexual Behaviors After First Human Papillomavirus Vaccination

Mullins, Tanya L. Kowalczyk; Zimet, Gregory D.; Rosenthal, Susan L.; Morrow, Charlene; Ding, Lili; Shew, Marcia L.; Fortenberry, J. Dennis; Bernstein, David I.; Kahn, Jessica A.

doi:10.1001/archpediatrics.2011.186

Cited by 58 publications

(74 citation statements)

References 26 publications

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“…18,20,[22][23][24] In fact, the vaccine has actually been shown to be associated with more responsible and safer sexual behaviors, such as condom use, regular Pap screening and STI testing. 25,26 In line with this, while the majority of parents in our sample who refused the vaccine reported several concerns regarding the effectiveness and safety of the vaccine, no parents reported concerns about the impact of vaccination on riskier or earlier sexual activity. This result highlights that claims made by some parents and/or the media suggesting that HPV vaccination will lead to risk compensation or younger sexual activity may be over exaggerated, and are not necessarily a legitimate post-vaccination concern among parents.…”

Section: Social Norms (N =10)supporting

confidence: 66%

Parents’ decision-making about the human papillomavirus vaccine for their daughters: II. Qualitative results

Krawczyk

Perez

King

et al. 2015

Human Vaccines & Immunotherapeutics

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The goal of the study was to examine the reasons given by parents who accepted or refused the HPV vaccine for their daughters in the context of a free provincial school-based vaccination program. A random sample of parents of 9-10 y old girls completed a mail-in questionnaire. Parents' responses to 2 open-ended questions were assessed using content analysis. Coding themes were derived from the Health Belief Model. 806 parents returned and answered the relevant items. 88% of these parents decided to vaccinate their daughter. The primary reasons for parents' acceptance was the perceived benefits (e.g., health protection, cancer/HPV prevention) and cues to action (e.g., physician recommendation, trusting the school vaccine program). Reasons for parental refusal included barriers (e.g., fear of side effects) and low susceptibility (e.g., their daughter is not at risk). Both groups of parents had unanswered questions, doubts and often inaccurate information. This study provides unique insight into parents' perspectives concerning the decision making process for their daughter. There appears to be a need for accurate and complete information to assure informed HPV vaccine decision-making by parents and to increase HPV vaccine uptake.

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Section: Social Norms (N =10)supporting

confidence: 66%

Parents’ decision-making about the human papillomavirus vaccine for their daughters: II. Qualitative results

Krawczyk

Perez

King

et al. 2015

Human Vaccines & Immunotherapeutics

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show abstract

“…This study provides a clinical validation and extends our understanding of numerous surveys reporting that most young women did not plan to modify their sexual behaviors after HPV vaccination. 15,[19][20][21][22][23][24][25] Although most previous surveys have been cross-sectional, a recent longitudinal survey conducted in the United Kingdom documented no difference in the proportion of women reporting initiation of sexual activity after HPV vaccination 30 ; however, that study was conducted in women aged 16 to 18, of whom 37% had already become sexually active. 30 In our analysis, HPV vaccination at ages 11 through 12 did not increase the likelihood of seeking medical attention for outcomes related to sexual activity with up to 3 years of follow-up.…”

Section: Discussionmentioning

confidence: 94%

“…[13][14][15][16][17][18] Most teenage girls surveyed on knowledge, attitudes, and practices related to HPV vaccination reported they would not modify their sexual behaviors after HPV vaccination. 15,[19][20][21][22][23][24][25] Most of these studies were limited by the use of selfreported, cross-sectional surveys, 15,[19][20][21][22][23][24][25] however, and it is unknown if these survey results would directly translate to clinical outcomes.…”

mentioning

confidence: 99%

Sexual Activity–Related Outcomes After Human Papillomavirus Vaccination of 11- to 12-Year-Olds

