Human Papillomavirus Vaccine Doesn’t Mean Quit Having Safe Sex

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HPV VaccineGirls who receive the human papillomavirus vaccine (HPV) still need to practice safe sex. Researchers have found that some girls who get the vaccine to prevent cervical cancer  have thought they no longer need to practice safe sex.

While most girls know the limitations, some believed they were less at risk for getting a sexually transmitted disease after getting the humanpapilloma virus vaccine.

Published in the Archives of Pediatric & Adolescent Medicine in January, Tanya Kowalczyk Mullins, MD, of the Cincinnati Children’s Hospital Medical Center in Cincinnati, and colleagues reported that those girls who thought they had a less need for safe sex were more likely to have a less understanding and knowledge of HPV and the vaccine.

Merck’s Gardasil and GlaxoSmithKline’s (NYSE:GSK) Cervarix vaccines protect against strains of the humanpapilloma virus or HPV that cause cervical cancer.  Cervical cancer is the easiest to prevent with annual cervical cancer screening.   The HPV test and cervical screening looks for the virus (human papillomavirus) that can cause these cell changes that cause cervix cancer.  Gardasil also protects against some strains of the virus that cause genital warts. Also, HPV vaccines can only prevent HPV infections; they do not treat active infections like cervical cancer.

Researchers surveyed 339 female participants, ages 13 to 21 after their first HPV vaccine shot and 235 mothers and female guardians and found that the outcome for the risk of human papillomavirus, cervical cancer and other sexually transmitted diseases were perceived to be at a lower risk after the vaccination.

The girls surveyed averaged 16.8 years old, 76.4% were black, and 57.5% were sexually active, the researchers reported.

Human Papillomavirus Vaccine

On 10-point scales, with lower numbers indicating less perceived risk or less need for sexual safety, the researchers found:

– An average score of 5 on the risk-of-HPV scale.
– An average of 6.1 on the scale for perceived risk of other sexually transmitted infections.
– An average of 8.5 on the scale for perceived need for safer sexual behavior.

Slightly more than half of the girls (50.7%) had a score of 9 or higher for perceived need for safer sexual behaviors, and only 3.8% had an average lower than 5, Mullins and colleagues reported.

Overall, girls perceived themselves to be at lower risk for HPV after vaccination than for other sexually transmitted infections, a difference that was significant.

In a multi-variable analysis, five factors among those vaccinated were significantly associated with a lower perceived need for safer sex:

– Lower HPV and HPV vaccine knowledge.
– Less concern about HPV infection.
– Lack of condom use at last intercourse with male main partner.
– No lifetime alcohol use.
– A teacher serving as a source of HPV vaccine information, possibly because information was not clear.

Among mothers and guardians, three factors were associated with a daughter’s lower perceived need for safer sex:

– Lower HPV and HPV vaccine knowledge.
– Lack of communication with the daughter about the vaccine.
– A physician serving as a source of information about the vaccine, again possibly because information was not delivered clearly.

The researchers wanted to point out that the study took place in a clinic that served a low-income urban population and that results might vary in different areas.

So how do we explain to girls that they still need to practice safe sex with a condom for STD prevention and for cervical cancer prevention? Explain that most girls who receive the human papillomavirus (HPV) vaccine shouldn’t take it as a license for riskier sexual behavior. Point out that those who saw less of a continued need for safer sex were more likely to have a lower level of knowledge about HPV and the vaccine itself.

A new recommendation from the CDC Advisory Committee on Immunization Practices says that males between the ages of 11 and 12 should be vaccinated regularly. Also, young men between the ages of 13 and 21 who have never been vaccinated should receive three doses. Men between 22 and 26 may receive the vaccine if they and their doctors decide it is appropriate. The vaccine is not licensed for individuals over age 26.

The CDC report announced the new recommendation that men who have sex with men have the highest risk of being infected with the HPV virus, and benefit the most from HPV vaccines. These individuals have higher rates of cervical intraepithelial neoplasia, anal cancer and genital warts / genital herpes.

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