Abstract
BackgroundPrevious studies were conflicting regarding the associations between HPV vaccination, cervical cancer risk perceptions, high-risk sexual behaviors and STIs. This study compared the HPV-vaccinated and non-vaccinated young women in Uganda regarding cervical cancer risk perceptions, high-risk sexual behaviors, syphilis and HIV infections 5 years after vaccine implementation.MethodsThis was a population-based comparative cross-sectional survey conducted in Uganda. The 438 participants were sexually active young women aged 15–24 years and mean age was 18.6 (SD 1.4). The majority (53.0%) were HPV-vaccinated in 2008 without assessment of sexual activity prior to HPV vaccination. Upon verbal assessment of sexual activity at the time of follow-up, data were collected using a questionnaire and laboratory testing of blood samples for syphilis and HIV infections.ResultsThere were no significant differences between the HPV-vaccinated and non-vaccinated groups regarding the prevalence of high-risk sexual behaviors, syphilis and HIV infections. Cervical cancer risk perceptions and age at sexual debut were nonetheless significantly lower among the vaccinated group compared to their non-vaccinated counterparts. However, HPV vaccination was not significantly associated to cervical cancer risk perceptions and early age at sexual debut in multivariate logistic regression analysis.ConclusionsWe found no associations between HPV vaccination, cervical cancer risk perceptions, high-risk sexual behaviors, syphilis and HIV infections among young women in Uganda 5 years after vaccine implementation. Young girls in the study population were found to be sexually active at a young age, affirming the importance of targeting girls of younger age for HPV vaccination.
Highlights
Previous studies were conflicting regarding the associations between Human papillomavirus (HPV) vaccination, cervical cancer risk perceptions, high-risk sexual behaviors and sexually transmitted infections (STIs)
The age range of the 438 study participants which comprised of 50.4% HPV-vaccinated young women was 15– 24 years and mean age was 18.6 (SD 1.4)
As shown in schema 1, of the 492 eligible young women whose demographic data were obtained for the study, 54 declined responding to the CC questionnaire
Summary
Previous studies were conflicting regarding the associations between HPV vaccination, cervical cancer risk perceptions, high-risk sexual behaviors and STIs. Cervical cancer (CC) is the third most common cancer among women globally in terms of 5-year prevalence (i.e. total cases identified over a 5-year period) with an estimated 527,624 new cases and 265,672 deaths in 2012 [1]. The vaccine in use during the pilot phase was the bivalent HPV vaccine (Cervarix®, GlaxoSmithKline, Belgium) which administered to girls aged 10 years or in primary school grade 5 in 3 doses at an interval of 0, 1 and 6 months. The vaccine is administered to girls aged 9 years or in primary school grade 4 in 2 doses at an interval of 0 and 6 months. The delivery of the HPV vaccines to the girls is integrated into a bi-annual (every April and October) school health programme popularly known as child health days plus (CHDP) during which health workers visits schools to provide catchup vaccination and medication against intestinal worms. At the time of the study, the Uganda ministry of health had no written strategic plan for use of 9-valent HPV vaccine instead of or concurrently with bivalent and quadrivalent vaccines
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