Changes in (risk) behavior and HPV knowledge among Dutch girls eligible for HPV vaccination: an observational cohort study
Abstract Background Implementation of human papillomavirus (HPV) vaccination raised concerns that vaccination could lead to riskier sexual behavior. This study explored how possible differences in sexual behavior and HPV knowledge developed over time between HPV-vaccinated and unvaccinated girls. Me...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-018-5745-6 |
| _version_ | 1818305104627892224 |
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| author | Robine Donken Adriana Tami Mirjam J. Knol Karin Lubbers Marianne A. B. van der Sande Hans W. Nijman Toos Daemen Willibrord C. M. Weijmar Schultz Hester E. de Melker |
| author_facet | Robine Donken Adriana Tami Mirjam J. Knol Karin Lubbers Marianne A. B. van der Sande Hans W. Nijman Toos Daemen Willibrord C. M. Weijmar Schultz Hester E. de Melker |
| author_sort | Robine Donken |
| collection | DOAJ |
| description | Abstract Background Implementation of human papillomavirus (HPV) vaccination raised concerns that vaccination could lead to riskier sexual behavior. This study explored how possible differences in sexual behavior and HPV knowledge developed over time between HPV-vaccinated and unvaccinated girls. Methods A random sample of 19,939 girls (16–17 year olds) eligible for the catch-up HPV vaccination campaign in the Netherlands was invited for a longitudinal study with questionnaires every 6 months over a two-year follow-up period. Possible differences over time between vaccinated and unvaccinated participants were studied using generalized equations estimation (GEE). Results A total of 2989 girls participated in round one, of which 1574 participated (52.7%) in the final 5th round. Vaccinated girls were more likely to live in more urban areas (OR 1.28, 95%CI 1.10–1.47) and to use alcohol (OR 1.46, 95%CI 1.24–1.70) and contraceptives (OR 1.69, 95%CI 1.45–1.97). Vaccinated and unvaccinated girls showed comparable knowledge on HPV, HPV vaccination, and transmission. Vaccinated girls were more likely to be sexually active (OR 1.19, 95%CI 1.02–1.39), and this difference increased over time (OR for interaction 1.06, 95%CI 1.00–1.12). However, they had a slightly lower number of lifetime sexual partners (mean difference − 0.20, 95%CI -0.41-0.00). Vaccinated girls were less likely to use a condom with a steady partner (aOR 0.71, 95%CI 0.56–0.89). However, the difference between vaccinated and unvaccinated girls with regard to condom use with casual or steady partner(s) did not significantly change over time. Conclusion Overall, we did not find indications that vaccination influenced sexual behavior in girls during 2 years of follow-up. The few differences found may be related to existing disparities in the socio-demographic characteristics of the young population pointing to the importance and improvement of education with regard to safe sex practices. Our findings do not suggest that vaccination status is associated with changes in sexual risk behavior and thus it is unlikely that this might influence the effectiveness of the vaccination program. |
| first_indexed | 2024-12-13T06:21:17Z |
| format | Article |
| id | doaj.art-bf5fa9575dc54afcad50a58443a529a8 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-13T06:21:17Z |
| publishDate | 2018-07-01 |
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| spelling | doaj.art-bf5fa9575dc54afcad50a58443a529a82022-12-21T23:56:51ZengBMCBMC Public Health1471-24582018-07-0118111010.1186/s12889-018-5745-6Changes in (risk) behavior and HPV knowledge among Dutch girls eligible for HPV vaccination: an observational cohort studyRobine Donken0Adriana Tami1Mirjam J. Knol2Karin Lubbers3Marianne A. B. van der Sande4Hans W. Nijman5Toos Daemen6Willibrord C. M. Weijmar Schultz7Hester E. de Melker8Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM)Department of Medical Microbiology, University of Groningen, University Medical Center GroningenCenter for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM)Department of Medical Microbiology, University of Groningen, University Medical Center GroningenCenter