Research Debunks “Promiscuity Objection” to HPV Vaccine

One of the objections to the HPV vaccine was that it might encourage promiscuity, and so should not be administered.  There was a number of reasons why the objection failed.

For one thing, it was never made clear that the fear of HPV would stop people having sex in the first place.  In fact, it plainly doesn’t – and the evidence for this is that – gasp! – people were having sex with each other even before the vaccine.  So, if someone is going to be having unsafe sex, then it’s not likely that the vaccine would make all that much difference – except to minimise at least one of the risk factors.  Nor is it clear that vaccination would make it less likely that people would use a condom.  Maybe the objectors had strangely powerful-yet-quiescent libidos, and they’d be hopping into bed and having unprotected sex at the drop of a hatwere it not for the vague threat not just of a sexually transmitted disease, but of this particular sexually transmitted disease.  Who knows?

Of course, the real point of the objection was nothing to do with the safety of sex – it was to do with the possibility that people (notably, the objectors’ own utterly sexless teenage daughters) might want, have, and enjoy sex at all.  The objection was, in essence, that if horizontal dancing were less risky, it might happen more.  That is (somehow) clearly bad, and the only way to stop it is, the thought goes, to keep it as dangerous as possible.  (Phew!  At least that way we might be able to pretend it doesn’t happen.)

Am I building an Aunt Sally here?  I don’t think so.  For example, in a letter to the Christian Medical Fellowship, a Newcastle paediatrician suggested that

providing such a vaccine to teenage girls will […] anticipate fornication and therefore condone it. Christian doctors should have no part in this.

[… Y]oung people will perceive that the consequences of fornication have been lessened and therefore fornicate more.

Obviously, there are people – the kind of people who use words like “fornicate” and “sin” – who do manage to think that the objection is powerful.  For the sake of the argument, let’s imagine that you’re one of them.  Are the worries warranted by the facts?  Well, it would appear not.  According to a paper just out in the British Journal of Cancer

Girls were asked to indicate their agreement (agree/disagree) with six statements that students had made during the piloting stages relating to how they, and others, perceived vaccination against a sexually transmitted infection. The majority agreed that HPV vaccination made them think about their health and future sexual relationships.

Of course, teenagers of both sexes spend quite a lot of time thinking about sexual relationships.  What’s actually meant here is that it would appear that awareness of the vaccine led girls to take their own sexual health more seriously than they otherwise might.  93% agreed with the statement “Having the vaccine shows that you are serious about your own health.”  78% agreed with the statement “Having the vaccination reminds me of the possible risks of sexual contact.”  In other words, the vaccine does not seem to be seen as a licence to shag.

On the other hand,

[a]lmost 14% (73) thought that being protected against HPV might lead them to take more sexual health risks in the future and 19% (99) said that boyfriends might expect them to.

Still, this doesn’t mean that the worries are well-founded.  Even if you think that being vaccinated will make a difference to your sexual behaviour, it doesn’t follow that you’re correct: there’s nothing to suggest that the girls questioned actually expected the vaccination to make a difference, or that any such expectation would be justified.  The figure could be explained by the fact that there was such a noise made by the proponents of the promiscuity objection: it wouldn’t be surprising if some of the fears had been translated to the girls themselves, and that the 14% figure simply reflects a report of those fears.  The point is that “I think it might make a difference” doesn’t mean “I’m going to let it make a difference.”  And, of course, noone ever said that the vaccine was a substitute for decent sex-education anyway.

The authors also note that

Approximately 20% of the total study population of girls completed this questionnaire and their parents may have held more liberal views on adolescent participation in consent than those of nonresponders.

If there’s anything worrying about the paper, then this is it.  The evidence is that kids who come from the most open families are the kids who’re least bashful about sex, and so those who’re most likely to seek out information and to know what’s what, and most likely to be confident enough in their sexuality to stand up agaist pressure to do things with which they aren’t comfortable.  In other words, we’re talking about the kids who’re probably least at risk to begin with.

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