The human papillomavirus (HPV) vaccine isn't widely used in the United States, despite strong evidence of its protective benefits. Concern that vaccination may promote risky sexual activity among adolescents is one of the reasons suggested for the low vaccination rate. In response to this low rate, researchers evaluated the effect of state-level legislation designed to raise awareness and use of HPV vaccination on adolescent sexual behaviors.

Using data from a state-based survey of ninth-to-12th-grade students, they compared changes in sexual behavior among adolescents living in states that had and hadn't passed HPV-related legislation. The types of legislation included, in the words of the study, "vaccination mandates, HPV education[horizontal ellipsis], and vaccine cost and accessibility."

From 2001 to 2015, nearly 900,000 high school students participated in the surveys; about 25% reported they had had sexual intercourse in the previous three months, and nearly 97% of these reported having used condoms.

There was no difference in risky sexual behaviors between students in states with and without HPV legislation. Similarly, there were no significant differences in rates of sexual intercourse or condom use in states with and without HPV-related legislation when the results were separated according to the type of legislation. There was also no difference in the number of sexual partners in the previous three months, although there was a "nonsignificant decrease" in the number of sexual partners in those states with HPV-related legislation.

The authors advise that concern about an increase in risky adolescent sexual behaviors not be a factor when states are considering whether to pass HPV-related legislation.-KR

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