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AIDS and Behavior

, Volume 22, Issue 6, pp 1826–1834 | Cite as

HIV-Infected Young Men Demonstrate Appropriate Risk Perceptions and Beliefs about Safer Sexual Behaviors after Human Papillomavirus Vaccination

  • Jessica A. Kahn
  • Jeannette Lee
  • Marvin Belzer
  • Joel M. Palefsky
  • For the AIDS Malignancy Consortium and Adolescent Medicine Trials Network for HIV/AIDS Interventions
Original Paper

Abstract

The aim of this study was to identify risk perceptions after human papillomavirus (HPV) vaccination among HIV-infected young men who have sex with men. On average, participants appropriately perceived themselves to be at lower than neutral risk for HPV (mean subscale score 4.2/10), at higher than neutral risk for other sexually transmitted infections (7.0/10), and that safer sexual behaviors were still important (8.5/10). Higher perceived risk of HPV was associated with African-American race (p = .03); higher perceived risk of other sexually transmitted infections with White race (p = .01) and higher knowledge about HPV (p = .001); and higher perceived need for safer sexual behaviors with consistent condom use (p = .02). The study provides reassuring data that HIV-infected young men who have sex with men generally have appropriate risk perceptions and believe that safer sexual behaviors after vaccination are still important. These findings mirror the results of studies in HIV-infected young women and HIV-uninfected adolescents.

Keywords

Human papillomavirus Vaccine HIV Adolescent Risk perceptions 

Resumen

El objetivo de esta investigación fue el de identificar percepciones de riesgos después de recibir la vacuna contra el virus del papiloma humano (VPH), en hombres jóvenes infectados con VIH que tienen relaciones sexuales con hombres. En promedio, los participantes reconocieron debidamente que están en un riesgo más bajo que el neutral para contraer VPH (promedio de un puntaje de menor escala 4.2/10), en un riesgo más alto que el neutral para contraer otras infecciones transmitidas sexualmente (7.0/10), y que los comportamientos sexuales seguros aún son importantes (8.5/10). La percepción de tener un mayor riesgo de contraer VPH fue asociada con la raza afro-americana (p = .03). La percepción de tener un mayor riesgo de contraer otras infecciones trasmitidas sexualmente fue asociada con la raza blanca (p = .01), así como un mayor conocimiento sobre VPH (p = .001). Una percepción mayor sobre la necesidad de tener comportamientos sexuales seguros estuvo asociada con el uso consistente de condones (p = .02). La investigación provee datos alentadores indicando que los hombres jóvenes infectados con VIH, que tienen relaciones sexuales con hombres, generalmente tienen percepciones de riesgos apropiados y creen que los comportamientos sexuales más seguros siguen siendo importantes después de la vacunación. Estos resultados son similares a los resultados de investigaciones hechas en mujeres jóvenes infectadas con VIH y adolescentes no infectados con VIH.

Notes

Acknowledgements

This study was supported by the AIDS Malignancies Consortium (AMC) from the National Cancer Institute (UM1CA121974). The following AMC sites participated in this study: Boston Medical Center (E. Stier), Washington University School of Medicine (L. Ratner, G. Bucher), UCSD Moores Cancer Center (W. Wachsman, E. Cachay, A. Sitapati), Laser Surgery Center (S. Goldstone, D. Worrall), UCSF Medical Center Mount Zion (L. Kaplan, M. Berry, N. Jay, J. Palefsky, M. Rubin), Thomas Street Clinic (E. Chiao), Wake Forest University Health Sciences (L. Barroso, L. Bachmann), and University of Puerto Rico (M. Tirado-Gomez, H. Guiot). This work was also supported by The Adolescent Trials Network for HIV/AIDS Interventions (ATN) from the National Institutes of Health [U01 HD 040533 and U01 HD 040474] through the National Institute of Child Health and Human Development (B. Kapogiannis, L. Serchuck), with supplemental funding from the National Institutes on Drug Abuse (N. Borek) and Mental Health (P. Brouwers, S. Allison). The study was scientifically reviewed by the ATN’s Therapeutic Leadership Group. Network, scientific and logistical support was provided by the ATN Coordinating Center (C. Wilson, C. Partlow) at The University of Alabama at Birmingham. Network operations and analytic support was provided by the ATN Data and Operations Center at Westat, Inc. (J. Korelitz, B. Driver). The following ATN sites participated in this study: John H. Stroger Jr. Hospital of Cook County (Martinez, Bojan), Montefiore Medical Center (Futterman, Campos), St. Jude’s Children’s Research Hospital (Flynn, Dillard), Children’s Hospital of Los Angeles (Belzer, Tucker), Baylor College of Medicine (Paul, Head), The Fenway Institute (Mayer, Dormitzer), and the University of Colorado, Denver (Reirden, Chambers). The investigators are grateful to the members of the local youth Community Advisory Boards for their insight and counsel and are indebted to the youth who participated in this study. The comments and views of the authors do not necessarily represent the views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Vaccine and HPV Mean Geometric Titers were provided through the Investigator-Initiated Studies Program of Merck & Co., Inc. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck & Co., Inc.

