Assessing the Effects of Female Adolescent Risky Sexual Behavior on HPV Vaccine Uptake
Dr. Amy Leader (Capstone Chair)
Dr. Al Crawford (Capstone preceptor)
Dr. Rob Simmons and Nancy Chernett
HPV vaccination is poised to lower the incidence rates, death rates, and racial disparities of cancers associated with HPV infection. Despite HPV vaccine availability since 2006, HPV vaccination coverage among American adolescents remains low. The present study was conducted to understand the effects of female adolescent risky sexual behavior levels on the perceived control, intentions, self-reported initiation, and actual initiation of the HPV vaccine. From 2006-2010, a study was conducted to understand the effects of a theory-guided educational intervention on HPV vaccination. The 516 female, primarily African-American participants were recruited from five Philadelphia neighborhoods similar in demographics and socio-economic status. Adolescents living in three of the five neighborhoods received an educational intervention, while adolescents in the other two neighborhoods served as controls. Baseline surveys measured risky sexual behavior, perceived control over and intentions to initiate HPV vaccination. Follow-up surveys captured self-reported initiation of HPV vaccination and actual HPV vaccination status was obtained from the Philadelphia Department of Public Health's “KIDS” Registry. Four levels of risky sexual behavior were derived from five baseline survey items measuring engagement in risky sexual behavior and avoidance of protective sexual behaviors. Chi-square and logistic regression analyses were performed to assess the relationship between risky sexual behavior and HPV vaccine uptake. As levels of risky sexual behavior increased, perceived control (p<.01), intentions to vaccinate (p<.01), and self-report of vaccination (p<.01) significantly increased. No significant increase was seen between risky sexual behavior and actual vaccination. When compared to those who had reported no risky sexual behavior, the odds of having high perceived control (p<.01), high intentions (p<.01) and self-reporting HPV vaccination initiation (p=.043) also increased as levels of risky sexual behavior increased. The odds of actual vaccination were not statistically significant. Neighborhoods that received an educational intervention had higher rates of perceived control, intentions, self-reported initiation, and actual initiation levels than control neighborhoods. Adolescent access to HPV vaccination education and the HPV vaccine is vital, especially for those of the highest risky sexual behavior levels and adolescents with low risk perceptions of HPV infection.
Presentation: 20 minutes