- Browse by Subject
Browsing by Subject "Risk compensation"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
Item Differences in cervical cancer screening knowledge, practices, and beliefs: An examination of survey responses(Elsevier, 2016-12-21) Kasting, Monica L.; Wilson, Shannon; Zollinger, Terrell W.; Dixon, Brian E.; Stupiansky, Nathan W.; Zimet, Gregory D.; Department of Epidemiology, Richard M. Fairbanks School of Public HealthAmong the identified barriers to HPV vaccination is the concern that women may compensate for their reduced susceptibility to cervical cancers by reducing cervical cancer screening. This exploratory study examined the relationship between cervical cancer screening rates and HPV vaccination. We conducted a cross-sectional survey using a convenience sample of women aged 21-35 attending a local minority health fair in July 2015. Data were analyzed in 2015-2016. Outcomes assessed were: receiving a Pap test within the last three years, awareness and comfort with current Pap test recommendations, and knowledge regarding the purpose of a Pap test. A total of 291 women were included in the analyses. Mean age was 28.5 years and 62% were non-Hispanic black. 84% had received a Pap test in the last three years and 33% had received at least one HPV vaccine. Logistic regression results showed that women who had been vaccinated did not have lower odds of having a Pap test in the past three years (OR = 1.32; 95% CI = 0.66-2.65). In an adjusted regression model controlling for age and race, vaccinated women were significantly more likely to have had a Pap test (AOR = 3.06; 95% CI = 1.37-6.83). Yet only 26% of women knew the purpose of a Pap test and the proportion who answered correctly was higher among non-Hispanic white women. Women who have been vaccinated for HPV are more likely to have been screened for cervical cancer. These results suggest areas for more robust studies examining pro-health attitudes, behaviors, and communication regarding vaccination and preventive screening.Item Human papillomavirus vaccination status association with subsequent health behaviors(2016-04-28) Kasting, Monica Louise; Zimet, Gregory D.Human papillomavirus (HPV) infection results in serious health issues including cervical, anal, vulvar, penile and oropharyngeal cancers. There are three vaccines against HPV but vaccination rates in the United States remain low. One barrier to uptake is a concern that individuals who are vaccinated may increase their risky sexual behaviors or decrease their use of cervical cancer screenings, an adjustment in perceived level of risk for HPV that can be studied using risk compensation theory. Methods Three distinct studies examined risk compensation after HPV vaccination. A systematic review examined literature from January 1, 2008-June 30, 2015, using three databases. A qualitative study using semi-structured interviews of 22 healthcare providers that assessed their beliefs regarding sexual disinhibition and cervical cancer screening following vaccination. A cross-sectional survey that assessed cervical cancer screening practices, awareness and comfort with recommendations, and knowledge regarding the purpose of a Papanicolaou (Pap) test. Results Twenty articles were included in the systematic review. None of the studies of sexual behaviors and/or biological outcomes found evidence of riskier behaviors after HPV vaccination. Instead, the studies found vaccinated individuals were less likely to report risky sexual behaviors, sexually transmitted infections (STIs), and pregnancy. Qualitative interviews found no healthcare providers believed the HPV vaccine would result in increased risky sexual behavior or decreased cervical cancer screening, and these concerns would not influence their vaccination recommendations. The survey included 291 women 21-35 years old; 62% were non-Hispanic black, 84% had a Pap test in the last three years, and 33% had at least one HPV vaccine. Logistic regression showed that vaccinated women did not have greater odds of having a Pap test in the past three years (OR=1.32; 95% CI=0.66-2.65; p=0.427). However, this odds ratio was significant when controlling for age and race (AOR=3.06; 95% CI=1.37-6.83; p=0.006). Conclusion These studies found no evidence of increased risky sexual behaviors or decreased cervical cancer screening rates after HPV vaccination. Furthermore, vaccinated women showed less evidence of risk compensation. These results should alleviate concerns about administering the HPV vaccination among parents and providers.Item Tempest in a teapot: A systematic review of HPV vaccination and risk compensation research(Taylor & Francis, 2016-06-02) Kasting, Monica L.; Shapiro, Gilla K.; Rosberger, Zeev; Kahn, Jessica A.; Zimet, Gregory D.; Department of Epidemiology, Richard M. Fairbanks School of Public HealthThere has been some concern among parents and in the media that vaccinating children against human papillomavirus could be seen as giving children permission to engage in risky sexual behaviors (also known as sexual disinhibition). Several studies have found this concern to be unfounded but there have been no attempts to synthesize the relevant studies in order to assess if there is evidence of sexual disinhibition. The aim of this study was to synthesize recent literature examining sexual behaviors and biological outcomes (e.g., sexually transmitted infections) post-HPV vaccination. We reviewed literature from January 1, 2008-June 30, 2015 using PubMed, CINAHL, and Embase with the following search terms: [(sex behavior OR sex behavior OR sexual) AND (human papillomavirus OR HPV) AND (vaccines OR vaccine OR vaccination)] followed by a cited reference search. We included studies that examined biological outcomes and reported behaviors post-vaccination in both males and females. Studies were reviewed by title and abstract and relevant studies were examined as full-text articles. We identified 2,503 articles and 20 were eventually included in the review. None of the studies of sexual behaviors and/or biological outcomes found evidence of riskier behaviors or higher rates of STIs after HPV vaccination. Instead, the studies found that vaccinated compared to unvaccinated individuals were less likely to report vaginal intercourse without a condom (OR = 0.5; 95%CI = 0.4-0.6) and non-use of contraception (OR = 0.27; 95%CI = 0.15-0.48) and unvaccinated participants had higher rates of Chlamydia (OR = 2.3; 95%CI = 1.06-5.00). These results should be reassuring to parents and health care providers.