Human Papillomavirus Vaccine and Sexual Behavior Among Adolescent and Young Women


      Vaccines to prevent certain types of human papillomavirus (HPV) and associated cancers are recommended for routine use among young women. Nationally representative reports of vaccine uptake have not explored the relationship between HPV vaccine initiation and various sexual behaviors.


      Explore sexual behavior and demographic correlates of HPV vaccine initiation from a nationally representative survey of adolescent and young adult women.


      In 2007–2008, a total of 1243 girls/women aged 15–24 years responded to questions about receiving HPV vaccine in the National Survey of Family Growth (NSFG). In 2010, demographic and sexual behavior correlates were evaluated in bivariate and multivariate analyses by age.


      HPV vaccine initiation was higher among those aged 15–19 years than those aged 20–24 years (30.3% vs 15.9%, p<0.001). No differences existed by race/ethnicity for those aged 15–19 years, but among women aged 20–24 years, non-Hispanic blacks were less likely than non-Hispanic whites to have received the HPV vaccine (AOR=0.15). HPV vaccine initiation was greater for those with insurance regardless of age. HPV vaccination was not associated with being sexually active or number of sex partners at either age. Among sexually active adolescents aged 15–19 years, those who received HPV vaccine were more likely to always wear a condom (AOR=3.0).


      This study highlights disparities in HPV vaccine initiation by insurance status among girls/women aged 15–24 years and by race/ethnicity among women aged >19 years. No association was found between HPV vaccination and risky sexual behavior.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Dunne E.F.
        • Unger E.R.
        • Sternberg M.
        • et al.
        Prevalence of HPV infection among females in the U.S..
        JAMA. 2007; 297: 813-819
        • Cogliano V.
        IARC Monographs on the evaluation of carcinogenic risks to humans: human papillomavirus.
        International Agency for Research on Cancer, Lyon, France2007
        • Bosch F.X.
        • de Sanjose S.
        Chapter 1: human papillomavirus and cervical cancer—burden and assessment of causality.
        J Natl Cancer Inst Monogr. 2003; 31: 3-13
        • Greer C.E.
        • Wheeler C.M.
        • Ladner M.B.
        • et al.
        Human papillomavirus (HPV) type distribution and serological response to HPV type 6 virus–like particles in patients with genital warts.
        J Clin Microbiol. 1995; 33: 2058-2063
        • Walboomers J.M.
        • Jacobs M.V.
        • Manos M.M.
        • et al.
        Human papillomavirus is a necessary cause of invasive cervical cancer worldwide.
        J Pathol. 1999; 189: 12-19
        • Clifford G.M.
        • Smith J.S.
        • Plummer M.
        • Muñoz N.
        • Franceschi S.
        Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis.
        Brit J Cancer. 2003; 88: 63-73
        • CDC
        FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP).
        MMWR Morb Mortal Wkly Rep. 2010; 59: 626-629
        • CDC
        Vaccination coverage among adolescents aged 13–17 years—U.S..
        MMWR Morb Mortal Wkly Rep 2007. 2008; 57: 1100-1103
        • CDC
        National, state, and local area vaccination coverage among adolescents aged 13–17 years—U.S..
        MMWR Morb Mortal Wkly Rep 2008. 2009; 58: 997-1001
        • CDC
        National, state, and local area vaccination coverage among adolescents aged 13–17 Years—U.S..
        MMWR Morb Mortal Wkly Rep 2009. 2010; 59: 1018-1023
        • Taylor L.
        • Hariri S.
        • Sternberg M.
        • Dunne E.F.
        • Markowitz L.E.
        Human papillomavirus vaccine coverage in the U.S., National Health and Nutrition Examination Survey, 2007-2008.
        Prev Med. 2011; 52: 398-400
        • CDC
        Statistics and surveillance: 2009 adult vaccination coverage, NHIS: the National Health Interview Survey (NHIS).
        National Center for Health Statistics, 2009
        • Wong C.A.
        • Berkowitz Z.
        • Dorell C.G.
        • Price R.A.
        • Lee J.
        • Saraiya M.
        Human papillomavirus vaccine uptake among 9- to 17-year-old girls: National Health Interview Survey, 2008.
        Cancer. 2011;
        • Lepkowski J.M.
        • Mosher W.D.
        • Davis K.E.
        • Groves R.M.
        • Van Hoewyk J.
        The 2006–2010 National Survey of Family Growth: sample design and analysis of a continuous survey.
        Vital Health Stat. 2010; 2: 1-36
        • Groves R.M.
        • Mosher W.D.
        • Lepkowski J.
        • Kirgis N.G.
        Planning and development of the continuous National Survey of Family Growth.
        Vital Health Stat. 2009; 1: 1-64
        • Mosher W.D.
        • Jones J.
        Use of contraception in the U.S.: 1982–2008.
        Vital Health Stat. 2010; 23: 1-44
        • Abma J.C.
        • Martinez G.M.
        • Copen C.E.
        Teenagers in the U.S.: sexual activity, contraceptive use, and childbearing, National Survey of Family Growth 2006–2008.
        Vital Health Stat. 2010; 23: 1-47
        • Winer R.L.
        • Feng Q.
        • Hughes J.P.
        • O'Reilly S.
        • Kiviat N.B.
        • Koutsky L.A.
        Risk of female human papillomavirus acquisition associated with first male sex partner.
        J Infect Dis. 2008; 197: 279-282
        • Olatunbosun O.
        Human papillomavirus vaccine, teen sex and politics.
        J Fam Plann Reprod Health Care. 2006; 32: 74
        • Lo B.
        HPV vaccine and adolescents' sexual activity.
        BMJ. 2006; 332: 1106-1107
        • Daley M.F.
        • Crane L.A.
        • Markowitz L.E.
        • et al.
        Human papillomavirus vaccination practices: a survey of U.S. physicians 18 months after licensure.
        Pediatrics. 2010; 126: 425-433