for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM)Department of Obstetrics and Gynecology, University of Groningen, University Medical Center GroningenDepartment of Medical Microbiology, University of Groningen, University Medical Center GroningenDepartment of Obstetrics and Gynecology, University of Groningen, University Medical Center GroningenCenter for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM)Abstract Background Implementation of human papillomavirus (HPV) vaccination raised concerns that vaccination could lead to riskier sexual behavior. This study explored how possible differences in sexual behavior and HPV knowledge developed over time between HPV-vaccinated and unvaccinated girls. Methods A random sample of 19,939 girls (16–17 year olds) eligible for the catch-up HPV vaccination campaign in the Netherlands was invited for a longitudinal study with questionnaires every 6 months over a two-year follow-up period. Possible differences over time between vaccinated and unvaccinated participants were studied using generalized equations estimation (GEE). Results A total of 2989 girls participated in round one, of which 1574 participated (52.7%) in the final 5th round. Vaccinated girls were more likely to live in more urban areas (OR 1.28, 95%CI 1.10–1.47) and to use alcohol (OR 1.46, 95%CI 1.24–1.70) and contraceptives (OR 1.69, 95%CI 1.45–1.97). Vaccinated and unvaccinated girls showed comparable knowledge on HPV, HPV vaccination, and transmission. Vaccinated girls were more likely to be sexually active (OR 1.19, 95%CI 1.02–1.39), and this difference increased over time (OR for interaction 1.06, 95%CI 1.00–1.12). However, they had a slightly lower number of lifetime sexual partners (mean difference − 0.20, 95%CI -0.41-0.00). Vaccinated girls were less likely to use a condom with a steady partner (aOR 0.71, 95%CI 0.56–0.89). However, the difference between vaccinated and unvaccinated girls with regard to condom use with casual or steady partner(s) did not significantly change over time. Conclusion Overall, we did not find indications that vaccination influenced sexual behavior in girls during 2 years of follow-up. The few differences found may be related to existing disparities in the socio-demographic characteristics of the young population pointing to the importance and improvement of education with regard to safe sex practices. Our findings do not suggest that vaccination status is associated with changes in sexual risk behavior and thus it is unlikely that this might influence the effectiveness of the vaccination program.http://link.springer.com/article/10.1186/s12889-018-5745-6Human papillomavirusHPV vaccinationAdolescentsKnowledgeSexual behaviorCondom use |
| spellingShingle | Robine Donken Adriana Tami Mirjam J. Knol Karin Lubbers Marianne A. B. van der Sande Hans W. Nijman Toos Daemen Willibrord C. M. Weijmar Schultz Hester E. de Melker Changes in (risk) behavior and HPV knowledge among Dutch girls eligible for HPV vaccination: an observational cohort study BMC Public Health Human papillomavirus HPV vaccination Adolescents Knowledge Sexual behavior Condom use |
| title | Changes in (risk) behavior and HPV knowledge among Dutch girls eligible for HPV vaccination: an observational cohort study |
| title_full | Changes in (risk) behavior and HPV knowledge among Dutch girls eligible for HPV vaccination: an observational cohort study |
| title_fullStr | Changes in (risk) behavior and HPV knowledge among Dutch girls eligible for HPV vaccination: an observational cohort study |
| title_full_unstemmed | Changes in (risk) behavior and HPV knowledge among Dutch girls eligible for HPV vaccination: an observational cohort study |
| title_short | Changes in (risk) behavior and HPV knowledge among Dutch girls eligible for HPV vaccination: an observational cohort study |
| title_sort | changes in risk behavior and hpv knowledge among dutch girls eligible for hpv vaccination an observational cohort study |
| topic | Human papillomavirus HPV vaccination Adolescents Knowledge Sexual behavior Condom use |
| url | http://link.springer.com/article/10.1186/s12889-018-5745-6 |
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