Table 2.

Studies that examined the influence of HPV vaccination on sexual behaviour outcomes among young females

STUDY*COUNTRYDESIGNPARTICIPANT CHARACTERISTICSOUTCOMES
HAS EVER HAD SEXUAL INTERCOURSENO. OF SEXUAL PARTNERSCONDOM USE
Donken et al,8 2018NetherlandsLongitudinal follow-up study using online questionnairesAge 16–17 y at inclusion; 1938 vaccinated and 1051 unvaccinatedVaccinated participants were more likely to have ever had sex (OR = 1.19, 95% CI 1.02 to 1.39) and this difference increased over time (OR = 1.06, 95% CI 1.00 to 1.12); however, after correction for sociodemographic factors, no difference was observedUnvaccinated participants had a slightly higher lifetime number of partners (mean difference of −0.20, 95% CI −0.41 to 0.00)No difference was observed for condom use with a casual partner. Vaccinated participants were less likely to always use a condom with their steady partner (adjusted OR = 0.71, 95% CI 0.57 to 0.89)
Liddon et al,10 2012United StatesData from the National Survey of Family GrowthAge 15–24 y; 279 vaccinated and 964 unvaccinatedHaving had vaginal sex was unrelated to receipt of HPV vaccineNAVaccinated females were more likely to use condoms consistently in the past 4 weeks (OR for always wearing a condom was 3.0, 95% CI 1.1 to 7.9)
Kumakech et al,12 2017UgandaPopulation-based comparative cross-sectional surveyAge 15–24 y (median age was 18.6 y); 438 females (53% of whom were vaccinated)NANo significant differences between vaccinated and unvaccinated participants in number of sexual partners in the previous 3 mo, the previous 1 y, the previous 4 y, or their lifetimeNo significant difference in having ever used a condom between vaccinated and unvaccinated participants
Cummings et al,14 2012United StatesComparison of a group of vaccinated adolescent girls with historical controls. Questionnaires and clinician or self- collected vaginal swabsAge 14–17 y; 75 vaccinated and 150 matched unvaccinatedNo difference in being sexually active at enrolment between unvaccinated (76.2%) and vaccinated participants (73.6%), P = .65.No significant difference in number of sex partners in the past year (OR = 1.1, 95% CI 0.9 to 1.3) or in the past 2 mo (OR = 1.2, 95% CI 0.9 to 1.5)Mean instances of vaginal intercourse without a condom in the past 2 mo were significantly lower among vaccinated adolescent girls (OR = 0.5, 95% CI 0.4 to 0.6)
Sadler et al,15 2015United KingdomClinical histories from genitourinary medicine clinic visitorsAge 14–20 y; 231 vaccinated and 132 unvaccinatedNANo difference was observed in the proportion of participants with >6 lifetime partners between vaccinated and unvaccinated females. Vaccinated females were more likely to have had ≥3 partners in the past 6 mo (OR = 2.12, 95% CI 1.08 to 4.17)Condom use at first intercourse contact was slightly higher among vaccinated females (OR 0.55, 95% CI 0.32 to 0.96), while condom use at last intercourse contact was not significantly different
Forster et al,16 2012United KingdomCross-sectional and longitudinal surveysAge 16–17 y; 433 vaccinated and 620 unvaccinatedNo difference between the group being offered the HPV vaccine and the group who had not been offered the vaccine (OR 0.98, 95% CI 0.70 to 1.38). Also, no difference in the group becoming sexually active over time (OR 0.80, 95% CI 0.40 to 1.59)No significant difference in the change in number of sexual partners over time between the 2 groupsNo significant difference in change in inconsistent condom use between the 2 groups (OR 0.88, 95% CI 0.58 to 1.33)
  • HPV—human papillomavirus, NA—not applicable, OR—odds ratio.

  • * Only some studies including participants younger than 18 years of age were included in this table. Studies including only adults were not included in this review.