HPV dilemma
A random telephone survey of Hoosier adults' opinions about whether the HPV vaccine should be mandatory for middle school students reveals an "ambivalence about sexuality in our culture," similar to debates surrounding contraception and sex education, said William L. Yarber, senior director of the Rural Center on AIDS/STD Prevention at Indiana University.
"Parents face a real dilemma. They want to protect their children, but they're fearful of the protective methods," said Yarber, professor in the School of Health, Physical Education and Recreation's Department of Applied Health Science.
The study, which will be published in the winter Health Education Monograph, found that survey respondents were three times as likely to oppose a mandatory vaccine if they also believed it would encourage youth to have sex.
Here are additional findings of the study, "Public Opinion in Indiana Regarding the Vaccination of Middle School Students for HPV," which involved phone surveys of 504 adults. The survey was conducted in 2005, just prior to the FDA approval of the HPV vaccine.
- More than one third (35.5 percent) of respondents reported opposing a mandatory vaccine.
- Almost a quarter (24.8 percent) of respondents reported favoring a mandatory vaccine for girls and boys (the vaccine is only approved for girls to date).
- The remaining respondents were uncertain.
- Survey respondents who had more than a high school education and were white were more likely to oppose the vaccine.
Background: The national Centers for Disease Control and Prevention released a national study earlier in March stating that at least one in four teenage girls reported having an STD. Of the girls who reported having sex, an estimated 40 percent had an STD. The HPV vaccine Gardasil has been shown to prevent cervical cancer precursors caused by four types of human papillomavirus that are responsible for 70 percent of all cervical cancers and 90 percent of cases of genital warts. HPV also is thought to cause some oral cancers in men. While some states have proposed mandatory vaccines from school-age girls, the issue is controversial.
Yarber said sexual intercourse in the middle school years is considered too early from sexual health education and mental health perspectives. From a public health perspective, however, research has shown that some youth become sexually active following puberty, indicating a need to protect youth from the associated health risks, which can be serious.
Yarber said many sexuality professionals think the HPV vaccine will not encourage sex because of the many other factors that more strongly influence this decision, but he added that more research is needed in this area. Schools require various vaccines, Yarber said, but public opinion plays an important role in policy involving the HPV vaccine because it involves sex.
Co-authors of the study include lead author Robin Milhausen, RCAP and University of Guelph, Ontario; and Richard Crosby, RCAP, the Kinsey Institute for Research in Sex, Gender and Reproduction and the College of Public Health at the University of Kentucky. Yarber also is a professor in the departments of Applied Health Science and Gender Studies and is a senior research fellow of the Kinsey Institute.
