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Does HPV Vaccine Legislation Affect Sexual Behavior?
Pediatrics; ePub 2018 Aug 13; Cook, Venkataramani, et al
Implementation of human papillomavirus (HPV) legislation was not associated with changes in adolescent sexual behaviors in the US, a recent study found. Therefore, concern that legislation will increase risky adolescent sexual behaviors should not be used when deciding to pass HPV legislation. Researchers conducted a difference-in-difference study in which they used data on adolescent sexual behaviors from the school-based state Youth Risk Behavior Surveillance System from 2001 to 2015. Sexual behaviors included ever having sexual intercourse in the last 3 months and condom use during last sexual intercourse. They compared changes in sexual behaviors among high school students before and after HPV legislation to changes among high school students in states without legislation. They found:
- A total of 715,338 participants reported ever having sexual intercourse in the last 3 months, and 217,077 sexually active participants reported recent condom use.
- There were no substantive or statistically significant associations between HPV legislation and adolescent sexual behaviors.
- Recent sexual intercourse decreased by 0.90 percentage points, and recent condom use increased by 0.96 percentage points among adolescents in states that enacted legislation compared with states that did not.
Cook EE, Venkataramani AS, Kim JJ, Tamimi RM, Holmes MD. Legislation to increase uptake of HPV vaccination and adolescent sexual behaviors. [Published online ahead of print August 13, 2018]. Pediatrics. doi:10.1542/peds.2018-0458.
HPV vaccination rates remain at <50% for girls and are even lower for boys. Since HPV vaccine prevents a sexually transmitted disease, there has been considerable debate and anxiety among some groups that giving the vaccine to adolescents would encourage sexual activity. Many parents have been reluctant to pursue the vaccine for their adolescent children due to this concern. This large study looked at states that had mandatory HPV vaccination for school entry and those that did not, and found no differences in sexual activity between the groups. This should, therefore, encourage more states to make HPV vaccination mandatory, as this is a proven way to increase vaccination rates.—Sarah Rawstron, MB, BS, FAAP, FIDSA; Pediatric Residency Program Director, The Brooklyn Hospital Center, NY; Clinical Associate Professor, Icahn School of Medicine, Mount Sinai, NY.