Bednarczyk

Davis

Ault³

et al. 2012

Pediatrics

172

106

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WHAT'S KNOWN ON THIS SUBJECT: Concerns persist about sexual disinhibition after human papillomavirus (HPV) vaccination of preteenage girls. Self-reported surveys have indicated few anticipated behavior changes after HPV vaccination. Little is known about sexual activity-related clinical outcomes after HPV vaccination. WHAT THIS STUDY ADDS:Utilizing managed care organization electronic data, we evaluated the incidence of adverse outcomes of sexual activity among vaccinated preteenage girls and found little difference between those who received HPV vaccine and those who did not. abstract OBJECTIVE: Previous surveys on hypothesized sexual activity changes after human papillomavirus (HPV) vaccination may be subject to selfresponse biases. To date, no studies measured clinical markers of sexual activity after HPV vaccination. This study evaluated sexual activity-related clinical outcomes after adolescent vaccination. METHODS:We conducted a retrospective cohort study utilizing longitudinal electronic data from a large managed care organization. Girls enrolled in the managed care organization, aged 11 through 12 years between July 2006 and December 2007, were classified by adolescent vaccine (HPV; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed; quadrivalent meningococcal conjugate) receipt. Outcomes (pregnancy/sexually transmitted infection testing or diagnosis; contraceptive counseling) were assessed through December 31, 2010, providing up to 3 years of follow-up. Incidence rate ratios comparing vaccination categories were estimated with multivariate Poisson regression, adjusting for health care-seeking behavior and demographic characteristics. RESULTS:The cohort included 1398 girls (493 HPV vaccine-exposed; 905 HPV vaccine-unexposed). Risk of the composite outcome (any pregnancy/sexually transmitted infection testing or diagnosis or contraceptive counseling) was not significantly elevated in HPV vaccineexposed girls relative to HPV vaccine-unexposed girls (adjusted incidence rate ratio:

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“…Along this line, another study conducted among 13-26 years old women at a teen health center indicated that condom use with the last sexual intercourse was actually higher in the vaccinee group (Conroy et al, 2009). A recent study conducted among young women aged 13-26 also showed that vaccinees reported continued need for safer sexual behaviors after the vaccination (Kowalczyk Mullins et al, 2012).…”

Section: Sexual Behaviors/practices and Hpv Vaccinationmentioning

confidence: 95%

What college women know, think and do about human papillomavirus (HPV) and HPV vaccine

Ratanasiripong¹

2013

Contraception

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Participants were a convenience sample of college women (n=384) ages 18 to 26 attending a large, public university in Southern California. An electronic self-administered survey was utilized to collect data. The theory of planned behavior provided a framework for understanding the factors associated with vaccine uptake and with post-vaccine sexual behaviors. Results: College women had good HPV/HPV vaccine knowledge. Over 90% of vaccinees and non-vaccinees knew that Pap test is still needed after the vaccination and an HPV vaccine does not protect against all STIs. Both groups also had positive attitudes toward mandatory vaccination. However, knowledge and attitudes toward the vaccine were not directly linked to the outcome predictors-intention to obtain the vaccine and vaccine uptake. While attitude toward getting vaccinated, subjective norms, and perceived behavioral control were correlated with the outcome predictors, subjective norms consistently predicted intention to obtain HPV vaccine and vaccine uptake. There were no significant differences in sexual behaviors (numbers of sexual partners in a life time, numbers of sexual partners in the past 12 months, condom use, condom use frequency) between non-vaccinees and vaccinees. The numbers of sexual partners before and after vaccination among vaccinees were also not significantly different. Conclusions: Strategies to ensure that those who are eligible for catch-up vaccination are vaccinated should include attention to college women's subjective norms. Vaccine mandatory proposal would not be unacceptable to this population and concerns that the HPV vaccine encourages unsafe sexual behaviors and practices among college aged women may be disregarded.

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Adolescent Perceptions of Risk and Need for Safer Sexual Behaviors After First Human Papillomavirus Vaccination

Cited by 58 publications

References 26 publications

Parents’ decision-making about the human papillomavirus vaccine for their daughters: II. Qualitative results

Parents’ decision-making about the human papillomavirus vaccine for their daughters: II. Qualitative results

Sexual Activity–Related Outcomes After Human Papillomavirus Vaccination of 11- to 12-Year-Olds

What college women know, think and do about human papillomavirus (HPV) and HPV vaccine

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