Adolescent Perceptions of Risk and Need for Safer Sexual Behaviors After First Human Papillomavirus Vaccination

Objectives: To (1) examine perceptions of risk of human papillomavirus (HPV) and other sexually transmitted infections (STIs), (2) examine perceived need for safer sexual behaviors, and (3) determine factors associated with less perceived need for safer sexual behaviors, all in the context of receiving the first HPV vaccination. Design: Cross-sectional baseline analysis from an ongoing longitudinal cohort study. Setting: An urban hospital-based adolescent primary care clinic. Participants: Girls 13 to 21 years (for this article girls are defined as being aged 13 to 21 years) (n=339) receiving their first HPV vaccination and their mothers (n=235). Main Outcome Measures: (1) Girls' perceived risk of HPV after HPV vaccination, (2) girls' perceived risk of other STIs after vaccination, (3) girls' perceived need for continued safer sexual behaviors after vaccination, and 4) factors associated with girls' perception of less need for safer sexual behaviors. Results: Mean age of girls was 16.8 years. Most participants (76.4%) were black, and 57.5% were sexually experienced. Girls perceived themselves to be at less risk for HPV than for other STIs after HPV vaccination (P<.001). Although most girls reported continued need for safer sexual behaviors, factors independently associated with perception of less need for safer sexual behaviors included adolescent factors (lower HPV and HPV vaccine knowledge and less concern about HPV) and maternal factors (lower HPV and HPV vaccine knowledge, physician as a source of HPV vaccine information, and lack of maternal communication about the HPV vaccine). Conclusions: Few adolescents perceived less need for safer sexual behaviors after the first HPV vaccination. Education about HPV vaccines and encouraging communication between girls and their mothers may prevent misperceptions among these adolescents.