Association between Sexual Activity and Human Papillomavirus (HPV) Vaccine Initiation and Completion among College Students

Abstract

HPV vaccination is most effective if received before initiation of sexual activity. Previous studies suggested that young adult women who were not sexually active were not interested in receiving the vaccine because they did not think it was necessary. Whether this misperception is still prevalent today—and also shared by men—is unknown. This study examined whether sexual activity was associated with HPV vaccine uptake (initiation and completion) among university students. A cross-sectional study was conducted between February and May 2021 among students (n = 951) at a public Midwestern University. Sexual activity was categorized as “never” or “ever” had oral and/or vaginal sex. Outcome variables were HPV vaccine initiation, defined as receipt of ≥1 dose, and completion, defined as receipt of ≥3 doses. Multivariable logistic regression models estimated the association between sexual activity and HPV vaccine uptake, adjusting for sociodemographic factors. Approximately 18% of students reported never engaging in sexual activity. Overall, 45.5% initiated the HPV vaccine, and 16.5% completed the vaccine series. After adjusting for covariates, compared to students that reported never engaging in sexual activity, those that had ever engaged in sexual activity were more likely to have initiated the vaccine series (aOR = 2.06, 95% CI: 1.34–3.17); however, no difference was observed for completion. HPV vaccination was low; sexually naïve students were less likely to initiate the HPV vaccine. Since sexually naïve students may benefit from receiving the HPV vaccination, targeted interventions should be implemented towards this population to help increase vaccination rates and prevent HPV-associated diseases.

Vaccine and Non-Vaccine HPV Types Presence in Adolescents with Vertically Acquired HIV Five Years Post Gardasil Quadrivalent Vaccination: The ZIMGARD Cohort

“…In our study, no baseline HPV genotyping was performed. It is well-known that HPV vaccines provide maximum benefit when administered before being sexually active [ 39 , 40 , 41 ]. A USA-based study among a group of women evaluated HPV vaccine protection nine to ten years post vaccination, and showed that VT prevalence decreased by 78% among 20–24 year-olds and 38% among 25–29 year-olds.…”

“…We observed that the age of vaccination was less than the age of self-reported sexual debut, meaning most of the participants were vaccinated before their first sexual encounter. HPV vaccination is most effective if received before sexual activity [ 39 , 40 , 41 ]. It is recommended to vaccinate boys and girls at the ages of 11 or 12 years [ 57 , 58 ].…”

“…Participants in this study were vaccinated at ages of 11 to 13 years. A study on college students between the ages of 18 and 38 also showed that sexually naïve students were more willing to receive the vaccine compared with sexually active ones [ 41 ].…”

“…In our study, no baseline HPV genotyping was performed. It is well-known that HPV vaccines provide maximum benefit when administered before being sexually active [39][40][41].…”

Analysis of Parents’ Attitudes and Knowledge toward Immunization and How These Factors Influence Their Decisions to Vaccinate Their Children against Human Papilloma Virus (HPV)

“…HPV is a sexually transmitted virus (STI), and concerns have been raised that vaccinated girls may perceive HPV immunization with parental consent as an acceptance of initiation at a young age and/or feel encouraged to begin their sexual lives early and engage in risky behaviors-such as not using condoms or frequently changing sexual partners [48][49][50][51][52]. Studies on this topic have found no association of HPV vaccination with earlier sexual activity [49][50][51][52][53]. Some studies have reported results indicating that vaccinated girls began sexual activity later than unvaccinated girls and had a lower tendency to engage in risky behavior, which has been linked no to the vaccines effects but to environmental factors, such as awareness and the socioeconomical status of their families [51,52].…”