Mothers' and Adolescents' Beliefs about Risk Compensation following HPV Vaccination

Purpose: To examine the prevalence and predictors of the belief that human papillomavirus (HPV) vaccination will result in "risk compensation," that is, will increase risky sexual behavior. Methods: Two surveys were carried out: with 332 mothers (Study 1) and 360 adolescent girls (Study 2). The outcome measure was the score on a risk compensation scale tapping beliefs that HPV vaccination would increase risky sexual behavior. Results: Among mothers, those from the lowest income group (F = 4.38, p < .01), from ethnic minority backgrounds (F = 7.41, p < .01), and who did not attend cervical screening (F = 9.96,p < .01), had the highest risk compensation scores. Among adolescents, girls with lower educational attainment (F = 4.14, p < .05), from ethnic minority backgrounds (F = 6.60, p < .001), and who felt themselves to be less sexually experienced than their peers (F = 3.31, p < .05), had the highest scores. Girls showed lower belief in risk compensation in relation to their own behavior (personal compensation) than for "girls in general" (general compensation; t = 13.68, p < .001). Lower knowledge of HPV was associated with higher personal risk compensation beliefs (F = 4.26, p < .05). Conclusions: A significant minority of mothers and adolescents themselves say that HPV vaccination would increase the chance of risky sexual behavior. Because risk compensation beliefs are likely to predict HPV vaccine acceptance, identifying the basis for these beliefs and providing appropriate information and education to parents and adolescents will be vital. Following the introduction of vaccination, it will be important to discover whether risk compensation actually takes place, and every effort should be made to ensure it does not. (C) 2009 Society for Adolescent Medicine. All rights reserved.