Human Papillomavirus Vaccination and Sexual Disinhibition in Females: A Systematic Review

Purnima Madhivanan, Dudith Pierre-Victor, Soumyadeep Mukherjee, Prasad Bhoite, Brionna Powell, Naomie Jean-Baptiste, Rachel Clarke, Tenesha Avent, Karl Krupp

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations


Context Some parents believe human papillomavirus (HPV) vaccination increases the chance of risky sexual behaviors among adolescents. This review summarizes the evidence available on adolescent girls and women engaging in risky sexual activity following HPV vaccination. Evidence acquisition Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted in 2014 and updated in 2015. Literature was searched for articles published between 2004 and 2015 in MEDLINE, PsycInfo, CINAHL, Cochrane Database, Web of Science, and EMBASE without language limits. Studies were screened according to predefined inclusion and exclusion criteria. Methodologic quality of the included articles was assessed. Evidence synthesis The search resulted in 21 articles to be included in the review, with 527,475 participants. Included studies were conducted in 12 different countries using experimental and observational study designs. The review included data on girls aged as young as 11 years to women aged 40 years. Studies measured changes in sexual behaviors using a variety of outcomes, including age at sexual debut; risky sexual behaviors; use of condoms and contraception; and clinical indicators such as rates of sexually transmitted infections, HIV, and pregnancy terminations. Available data showed either no association between vaccination status and the outcomes of interest or a positive association between safer sexual behaviors, such as condom use and receipt of HPV vaccination. Methodologic quality of all but one study was moderate or weak. Conclusions This review did not find sufficient evidence to support compensatory sexual risk behaviors following HPV vaccination among adolescent girls or women.

Original languageEnglish (US)
Pages (from-to)373-383
Number of pages11
JournalAmerican Journal of Preventive Medicine
Issue number3
StatePublished - Sep 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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