Gilbert T. Chua, MRCPCH(UK), Frederick K Ho, PhD, Keith T Tung, MPH, Rosa S Wong, MPhil, Kai Ning Cheong, FHKAM, Paul S Yip, PhD, Susan Y Fan, MRCOG(UK), Wilfred H Wong , PhD, Youlin Qiao, PhD, Celine SL Chui, PhD, Shirley X Li, PhD, Patrick Ip, MPH
OBJECTIVES: Human papillomavirus (HPV) vaccination and cervical screening prevent cervical cancer effectively. However, there are concerns whether vaccination leads to high-risk sexual behaviors and less intention for cervical screening. We aimed to evaluate the influence of HPV vaccination on high-risk sexual behaviors, and intention for cervical screening among young Chinese females. We also reported the latest HPV vaccination uptake in Hong Kong. METHODS: A population-based survey was conducted between September 2016 and January 2017. Subjects were school-age girls from twenty-five secondary schools (in-school) and community females between 18 and 27 years (out-school). Demographics, vaccine-related attitudes, intention for cervical screening and participants’ sexual behaviors were examined. RESULTS: We surveyed 2260 females from in-school (n=1664) and out-school (n=596) settings. 11.5% in-school and 23.5% out-school participants received at least one dose of HPV vaccine. Vaccination was not associated with underage sex (in-school Odds Ratio [OR] 1.22, p=0.80; out-school OR 0.63, p=0.67), early sexual exposure (in-school ? 0.01, p=0.99; out-school ? 0.13, p=0.75), multiple sex partners (in-school OR 3.27, p=0.08; out-school OR 1.16, p=0.43), and unprotected sex (in-school OR 1.14, p=0.78; out-school OR 0.60, p=0.10). More vaccinated females intended for cervical screening (in-school 23.6% vs. 21.1%; out-school 53.6% vs. 43.6%). Costs and knowledge were important factors for non-vaccination and non-intention for cervical screening. CONCLUSIONS: HPV vaccination was not associated with high risk sexual behavior but higher intention for cervical screening among Chinese young females. A government-subsidized universal HPV vaccination program with education support is warranted to increase HPV vaccine uptake.