Background The human papillomavirus (HPV) is a sexually transmitted infection responsible for the majority of cervical and anogenital cancers. HPV vaccination aims to reduce this risk especially against the four most influential strains, HPV genotype 6, 11, 16 and 18. However, it is not known if HPV vaccination also exerts an influence over sexual behaviour. The objective of this study is to investigate whether a positive HPV vaccination increases the risk of engaging in unsafe sexual health practice.
Methods A systematic literature search was conducted in MEDLINE, Scopus, Embase, Discovery and Google Scholar, from the 1st of January 2007 to the 1st of March 2015. Titles, abstracts and in case of relevance, full-texts, were screened according to predefined inclusion and exclusion criteria. Relevant study characteristics and results were transcribed and narratively synthesised into a pre-specified form. Each study was critically appraised by three researchers in accordance with internationally accepted criteria (STROBE, CONSORT, PRISMA).
Results Four relevant studies were identified and each assessed differing aspects of HPV vaccination and its association with sexual health. Vaccination was not a significant predictor of perceived vulnerability to cervical cancer (p = 0.601), intention to participate in HPV screening (p = 0.521) or uptake of cervical screening (p = 0.181). HPV vaccination was not a significant predictor of safer sexual behaviour (p = 0.515) or consistent condom use (p = 0.876).
Conclusion The results have proven inconclusive, as there is insufficient evidence to support or refute that HPV vaccination increases the risk of unsafe sexual behaviours. Notwithstanding, we observed a number of misconceptions regarding HPV, vaccination programs and cervical cancer screening. A positive HPV vaccination status contributed to a sense of complacency regarding the need for regular cervical cancer screening. Moreover, unvaccinated women were more likely to believe that HPV vaccine could be used as treatment for cervical cancer. As such these issues must be addressed in future research.
Disclosure of interest statement Nothing to declare