{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T01:29:28Z","timestamp":1789349368473,"version":"build-2803163510"},"reference-count":34,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>Previous surveys on hypothesized sexual activity changes after human papillomavirus (HPV) vaccination may be subject to self-response biases. To date, no studies measured clinical markers of sexual activity after HPV vaccination. This study evaluated sexual activity\u2013related clinical outcomes after adolescent vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study utilizing longitudinal electronic data from a large managed care organization. Girls enrolled in the managed care organization, aged 11 through 12 years between July 2006 and December 2007, were classified by adolescent vaccine (HPV; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed; quadrivalent meningococcal conjugate) receipt. Outcomes (pregnancy\/sexually transmitted infection testing or diagnosis; contraceptive counseling) were assessed through December 31, 2010, providing up to 3 years of follow-up. Incidence rate ratios comparing vaccination categories were estimated with multivariate Poisson regression, adjusting for health care\u2013seeking behavior and demographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The cohort included 1398 girls (493 HPV vaccine\u2013exposed; 905 HPV vaccine\u2013unexposed). Risk of the composite outcome (any pregnancy\/sexually transmitted infection testing or diagnosis or contraceptive counseling) was not significantly elevated in HPV vaccine\u2013exposed girls relative to HPV vaccine\u2013unexposed girls (adjusted incidence rate ratio: 1.29, 95% confidence interval [CI]: 0.92 to1.80; incidence rate difference: 1.6\/100 person-years; 95% CI: \u22120.03 to 3.24). Incidence rate difference for Chlamydia infection (0.06\/100 person-years [95% CI: \u22120.30 to 0.18]) and pregnancy diagnoses (0.07\/100 person-years [95% CI: \u22120.20 to 0.35]), indicating little clinically meaningful absolute risk differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>HPV vaccination in the recommended ages was not associated with increased sexual activity\u2013related outcome rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2012-1516","type":"journal-article","created":{"date-parts":[[2012,10,15]],"date-time":"2012-10-15T21:52:40Z","timestamp":1350337960000},"page":"798-805","source":"Crossref","is-referenced-by-count":162,"title":["Sexual Activity\u2013Related Outcomes After Human Papillomavirus Vaccination of 11- to 12-Year-Olds"],"prefix":"10.1542","volume":"130","author":[{"given":"Robert A.","family":"Bednarczyk","sequence":"first","affiliation":[{"name":"Center for Health Research-Southeast, Kaiser Permanente, Atlanta, Georgia; and"},{"name":"Rollins School of Public Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Davis","sequence":"additional","affiliation":[{"name":"Center for Health Research-Southeast, Kaiser Permanente, Atlanta, Georgia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Ault","sequence":"additional","affiliation":[{"name":"School of Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Orenstein","sequence":"additional","affiliation":[{"name":"School of Medicine, and"},{"name":"Emory Vaccine Center, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saad B.","family":"Omer","sequence":"additional","affiliation":[{"name":"Center for Health Research-Southeast, Kaiser Permanente, Atlanta, Georgia; and"},{"name":"Rollins School of Public Health,"},{"name":"School of Medicine, and"},{"name":"Emory Vaccine Center, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2012,11,1]]},"reference":[{"key":"2021120903103897700_B1","first-page":"1","article-title":"Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP).","volume":"56","author":"Markowitz","year":"2007","journal-title":"MMWR Recomm Rep"},{"issue":"17","key":"2021120903103897700_B2","first-page":"297","article-title":"Sexual experience and contraceptive use among female teens\u2014United States, 1995, 2002, and 2006-2010.","volume":"61","author":"Centers for Disease Control and Prevention (CDC)","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021120903103897700_B3","volume-title":"Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2006-2010 National Survey of Family Growth","author":"Martinez","year":"2011"},{"issue":"5","key":"2021120903103897700_B4","first-page":"1","article-title":"Youth risk behavior surveillance\u2014United States, 2009.","volume":"59","author":"Eaton","year":"2010","journal-title":"MMWR Surveill Summ"},{"issue":"4","key":"2021120903103897700_B5","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1093\/infdis\/jir341","article-title":"Prevalence of genital human papillomavirus among females in the United States, the National Health And Nutrition Examination Survey, 2003-2006.","volume":"204","author":"Hariri","year":"2011","journal-title":"J Infect Dis"},{"issue":"4","key":"2021120903103897700_B6","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1093\/infdis\/jir342","article-title":"Human papillomavirus (HPV) 6, 11, 16, and 18 prevalence among females in the United States\u2014National Health And Nutrition Examination Survey, 2003-2006: opportunity to measure HPV vaccine impact?","volume":"204","author":"Dunne","year":"2011","journal-title":"J Infect Dis"},{"issue":"33","key":"2021120903103897700_B7","first-page":"1117","article-title":"National and state vaccination coverage among adolescents aged 13 through 17 years\u2014United States, 2010.","volume":"60","author":"Centers for Disease Control and Prevention (CDC)","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021120903103897700_B8","first-page":"1","article-title":"Prevention and control of meningococcal disease. Recommendations of the Advisory Committee on Immunization Practices (ACIP).","volume":"54","author":"Bilukha","year":"2005","journal-title":"MMWR Recomm Rep"},{"key":"2021120903103897700_B9","first-page":"1","article-title":"Preventing tetanus, diphtheria, and pertussis among adolescents: use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccines recommendations of the Advisory Committee on Immunization Practices (ACIP).","volume":"55","author":"Broder","year":"2006","journal-title":"MMWR Recomm Rep"},{"issue":"17","key":"2021120903103897700_B10","doi-asserted-by":"crossref","first-page":"3138","DOI":"10.1016\/j.vaccine.2011.02.045","article-title":"Human papillomavirus vaccine uptake and barriers: association with perceived risk, actual risk and race\/ethnicity among female students at a New York State university, 2010.","volume":"29","author":"Bednarczyk","year":"2011","journal-title":"Vaccine"},{"issue":"16","key":"2021120903103897700_B11","doi-asserted-by":"crossref","first-page":"2676","DOI":"10.1016\/j.vaccine.2012.02.007","article-title":"Intent to receive HPV vaccine and reasons for not vaccinating among unvaccinated adolescent and young women: findings from the 2006-2008 National Survey of Family Growth.","volume":"30","author":"Liddon","year":"2012","journal-title":"Vaccine"},{"issue":"2","key":"2021120903103897700_B12","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1080\/07448481.2011.580028","article-title":"Human papillomavirus vaccine intent and uptake among female college students.","volume":"60","author":"Patel","year":"2012","journal-title":"J Am Coll Health"},{"key":"2021120903103897700_B13","unstructured":"United Press International. Promiscuity fears hinders HPV vaccine use. Available at: www.upi.com\/Health_News\/2008\/12\/19\/Promiscuity-fears-hinders-HPV-vaccine-use\/UPI-54571229744264\/. Accessed October 28, 2011"},{"key":"2021120903103897700_B14","unstructured":"Rubin R. Injected into a controversy. USA Today. Available at: www.usatoday.com\/news\/health\/2005-10-19-cervical-cancer-injection_x.htm. 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