Risk perceptions after human papillomavirus vaccination in HIV-infected adolescents and young adult women

Abstract

Purpose: To examine risk perceptions (perceived risk of human papillomavirus [HPV], perceived risk of other sexually transmitted infections [STIs], and need for safer sexual behaviors) and to determine factors associated with these risk perceptions after HPV vaccination.

Methods: Data were collected at the baseline visit of an HPV-6, -11, -16, -18 vaccine clinical trial in 16-23-year-old HIV-infected young women (N = 99). Immediately after receiving the first vaccine dose, participants completed a confidential questionnaire that included three 5-item scales measuring perceived risk of HPV, perceived risk of other STIs, and need for safer sexual behaviors. Linear and logistic regression models were used to examine associations between baseline characteristics (demographic characteristics; cluster of differentiation antigen 4 (CD4(+)) count; HIV viral load; knowledge about HPV and HPV vaccines; sexual behaviors; and STI diagnosis) and each measure of risk perceptions.

Results: Most participants perceived themselves to be at lower risk for HPV (mean scale score = 19.5/50), most perceived that they were not at lower risk for other STIs (mean = 31.2/50), and the vast majority reported that there was still a need for safer sexual behaviors after vaccination (mean = 43.1/50). Multivariate analyses indicated that knowledge about HPV and HPV vaccines was associated with perceived need for safer sexual behaviors (OR = 1.05, 95% CI = 1.0-1.1).

Conclusions: Although almost all young women in this study believed that safer sexual behaviors were still important after HPV vaccination, a subset believed they were at less risk for STIs other than HPV. Educational interventions are needed to prevent misperceptions and promote healthy behaviors after vaccination.

Figure 1

Box plot demonstrating mean scores (circles), maximum score, 75^th percentile, median, 25^th percentile, and minimum score for the 15 individual items and each of the three subscales. The score range for each individual item is 0 to 10, and the items corresponding to each number are found in Table 2. The score range of each scale is 0 to 50, and each subscale score was computed by summing the scores of the five individual items comprising the subscale. The three subscales included: HPV (perceived risk of HPV infection after vaccination), STI (perceived risk of sexually transmitted infections other than HPV after vaccination), and Need (perceived need for safer sexual behaviors after vaccination).