Risk perceptions and subsequent sexual behaviors after HPV vaccination in adolescents

Allison Mayhew, Tanya L. Kowalczyk Mullins, Lili Ding, Susan L. Rosenthal, Gregory D. Zimet, Charlene Morrow, Jessica A. Kahn

Research output: Contribution to journalArticle

40 Scopus citations


OBJECTIVES: Concerns have been raised that human papillomavirus (HPV) vaccination could lead to altered risk perceptions and an increase in risky sexual behaviors among adolescents. The aim of this study was to assess whether adolescent risk perceptions after the first vaccine dose predicted subsequent sexual behaviors. METHODS: Young women 13 to 21 years of age (N = 339) completed questionnaires immediately after HPV vaccination, and 2 and 6 months later, assessing demographic characteristics, knowledge/attitudes about HPV vaccination, risk perceptions, and sexual behaviors. Risk perceptions were measured by using 2 5-item scales assessing: (1) perceived risk of sexually transmitted infections (STI) other than HPV, and (2) perceived need for safer sexual behaviors after HPV vaccination. We assessed associations between risk perceptions at baseline and sexual behaviors over the next 6 months by using logistic regression, stratifying participants by sexual experience at baseline and age (13-15 vs 16-21 years). RESULTS: Among all sexually inexperienced participants (42.5%), baseline risk perceptions were not associated with subsequent sexual initiation; in age-stratified analyses, girls 16 to 21 years of age who reported lower perceived risk for other STI (an inappropriate perception) were less likely to initiate sex (odds ratio [OR] 0.13, 95% confidence interval [CI] 0.03-0.69). Among all sexually experienced participants (57.5%) and in age-stratified analyses, baseline risk perceptions were not associated with subsequent number of sexual partners or condom use. CONCLUSIONS: Risk perceptions after HPV vaccination were not associated with riskier sexual behaviors over the subsequent 6 months in this study sample.

Original languageEnglish (US)
Pages (from-to)404-411
Number of pages8
Issue number3
StatePublished - Jan 1 2014



  • Adolescent
  • HPV vaccines
  • Perception
  • Risk
  • Sexual behavior

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Mayhew, A., Kowalczyk Mullins, T. L., Ding, L., Rosenthal, S. L., Zimet, G. D., Morrow, C., & Kahn, J. A. (2014). Risk perceptions and subsequent sexual behaviors after HPV vaccination in adolescents. Pediatrics, 133(3), 404-411. https://doi.org/10.1542/peds.2013-2822