title: Tempest in a teapot: A systematic review of HPV vaccination and risk compensation research.
abstract: There has been some concern among parents and in the media that vaccinating children against human papillomavirus could be seen as giving children permission to engage in risky sexual behaviors (also known as sexual disinhibition). Several studies have found this concern to be unfounded but there have been no attempts to synthesize the relevant studies in order to assess if there is evidence of sexual disinhibition. The aim of this study was to synthesize recent literature examining sexual behaviors and biological outcomes (e.g., sexually transmitted infections) post-HPV vaccination. We reviewed literature from January 1, 2008-June 30, 2015 using PubMed, CINAHL, and Embase with the following search terms: [(sex behavior OR sex behavior OR sexual) AND (human papillomavirus OR HPV) AND (vaccines OR vaccine OR vaccination)] followed by a cited reference search. We included studies that examined biological outcomes and reported behaviors post-vaccination in both males and females. Studies were reviewed by title and abstract and relevant studies were examined as full-text articles. We identified 2,503 articles and 20 were eventually included in the review. None of the studies of sexual behaviors and/or biological outcomes found evidence of riskier behaviors or higher rates of STIs after HPV vaccination. Instead, the studies found that vaccinated compared to unvaccinated individuals were less likely to report vaginal intercourse without a condom (OR = 0.5; 95%CI = 0.4-0.6) and non-use of contraception (OR = 0.27; 95%CI = 0.15-0.48) and unvaccinated participants had higher rates of Chlamydia (OR = 2.3; 95%CI = 1.06-5.00). These results should be reassuring to parents and health care providers.
authors: a Indiana University School of Public Health , Department of Epidemiology , Indianapolis , IN , USA.
authors: Monica L
authors: ML
authors: Kasting
authors: b Department of Psychology , McGill University , Montreal , QC , Canada.|c Lady Davis Institute for Medical Research & Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital , Montreal , QC , Canada.
authors: Gilla K
authors: GK
authors: Shapiro
authors: b Department of Psychology , McGill University , Montreal , QC , Canada.|c Lady Davis Institute for Medical Research & Louise Granofsky Psychosocial Oncology Program, Jewish General Hospital , Montreal , QC , Canada.
authors: Zeev
authors: Z
authors: Rosberger
authors: d Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine , Cincinnati , OH , USA.
authors: Jessica A
authors: JA
authors: Kahn
authors: e Indiana University School of Medicine, Section of Adolescent Medicine , Indianapolis , IN , USA.
authors: Gregory D
authors: GD
authors: Zimet
mesh_terms: D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D014611:Vaccination / Q000523:psychology*
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccination; adolescent; behavior; infectious disease; pediatrics; risk compensation; sexual disinhibition