Funding

This study was funded by the AIDS Malignancies Consortium (AMC) from the National Cancer Institute (UM1CA121974). This work was also supported by The Adolescent Trials Network for HIV/AIDS Interventions (ATN) from the National Institutes of Health (U01 HD 040533 and U01 HD 040474) through the National Institute of Child Health and Human Development. Vaccine and HPV Mean Geometric Titers were provided through the Investigator-Initiated Studies Program of Merck & Co., Inc.

Compliance with Ethical Standards

Conflicts of interest

Dr. Kahn has received research funding from Merck & Co. for clinical trials of the quadrivalent HPV vaccine in HIV-infected men and women; the trials were NIH-funded and Merck & Co. provided vaccine and immunogenicity testing. Dr. Belzer received research funding from ViiV Healthcare. Dr. Palefsky has received travel support and research support from Merck & Co. and serves on the scientific advisory boards for Agenovir Corporation, Antiva Biosciences, and The Vax. Dr. Lee reports has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

References

  1. 1.
    Palefsky JM. Human papillomavirus-related disease in men: not just a women’s issue. J Adolesc Health. 2010;46(4 Suppl):S12–9.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Piketty C, Selinger-Leneman H, Grabar S, Duvivier C, Bonmarchand M, Abramowitz L, et al. Marked increase in the incidence of invasive anal cancer among HIV-infected patients despite treatment with combination antiretroviral therapy. AIDS. 2008;22(10):1203–11.CrossRefPubMedGoogle Scholar
  3. 3.
    D’Souza G, Wiley DJ, Li X, Chmiel JS, Margolick JB, Cranston RD, et al. Incidence and epidemiology of anal cancer in the multicenter AIDS cohort study. J Acquir Immune Defic Syndr. 2008;48(4):491–9.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Markowitz LE, Dunne EF, Saraiya M, Chesson HW, Curtis CR, Gee J, et al. Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recommend Rep. 2014;63(RR-05):1–30.Google Scholar
  5. 5.
    Petrosky E, Bocchini JA Jr, Hariri S, Chesson H, Curtis CR, Saraiya M, et al. Use of 9-valent human papillomavirus (HPV) vaccine: updated HPV vaccination recommendations of the advisory committee on immunization practices. MMWR Morb Mortal Wkly Rep. 2015;64(11):300–4.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Kasting ML, Shapiro GK, Rosberger Z, Kahn JA, Zimet GD. Tempest in a teapot: a systematic review of HPV vaccination and risk compensation research. Human vaccines & immunotherapeutics. 2016;12(6):1435–50.CrossRefGoogle Scholar
  7. 7.
    Chesney MA, Chambers DB, Kahn JO. Risk behavior for HIV infection in participants in preventive HIV vaccine trials: a cautionary note. J Acquir Immune Defic Syndr Hum Retrovirol. 1997;16(4):266–71.CrossRefPubMedGoogle Scholar
  8. 8.
    Stolte G, Dukers NH, de Wit JB, Fennema H, Coutinho RA. A summary report from Amsterdam: increase in sexually transmitted diseases and risky sexual behaviour among homosexual men in relation to the introduction of new anti-HIV drugs. Euro Surveill. 2002;7(2):19–22.CrossRefPubMedGoogle Scholar
  9. 9.
