Sexual behavior, clinical outcomes and attendance of cervical cancer screening by HPV vaccinated and unvaccinated sexually active women

ABSTRACT

Concerns were raised about HPV vaccination possibly leading to riskier sexual behavior. We assessed sexual behaviors, risk of sexually transmitted infection, and attendance to cervical cancer screening by HPV vaccinated and unvaccinated young women. In this analysis, 1475 questionnaires completed by women aged 17–29 years were included. The majority of respondents (67.9%) were vaccinated against HPV. The proportion of those vaccinated decreased with age: from 93.2% in those aged 17–19 to 72.9% in those aged 20–22, and 21.8% in 23–29-year olds. A higher proportion of unvaccinated respondents had at least one sexual intercourse under the age of 15 when compared to those vaccinated (30% vs. 23%, p < .0001). The number of sexual partners during the last 12 months was similar between vaccinated and unvaccinated participants. Vaccinated participants reported more condom use (45% versus 38%; p = .0002), and less sexually transmitted infections (10% versus 28%; p < .0001), and less anogenital condylomas (2.2% vs. 11.6%; p < .0001). A screening test has been reported by 51% and 77% of vaccinated and unvaccinated participants, respectively (p < .0001). The association between vaccination status and cervical cancer screening disappeared when adjusting for participants’ age. The study results consolidate the existing body of data regarding the absence of an impact of HPV vaccination on sexual behavior or use of contraceptives.

KEYWORDS:

• Human papillomavirus
• HPV vaccination
• Sexual behavior, cervical cancer screening

Acknowledgments

Julie Guenoun, B. Sc. Émilie Cométe, M. Sc. Laboratoire de virologie moléculaire, Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM); Patricia Goggin, Médecin retraité et Marie-Hélne Mayrand, MD, PhD, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM). The authors also want to thank Anne-Marie Berard, who coordinated the data collection and all the other contributors and the participants.

Disclosure of potential conflicts of interest

F. Coutlee has received grants through his institution from Merck Sharp and Dome and Roche, as well as honoraria from Merck and Roche for lectures on human papillomavirus (HPV). PG, CS, VG, FD, GL and SMC declare no conflicts of interest.

Ethics

Ethics approval for this study was received from the research ethics boards of the Agence de la Sante et des Services sociaux de Montreal and the Centre hospitalier de l’Universite de Montreal.

Additional information

Funding

This analysis was funded by the Ministére de la Sante et des Services Sociaux du Quebec.