title: Healthcare providers' beliefs and attitudes regarding risk compensation following HPV vaccination.
abstract: Provider recommendation is a significant predictor of HPV vaccine uptake. Prior research suggests that concerns regarding risk compensation could cause some providers to hesitate recommending the HPV vaccine.
  
  
  
  During 15-30 minute semi-structured interviews in early 2015, 22 U.S. pediatric providers were asked about their beliefs regarding sexual risk compensation and cervical cancer screening following HPV vaccination. Providers were asked if these beliefs result in reservations recommending the vaccine. Interviews were audio-recorded, transcribed, and analyzed using inductive content analysis.
  
  
  
  None of the providers believed the HPV vaccine would result in risky sexual behavior. Half indicated it was better to start vaccination early, before sexual activity was a worry. Others noted that patients' risky behavior decisions happen independently of vaccination. When providers were asked if they were concerned about decreased cervical cancer screening, half said they did not know and some stated they had never thought about it before. The main themes addressed were the significant time lapse between vaccination and screening and that women tend to get over-screened as opposed to under-screened.
  
  
  
  Providers were generally in favor of HPV vaccination and do not perceive risk compensation as a barrier to HPV recommendation.
authors.affiliation: Indiana University Fairbanks School of Public Health, Department of Epidemiology, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202, USA.
authors.forename: Monica L
authors.initials: ML
authors.lastname: Kasting
authors.affiliation: Indiana University School of Medicine, Department of Pediatrics, 410 W 10 Street Suite 1001, Indianapolis, IN 46202, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Wilson
authors.affiliation: Indiana University Fairbanks School of Public Health, Department of Epidemiology, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202, USA; Regenstrief Institute, Inc., Center for Biomedical Informatics, 1101 W. 10th St., Indianapolis, IN 46202, USA; Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, 1481 W. 10th St, 11H, Indianapolis, IN 46202, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Dixon
authors.affiliation: Indiana University School of Medicine, Department of Pediatrics, 410 W 10 Street Suite 1001, Indianapolis, IN 46202, USA; Regenstrief Institute, Inc., Center for Biomedical Informatics, 1101 W. 10th St., Indianapolis, IN 46202, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Downs
authors.affiliation: Merck & Co., 2000 Galloping Hill Road, Kenilworth, NJ 07033, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Kulkarni
authors.affiliation: Indiana University School of Medicine, Department of Pediatrics, 410 W 10 Street Suite 1001, Indianapolis, IN 46202, USA.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Zimet
mesh_terms: D002648:Child; D055088:Early Detection of Cancer / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care; D000072143:Pediatricians / Q000523:psychology; D018570:Risk Assessment; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D047568:Unsafe Sex; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000821:virology; D014611:Vaccination
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV vaccination; behavior; cervical cancer screening; healthcare provider; risk compensation