    Stolte IG, Dukers NH, Geskus RB, Coutinho RA, de Wit JB. Homosexual men change to risky sex when perceiving less threat of HIV/AIDS since availability of highly active antiretroviral therapy: a longitudinal study. Aids. 2004;18(2):303–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Wilson TE, Gore ME, Greenblatt R, Cohen M, Minkoff H, Silver S, et al. Changes in sexual behavior among HIV-infected women after initiation of HAART. Am J Public Health. 2004;94(7):1141–6.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Bartholow BN, Buchbinder S, Celum C, Goli V, Koblin B, Para M, et al. HIV sexual risk behavior over 36 months of follow-up in the world’s first HIV vaccine efficacy trial. J Acquir Immune Defic Syndr. 2005;39(1):90–101.CrossRefPubMedGoogle Scholar
  12. 12.
    Kibira SP, Nansubuga E, Tumwesigye NM, Atuyambe LM, Makumbi F. Differences in risky sexual behaviors and HIV prevalence of circumcised and uncircumcised men in Uganda: evidence from a 2011 cross-sectional national survey. Reprod Health. 2014;11(1):25.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Lampinen TM, Chan K, Remis RS, Merid MF, Rusch M, Vincelette J, et al. Sexual risk behaviour of Canadian participants in the first efficacy trial of a preventive HIV-1 vaccine. CMAJ. 2005;172(4):479–83.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Westercamp N, Agot K, Jaoko W, Bailey RC. Risk compensation following male circumcision: results from a two-year prospective cohort study of recently circumcised and uncircumcised men in Nyanza Province, Kenya. AIDS Behav. 2014;18(9):1764–75.CrossRefPubMedGoogle Scholar
  15. 15.
    Ostrow DE, Fox KJ, Chmiel JS, Silvestre A, Visscher BR, Vanable PA, et al. Attitudes towards highly active antiretroviral therapy are associated with sexual risk taking among HIV-infected and uninfected homosexual men. Aids. 2002;16(5):775–80.CrossRefPubMedGoogle Scholar
  16. 16.
    Vanable PA, Ostrow DG, McKirnan DJ. Viral load and HIV treatment attitudes as correlates of sexual risk behavior among HIV-positive gay men. J Psychosom Res. 2003;54(3):263–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Stolte IG, de Wit JB, van Eeden A, Coutinho RA, Dukers NH. Perceived viral load, but not actual HIV-1-RNA load, is associated with sexual risk behaviour among HIV-infected homosexual men. Aids. 2004;18(14):1943–9.CrossRefPubMedGoogle Scholar
  18. 18.
    van der Snoek EM, de Wit JB, Mulder PG, van der Meijden WI. Incidence of sexually transmitted diseases and HIV infection related to perceived HIV/AIDS threat since highly active antiretroviral therapy availability in men who have sex with men. Sex Transm Dis. 2005;32(3):170–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Elford J. Changing patterns of sexual behaviour in the era of highly active antiretroviral therapy. Curr Opin Infect Dis. 2006;19(1):26–32.CrossRefPubMedGoogle Scholar
  20. 20.
    Davis K, Dickman ED, Ferris D, Dias JK. Human papillomavirus vaccine acceptability among parents of 10- to 15-year-old adolescents. J Low Genit Tract Dis. 2004;8(3):188–94.CrossRefPubMedGoogle Scholar
  21. 21.
    Kahn JA, Zimet GD, Bernstein DI, Riedesel JM, Lan D, Huang B, et al. Pediatricians’ intention to administer human papillomavirus vaccine: the role of practice characteristics, knowledge, and attitudes. J Adolesc Health. 2005;37(6):502–10.CrossRefPubMedGoogle Scholar
  22. 22.
    Kahn JA, Ding L, Huang B, Zimet GD, Rosenthal SL, Frazier AL. Mothers’ intention for their daughters and themselves to receive the human papillomavirus vaccine: a national study of nurses. Pediatrics. 2009;123(6):1439–45.CrossRefPubMedGoogle Scholar
  23. 23.
