Young women who are vaccinated against the human papillomavirus (HPV) do not engage in riskier sexual behavior as a result, finds a new study in Pediatrics by Allison Mayhew from the University of Cincinnati College of Medicine and colleagues. HPV is the most common STI in the United States and the principal cause of cervical cancer. These findings yet again confirm the scientific consensus that providing adolescents access to services and information related to sexual and reproductive health is not linked to riskier sexual behavior, as social conservatives have often argued.
For instance, strong evidence also suggests that comprehensive approaches to sex education that stress waiting to initiate sex but also provide adolescents with accurate, age-appropriate information about contraception have a positive impact. Comprehensive sex education programs have been shown to help young people both withstand the pressures to have sex too soon and have healthy, responsible and mutually protective relationships when they do become sexually active. As is the case with the HPV vaccine, social conservatives—despite this strong evidence—oppose such programs and instead champion discredited abstinence-only programs.
The Centers for Disease Control and Prevention (CDC) recommends routine HPV vaccination for girls and boys aged 11–12. The Center announced last year that HPV vaccination had led to a steep 56% decrease in the number of 14–19-year-old young women infected with the virus. This marks a significant public health victory. Yet despite the vaccine’s proven effectiveness, uptake is low: 2010 CDC data showed that just 32% of young women aged 13–17 had been vaccinated.
One reason for this slow uptake is conservative opposition to the HPV vaccine and its inclusion in school-based programs. When the vaccine was introduced in 2006, social conservatives opposed it strenuously, arguing that it would promote teenage promiscuity and undermine abstinence efforts. However, Guttmacher research indicates that even after the introduction of the HPV vaccine, sexual activity amongst the youngest adolescents has been and continues to be rare. Only Virginia and Washington, DC require the HPV vaccine for school attendance, and both locales provide parental opt-outs.
The slow uptake of the vaccine is highly problematic, since the great promise of the vaccine is not just that it protects against cervical and other cancers, but also that it has the potential to significantly reduce tremendous current disparities in rates of both HPV infection and related deaths. CDC data on cases of HPV reported in 2007 show that Hispanic women had the highest rate of cervical cancer—53% greater than the rate for white women. Black women’s rate was 36% higher than white women’s. Additionally, black women were most likely to die from the disease—their mortality rate was twice that of white women, while Hispanic women had a mortality rate 35% higher than that of white women.
The Affordable Care Act (ACA) also has the potential to increase HPV vaccination rates by expanding public and private insurance coverage for millions of Americans. The ACA guarantees coverage without cost-sharing of the otherwise expensive HPV vaccine under most private insurance plans. Likewise, Medicaid, which is being expanded significantly under the ACA, covers the HPV vaccine under most circumstances.
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