Education on HPV vaccine doesn’t influence teens’ sexual behaviors


A new study reviewed rates of sexual activity and condom use in states that have passed legislation on HPV vaccine education. Here’s what researchers found regarding the prevalence of risky behaviors.

States that have passed legislation regarding access to and education about human papillomavirus (HPV) vaccination have not seen an uptick in teenaged sexual activity, according to a new report, which aims to put to rest concerns that education campaigns on the vaccine will influence adolescents’ attitudes on sex.

The report, published in Pediatrics, reviewed data on more than 800,000 teenagers from 2001 to 2015. Sexual behaviors before and after legislation in the 24 states regarding access and education for adolescents about the vaccine were reviewed, with the research team finding no significant association between legislation related to HPV and sexual behaviors.1

The study used data from the Youth Risk Behavior Surveillance System, investigating behaviors such as frequency of sexual activity and condom use.

Mixed outcomes

Researchers found that about a quarter of the students polled reported having sexual intercourse in the prior 3 months. Rates of education on sex and sexually transmitted diseases, sexual activity, and condom use were similar among teenagers who lived in states that passed HPV legislation and in students who were in states that did not pass HPV legislation, according to the report. In fact, the report notes that rates of sexual intercourse among teenagers living in states where HPV legislation has been passed decreased by 0.9 percentage points, and condom use increased by 0.96 percentage points, compared with teenagers living in states where no HPV legislation has been passed.

“We found no association between the passage of legislation designed to increase uptake of the HPV vaccine and sexual behaviors among high school-going adolescents in the United States,” the report concludes.

Although the study seeks to put an end to concerns that HPV legislation will negatively impact teenaged sexual behaviors, it also found that legislated education on the vaccine has done little to boost vaccination rates.

According to the Centers for Disease Control and Prevention (CDC), although HPV vaccination rates are slowly on the rise, with 66% of 13- to 17-year-olds initiating the vaccine series in 2017, only about half completed the series.2 However, rates of teenaged sex are decreasing overall, notes the report, and condom use has also dropped slightly since the 1990s and early 2000s.

The researchers note that whereas legislation aimed at educating teenagers to boost HPV vaccination has not been as effective as hoped in increasing vaccination rates-with little uptake in the vaccine noted before and after legislation was passed-concerns that HPV legislation would increase risky sexual behaviors do not appear to be substantiated.

Erin Cook, MPH, ScD, lead author of the report, who conceptualized and worked on the study while a doctoral candidate at the Harvard T.H. Chan School of Public Health, Boston, Massachusetts, and currently an associate at the Analysis Group, Boston, says that although the study did not review the best methods for educating teenagers on the HPV vaccine, or whether mandated vaccination programs are effective, she hopes it will at least clear up concerns that information on the vaccine will lead to risky sexual behaviors in adolescents.

“This study attempts to clear up concern that enacting legislation related to HPV will lead to an increase in sexual behaviors in teens,” Cook says. “If parents are concerned about these legislative policies, this study shows that enacting these policies does not appear to change adolescent sexual behaviors.”


Pediatricians should continue to educate patients and their families about the vaccine and use this data to alleviate parental concerns that education on the vaccine could promote increased sexual behaviors in their child.


1. Cook EE, Venkataramani AS, Kim JJ ,Tamimi RM , Holmes MD. Legislation to increase uptake of HV vaccination and adolescent sexual behaviors. Pediatrics. 2018;142(3):e20180458.

2. Centers for Disease Control and Prevention. CDC Newsroom: More US adolescents up–to-date on HPV vaccination [press release]. Available at: Updated August 23, 2018. Accessed October 2, 2018.

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