One More Time, With Feeling: The HPV Vaccine Does Not Encourage Sexual Behavior

Despite a mounting body of evidence to the contrary, there continues to be a fear among adults that vaccinating young people against an STD is akin to giving them a license to have sex. Yet another study promises this isn't going to happen.

Despite overwhelming scientific evidence showing that vaccines are safe and effective, many parents have become skeptical. Vaccines via Shutterstock

The human papillomavirus (HPV) vaccine prevents cancer, and yet it remains controversial. Because HPV is sexually transmitted, and because it is recommended that young people get the vaccine around age 11, some parents remain reluctant to have their children vaccinated. The fear: that giving an 11 year old protection against a sexually transmitted disease (STD) will encourage him or her—though, let’s face it, mostly her—to be sexual active.

Well, once again, a study says this isn’t going to happen.

This most recent study, published online in the March issue of Pediatrics, looks at the perceptions of young people who had received the vaccine. Researchers recruited 329 young women between the ages of 13 and 24, both sexually experienced and not, and asked them two important questions: After receiving the vaccine, do they feel it’s still necessary to practice safer sex, and do they think they’re protected against other STDs? Participants were also asked about their sexual behavior. The survey was repeated two months and then six months after the vaccine was given.

The findings show that immediately after vaccination, the majority of respondents believed it was still important to practice safer sex, and most also understood that the shot only covers HPV and not any of the other STDs that they might be exposed to during unsafe sex. Neither age nor sexual experience were associated with those beliefs.

The participants’ sexual behavior was consistent with their answers. Among those who were sexually active when they got the vaccine, 61 percent said they had used a condom the last time they had sex during the two-month survey, and 62 percent said so during the six-month survey. Moreover, only 20 percent of these young women said they had had more than two partners since the last survey at the two-month mark, and only 34 percent of participants said so at the six-month mark.

The misguided fear about the HPV vaccine is based on the notion that once young people get vaccinated they will perceive themselves as being less at-risk of STDs and therefore have more or riskier sex. The authors’ analysis showed that this was not the case. There was no correlation between perceived risk right after the vaccine and sexual behavior in the next few months for almost every group of girls (when looked at by age or sexual experience). In fact, the only correlation they found is that sexually inexperienced young women ages 16 to 21 who inaccurately believed that they were protected from other STDs because of the vaccine were actually less likely to become sexually active during the six months after they got the vaccine than those who knew the vaccine only protected against HPV. This is the opposite of the expected (or feared) correlation. Jessica Kahn, one of the researchers, told Healthline, “Whatever they believed, those key beliefs around the need for safe sex, and whether they’re protected against other sexually transmitted infections, they were not associated with riskier behaviors.”

This study is far from the first to find that the HPV vaccine does not increase sexual risk behaviors. A January 2012 study sponsored by the Centers for Disease Control and Prevention (CDC) found that the HPV vaccination is not associated with being sexually active or with the number of sex partners young women have had. Moreover, it found that among sexually active adolescents ages 15 to 19, those who have received the HPV vaccine are more likely to always wear a condom.

As Rewire reported in October 2012, another study followed 1,400 girls in Atlanta for three years after they’d received their HPV vaccine; the researchers examined their medical records for markers of sexual risks such as pregnancy tests, contraceptive counseling, or STD diagnoses. They found no differences between girls who got the HPV vaccine and girls who got other vaccines but not the HPV vaccine. One of the authors of the study told NBC News at the time, “We feel this is reassuring. We can start to move beyond these concerns.”

Unfortunately, we do not seem to have moved beyond concerns of promiscuity linked to the HPV vaccine. A study from last spring found that fewer teens were receiving HPV vaccines than other recommended vaccinations and that parents’ reason for not vaccinating their children included “[he/she] is not sexual active” or “[he/she] is not appropriate age.” Other reasons for not vaccinating included a lack of information and safety concerns.

It is clear that we have to do a better job educating parents about the HPV vaccine. We have to reassure them that the vaccine is safe and effective, that it has the potential to prevent cancer, and that there is a growing body of research that shows exposure to the vaccine (and the conversations that often come with it) will not increase the likelihood that their child becomes sexually active or engages is risky sexual behavior.

Put another way: The vaccine will not make young people sexually promiscuous, but it may save their lives.

We also have to remind people that HPV is extremely widespread. According to the CDC, approximately 79 million Americans are currently infected with HPV, and about 14 million people become newly infected each year. Most people who have HPV will have no symptoms or health problems and may never even know they have it. Some people will get genital warts, which may go away on their own or may need to be removed by a health-care provider. And certain strains of the virus, if left untreated, can lead to cervical cancer. Approximately 12,000 women in the United States are diagnosed with cervical cancer each year, and about 4,000 die. HPV can also cause cancer of the penis and anus, and is responsible for a recent increase in cases of head and neck cancers.

HPV is easily spread from infected skin to uninfected skin. Transmission of HPV can be prevented by condoms, but only if the infected skin is in an area covered by the condom. If it is on an area such as a man’s scrotum, condoms cannot help reduce transmission. Of course, transmission can also be prevented by the available vaccines. Gardasil, which was introduced in 2006, provides protection against four common strains of the virus: the two that account for 70 percent of cervical cancers and the two that account for 90 percent of genital warts. A second vaccine, called Cervarix, was approved in 2009 and protects against the two strains that cause cervical cancer.

Research shows the vaccines are working. A 2013 study that looked at the impact of Gardasil found that despite the fact that only half of teen girls had gotten one dose of the vaccine and fewer than a third had gotten the recommended three doses, the proportion of teen girls infected with the strains of HPV that the vaccine addresses has dropped by 56 percent.

Imagine what could happen if more young people got the vaccine—if everyone stopped worrying about raising a generation of promiscuous young people and started working toward a generation without cervical cancer?