No evidence that HPV vaccination leads to sexual risk compensation

Hansen, Bo T.

doi:10.1080/21645515.2016.1158367

Cited by 10 publications

(7 citation statements)

References 26 publications

(19 reference statements)

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“…Previous studies suggested that most vaccine recipients understood that the HPV vaccines could not provide them 100% protection against STDs and that behaviors to avoid these risks should be continued. 46 About 30% of the participants perceived some positive outcomes of CAI with men after receiving HPV vaccination, such as it would increase intimacy and trust between sex partners. Such positive outcome expectancies were associated with a higher intention to perform risk compensation behaviors after receiving the HPV vaccination.…”

Section: Discussionmentioning

confidence: 99%

Behavioral intention to perform risk compensation behaviors after receiving HPV vaccination among men who have sex with men in China

Fang

et al. 2019

Human Vaccines & Immunotherapeutics

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Men who have sex with men (MSM) are recommended to take up human papillomavirus (HPV) vaccination. There are concerns that MSM would increase sexual risk behaviors after taking up HPV vaccination, a phenomenon known as risk compensation. This study investigated the prevalence of and factors associated with behavioral intention to reduce the frequency of condom use with men after receiving the HPV vaccination. The study was based on the baseline sample of an ongoing randomized controlled trial promoting HPV vaccination among MSM in Hong Kong. Hong Kong Chinese-speaking MSM who have never vaccinated against HPV were recruited from multiple sources. A total of 624 participants completed the baseline survey during July to December 2017. The prevalence of behavior intention to reduce the frequency of condom use with regular and non-regular male sex partners after receiving HPV vaccination was 6.9% and 4.0%; 8.0% of them intended to reduce condom use with either type of male partners after receiving the HPV vaccination. Adjusting for significant background variables (education level and condomless anal intercourse with men in the last six months), two constructs of the pre-intentional phase of Health Action Process Approach model were significantly associated with the dependent variable in the expected direction. They were (1) positive outcome expectancies of condomless anal intercourse after receiving HPV vaccination (adjusted odds ratios [AOR]: 1.29, 95% confidence interval [CI]: 1.12, 1.48, p < 0.001) and (2) perceived self-efficacy of consistent condom use after receiving HPV vaccination (AOR: 0.83, 95% CI: 0.70, 0.92, p = 0.001). Risk compensation may not be a major concern when promoting HPV vaccination among MSM. The results should be assuring health-care providers and policymakers.

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Section: Discussionmentioning

confidence: 99%

Behavioral intention to perform risk compensation behaviors after receiving HPV vaccination among men who have sex with men in China

Fang

et al. 2019

Human Vaccines & Immunotherapeutics

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“…What the PrEP example shows is nothing new. In the last decades, other prevention tools were all met with caution as they could possibly induce behavioural changes leading to an increased risk and consequently counteract the benefit of the prevention tool in question: the oral contraceptive pill in the 1950s , treatment for syphilis in the 1960s and 1970s , needle exchange programmes for injecting drug users , the morning‐after pill , and more recently HPV vaccination . Although different BI for HIV prevention have shown their effectiveness (e.g.…”

Section: Introductionmentioning

confidence: 99%

Give PrEP a chance: moving on from the “risk compensation” concept

Castro

Delabre²,

Molina

2019

J Intern AIDS Soc

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Introduction While bio‐behavioural interventions (BIs) for sexually transmitted infections (STIs) and HIV prevention have shown their effectiveness (e.g. treatment for syphilis, HPV vaccination or pre‐exposure prophylaxis [PrEP]), they have also aroused major concerns regarding behavioural changes that could counteract their benefit. Risk compensation (RC) fears concerning BIs in the HIV/STIs prevention field are intimately linked to representations, judgements and social control on sexual behaviour. With an increasing number of PrEP studies describing a rise in STIs due to RC, this paper argues for a shift away from the focus on RC and proposes a more constructive approach to respond to the needs of people living with HIV and populations most at risk. Discussion The concept of RC, stemming from road safety and derived from economic theory, relies on rational theoretical models of human behaviour. Although widely applied in several contexts its use has been reasonably questioned. Major methodological issues regarding RC have been raised within HIV/AIDS literature. Although behavioural changes (e.g. condomless sex and number of sexual partners) are often erroneously assimilated with RC, there is no evidence that behavioural changes have undermined the effectiveness of previous and current BIs. Still, PrEP has not escaped RC concerns. Increases in condomless sex within the context of growing uptake of PrEP signals a continued need for integrated and innovative HIV and STI prevention strategies and a comprehensive sexual health approach. Routine HIV/STI testing, peer‐led counselling, and identification of sexual health needs within the PrEP model of care could become a gold standard in the sexual health field for all populations. Conclusions RC remains a frequent argument against the availability and provision of prevention methods for vulnerable populations. Individuals should be able to benefit from the full panel of BIs options available, to find and adapt methods according to their needs. Current, past and future PrEP users, with other stakeholders, may provide valuable insight into innovative solutions and programmes to control HIV and other STIs.

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“…We excluded papers focusing on medical prevention (e.g., medical treatment of risk factors, such as hypertension), as well as secondary (e.g., prostate or breast cancer screening programmes) or tertiary prevention. Regarding borderline cases, such as vaccinations, which can be regarded as a public health or as a medical prevention effort, we excluded those publications exclusively addressing the iatrogenic effects of vaccines as medical products (e.g., fever, immune reactions), but included those reporting on the AUCs of vaccination programmes beyond adverse drug reactions (53). The full list of inclusion and exclusion criteria is provided in Additional File 2.…”

Section: Identification Of Eligible Publications For "Best Fit" Frame...mentioning

confidence: 99%

Anticipating and assessing adverse and other unintended consequences of public health interventions: the (CONSEQUENT) framework

Stratil

Biallas

Movsisyan

et al. 2023

Preprint

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Despite the best intentions public health interventions (PHIs) can have adverse and other unintended consequences (AUCs). AUCs are rarely systematically examined when developing, evaluating or implementing PHIs. We used a structured, multi-pronged and evidence-based approach to develop a framework to support researchers and decision-makers in conceptualising and categorising AUCs of PHIs. We employed the "best-fit" framework synthesis approach. We designed the a-priori framework using elements of the WHO-INTEGRATE framework and the Behaviour Change Wheel. Next, we conducted a qualitative systematic review of theoretical and conceptual publications on the AUCs of PHIs in the databases Medline and Embase as well as through grey literature searches. Based on these findings, we iteratively revised and advanced the a-priori framework based on thematic analysis of the identified research. To validate and further refine the framework, we coded four systematic reviews on AUCs of distinct PHIs against it. The CONSEQUENT framework includes two components: the first focuses on AUCs and serves to categorise them; the second component highlights the mechanisms through which AUCs may arise. The first component comprises eight domains of consequences - health, health system, human and fundamental rights, acceptability and adherence, equality and equity, social and institutional, economic and resource, and ecological. The CONSEQUENT framework is intended to facilitate conceptualisation and categorising of AUCs of PHIs during their development, evaluation and implementation to support evidence-informed decision-making.

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No evidence that HPV vaccination leads to sexual risk compensation

Cited by 10 publications

References 26 publications

Behavioral intention to perform risk compensation behaviors after receiving HPV vaccination among men who have sex with men in China

Behavioral intention to perform risk compensation behaviors after receiving HPV vaccination among men who have sex with men in China

Give PrEP a chance: moving on from the “risk compensation” concept

Anticipating and assessing adverse and other unintended consequences of public health interventions: the (CONSEQUENT) framework

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