1.9 Does the HPV vaccine lead to more sex in teenagers?

In the chapter introduction, we mentioned that many health professionals advocate vaccinating adolescents against HPV prior to the onset of sexual activity. The two most common forms of the vaccine (Cervarix and Gardasil) have been shown, through a series of long-term studies, to be effective at preventing most types of HPV. However, some parents feel like selecting HPV vaccination for their kids is a way of giving their teenagers “permission” to be sexually active. Is there any evidence that this is the case? Specifically, does receiving the vaccine make an individual more likely to engage in sexual activity, especially at an early age?

Several studies have addressed this question. For example, in 2012, Nicole Liddon and colleagues published “Human Papillomavirus Vaccine and Sexual Behavior Among Adolescent and Young Women” in The American Journal of Preventative Medicine. Read their summary, below, and consider the following questions.

Background: Vaccines to prevent certain types of human papillomavirus (HPV) and associated cancers are recommended for routine use among young women. Nationally representative reports of vaccine uptake have not explored the relationship between HPV vaccine initiation and various sexual behaviors.

Purpose: Explore sexual behavior and demographic correlates of HPV vaccine initiation from a nationally representative survey of adolescent and young adult women.

Methods: In 2007-2008, a total of 1243 girls/women aged 15-24 years responded to questions about receiving HPV vaccine in the National Survey of Family Growth (NSFG). In 2010, demographic and sexual behavior correlates were evaluated in bivariate and multivariate analyses by age.

Results: HPV vaccine initiation was higher among those aged 15-19 years than those aged 20-24 years (30.3% vs 15.9%, p<0.001). No differences existed by race/ethnicity for those aged 15-19 years, but among women aged 20-24 years, non-Hispanic blacks were less likely than non-Hispanic whites to have received the HPV vaccine (AOR=0.15). HPV vaccine initiation was greater for those with insurance regardless of age. HPV vaccination was not associated with being sexually active or number of sex partners at either age. Among sexually active adolescents aged 15-19 years, those who received HPV vaccine were more likely to always wear a condom (AOR=3.0).

Conclusions: This study highlights disparities in HPV vaccine initiation by insurance status among girls/women aged 15-24 years and by race/ethnicity among women aged >19 years. No association was found between HPV vaccination and risky sexual behavior.

-from Liddon NC, Leichliter JS, Markowitz LE. Human papillomavirus vaccine and sexual behavior among adolescent and young women. Am J Prev Med. 2012;42(1):44–52. DOI: 10.1016/j.amepre.2011.09.024

  Check Yourself

Liddon’s studies were followed by similar work refuting the idea that women with HPV vaccine would be more likely to contract other sexually transmitted infections (such as chlamydia or herpes). In fact, a study by Tanya Mather and colleagues found that vaccinated women were more likely to have positive attitudes about safe-sex practices. Thus, the evidence collected thus far seems to discredit the idea that HPV vaccination leads to more sex, or to risky sexual behavior.

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The Evolution and Biology of Sex by Sehoya Cotner and Deena Wassenberg is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.