HPV vaccination has not increased sexual activity or accelerated sexual debut in a college-aged cohort of men and women

BMC Public Health. 2019 Jun 25;19(1):821. doi: 10.1186/s12889-019-7134-1.


Background: The human papillomavirus (HPV) is the most common sexually transmitted infection and is linked to several types of cancer. HPV vaccination uptake in the U.S. is relatively low, despite the vaccine's high efficacy. Some parents of adolescents have concerns that vaccination will encourage sexual behavior and therefore choose not to vaccinate. Previous studies investigating vaccination and sexual behavior have included only young women and girls.

Methods: The objective of this study is to assess associations between HPV-vaccination and sexual behavior in a college-age cohort of both men and women. We analyzed questionnaire data collected from the Michigan HPV and Oropharyngeal Cancer Study, a cohort study designed to investigate HPV infection and its association with sexual behavior (data collected 2015-17, Ann Arbor, MI). Here, we consider vaccination status, sexual behavior, and substance use among 241 college-aged men and women. Logistic, Poisson, and Cox regression were used to determine the relationship between probability of sexual debut, number of sexual partners, and HPV vaccination status at baseline as well as between age at sexual debut and vaccination status at debut.

Results: HPV vaccination status was not significantly associated with an increased likelihood of sexual debut (odds ratio: 0.80 (95% CI: 0.41-1.58), decreased age of sexual debut (hazard ratio: 0.81 (95% CI: 0.65-1.00), nor an increased number of sexual partners (per year sexually active; incidence rate ratio: 1.27 (95% CI: 0.86-1.87)) in this cohort, after controlling for age, race, sex, and substance use. Instead, race or alcohol use were independent predictors of sexual behavior.

Conclusions: Concerns about the influence of the HPV vaccine on sexual behavior are likely unfounded for both men and women. These results can aid in increasing vaccine acceptability, inform and strengthen physician recommendations, and ultimately reduce the burden of HPV and HPV-related cancers in the U.S.

Keywords: Cohort study; College-aged population; HPV vaccine; Human papillomavirus; M-HOC study; Sexual behavior.

MeSH terms

  • Adolescent
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Michigan
  • Papillomavirus Vaccines / administration & dosage*
  • Sexual Behavior / psychology*
  • Sexual Behavior / statistics & numerical data*
  • Universities
  • Young Adult


  • Papillomavirus Vaccines