Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2018 Jul 5;18(1):837.
doi: 10.1186/s12889-018-5745-6.

Changes in (risk) behavior and HPV knowledge among Dutch girls eligible for HPV vaccination: an observational cohort study

Robine Donken  1   2 , Adriana Tami  3 , Mirjam J Knol  4 , Karin Lubbers  3 , Marianne A B van der Sande  4   5   6 , Hans W Nijman  7 , Toos Daemen  3 , Willibrord C M Weijmar Schultz  7 , Hester E de Melker  4
Affiliations
Observational Study

Changes in (risk) behavior and HPV knowledge among Dutch girls eligible for HPV vaccination: an observational cohort study

Robine Donken et al. BMC Public Health. .

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.

Keywords: Adolescents; Condom use; HPV vaccination; Human papillomavirus; Knowledge; Sexual behavior.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

This research was performed in accordance to the principles of the Declaration of Helsinki. [25]. Based on the nature of the study, the Dutch Central Committee on Research Involving Human Subjects (Centrale Commissie Mensgebonden Onderzoek (CCMO)) decided that approval from a medical-ethical review committee was not required for this study, in agreement with the Dutch Medical Research involving Human Subjects Act. The CCMO allowed to receive consent through the online system from the participating girls, no written consent from the girls or their parents was required [24].

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Similar articles

See all similar articles

Cited by

References

    1. zur Hausen H, Gissmann L, Steiner W, Dippold W, Dreger I. Human papilloma viruses and cancer. Bibl Haematol. 1975;(43):569–71. PMID:183728. - PubMed
    1. Syrjanen K, Hakama M, Saarikoski S, Vayrynen M, Yliskoski M, Syrjanen S, Kataja V, Castren O. Prevalence, incidence, and estimated life-time risk of cervical human papillomavirus infections in a nonselected Finnish female population. Sex Transm Dis. 1990;17(1):15–19. doi: 10.1097/00007435-199017010-00004. - DOI - PubMed
    1. de Melker HE, Conyn-van Spaendonck MAE, Coutinho RA, Boot HJ. Introductie van vaccinatie tegen baarmoederhalskanker [Introduction to vaccination against cervical cancer]. Ned Tijdschr Geneeskd. 2009;153(14):658-61. - PubMed
    1. van Lier A. Vaccinatiegraad Rijksvaccinatieprogramma Nederland, Verslagjaar 2011. 2012.
    1. Forster AS, Marlow LA, Stephenson J, Wardle J, Waller J. Human papillomavirus vaccination and sexual behaviour: cross-sectional and longitudinal surveys conducted in England. Vaccine. 2012;30(33):4939–4944. doi: 10.1016/j.vaccine.2012.05.053. - DOI - PubMed

Publication types

Substances

LinkOut - more resources