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Human papillomavirus vaccine and behavioural disinhibition
  1. Christine L Schuler1,2,
  2. Paul L Reiter2,3,
  3. Jennifer S Smith2,3,
  4. Noel T Brewer2,3
  1. 1University of North Carolina, School of Medicine, Chapel Hill, North Carolina, USA
  2. 2University of North Carolina, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
  3. 3Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
  1. Correspondence to Paul L Reiter, Department of Health Behavior and Health Education, University of North Carolina Gillings School of Global Public Health, 323D Rosenau Hall, CB 7440, Chapel Hill, NC 27599-7440, USA; preiter{at}


Objectives We sought to identify characteristics of parents who believe in sexual disinhibition and that Pap smears can safely be stopped after females receive the human papillomavirus (HPV) vaccine.

Methods We surveyed 647 parents of adolescent girls living in areas of North Carolina with elevated rates of cervical cancer. We report data primarily from a survey conducted in October and November 2008.

Results Only 16% (101/647) of parents agreed that teenage girls who receive HPV vaccine may be more likely to have sex. Parents who believed in vaccine-induced sexual disinhibition were more likely to be older (OR 1.89, 95% CI 1.09 to 3.26) or report conservative political views (OR 2.26, 95% CI 1.37 to 3.73). Parents were less likely to believe in sexual disinhibition if they had greater knowledge about HPV vaccine (OR 0.52, 95% CI 0.32 to 0.85) or if their daughters had received HPV vaccine (OR 0.31, 95% CI 0.17 to 0.57). While few parents (5%; 30/647) believed that women could safely stop getting regular Pap smears after receiving HPV vaccine, this belief was somewhat more common among racial and ethnic minority parents (16%) and among fathers (13%).

Conclusions Few parents believed that HPV vaccine is likely to lead to increased sexual activity among females or reduce the need for vaccinated women to have regular Pap smears in the future. Characterising parents who hold beliefs in behavioural disinhibition is important as clinicians encountering parents in practice may desire information about this population.

  • Risk compensation
  • risk homeostasis
  • HPV vaccine
  • cervical cancer
  • screening
  • HPV
  • vaccination

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  • Funding The study received funding primarily from the Centers for Disease Control and Prevention (NB, JS) with additional support from the American Cancer Society (CS, NB) and the Cancer Control Education Program at Lineberger Comprehensive Cancer Center (R25 CA57726) (PR). Authors on the study hold research grants from Merck & Co, Inc (NB, PR) and GlaxoSmithKline (NB, JS). JS and NB have received honoraria or consulting fees from these companies in the last 4 years. Funding from Merck & Co, Inc and GlaxoSmithKline did not support this research study.

  • Competing interests None.

  • Ethics approval The Institutional Review Board at UNC Chapel Hill approved this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.