    Kahn JA, Cooper HP, Vadaparampil ST, Pence BC, Weinberg AD, LoCoco SJ, et al. Human papillomavirus vaccine recommendations and agreement with mandated human papillomavirus vaccination for 11-to-12-year-old girls: a statewide survey of Texas physicians. Cancer Epidemiol Biomarkers Prev. 2009;18(8):2325–32.CrossRefPubMedGoogle Scholar
  24. 24.
    Wetzel C, Tissot A, Kollar LM, Hillard PA, Stone R, Kahn JA. Development of an HPV Educational Protocol for Adolescents. J Pediatr Adolesc Gynecol. 2007;20(5):281–7.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Kahn JA, Rosenthal SL, Jin Y, Huang B, Namakydoust A, Zimet GD. Rates of human papillomavirus vaccination, attitudes about vaccination, and human papillomavirus prevalence in young women. Obstet Gynecol. 2008;111(5):1103–10.CrossRefPubMedGoogle Scholar
  26. 26.
    Conroy K, Rosenthal SL, Zimet GD, Jin Y, Bernstein DI, Glynn S, et al. Human papillomavirus vaccine uptake, predictors of vaccination, and self-reported barriers to vaccination. J Womens Health (Larchmt). 2009;18(10):1679–86.CrossRefGoogle Scholar
  27. 27.
    Kahn JA, Xu J, Zimet GD, Liu N, Gonin R, Dillard ME, et al. Risk perceptions after human papillomavirus vaccination in HIV-infected adolescents and young adult women. J Adolesc Health. 2012;50(5):464–70.CrossRefPubMedGoogle Scholar
  28. 28.
    Mullins TL, Zimet GD, Rosenthal SL, Morrow C, Ding L, Shew M, et al. Adolescent perceptions of risk and need for safer sexual behaviors after first human papillomavirus vaccination. Arch Pediatr Adolesc Med. 2012;166(1):82–8.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Mayhew A, Mullins TL, Ding L, Rosenthal SL, Zimet GD, Morrow C, et al. Risk perceptions and subsequent sexual behaviors after HPV vaccination in adolescents. Pediatrics. 2014;133(3):404–11.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Mullins TL, Zimet GD, Rosenthal SL, Morrow C, Ding L, Huang B, et al.. Human papillomavirus vaccine-related risk perceptions and subsequent sexual behaviors and sexually transmitted infections among vaccinated adolescent women. Vaccine. 2016.Google Scholar
  31. 31.
    Mullins TL, Widdice LE, Rosenthal SL, Zimet GD, Kahn JA. Risk perceptions, sexual attitudes, and sexual behavior after HPV vaccination in 11-12 year-old girls. Vaccine. 2015;33(32):3907–12.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Johnson WD, Diaz RM, Flanders WD, Goodman M, Hill AN, Holtgrave D, et al. Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. The Cochrane database of systematic reviews. 2008;3:CD001230.Google Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Jessica A. Kahn
    • 1
    • 5
  • Jeannette Lee
    • 2
  • Marvin Belzer
    • 3
  • Joel M. Palefsky
    • 4
  • For the AIDS Malignancy Consortium and Adolescent Medicine Trials Network for HIV/AIDS Interventions
  1. 1.Department of PediatricsCincinnati Children’s Hospital Medical Center and the University of Cincinnati College of MedicineCincinnatiUSA
  2. 2.Department of BiostatisticsUniversity of Arkansas for Medical SciencesLittle RockUSA
  3. 3.Department of PediatricsUniversity of Southern CaliforniaLos AngelesUSA
  4. 4.Department of MedicineUniversity of California San FranciscoSan FranciscoUSA
  5. 5.Division of Adolescent Medicine, MLC 4000Cincinnati Children’s Hospital Medical CenterCincinnatiUSA

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