Sexual behaviors and human papillomavirus vaccine non-initiation among young adult cancer survivors.
Sexual behaviors and human papillomavirus vaccine non-initiation among young adult cancer survivors.
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年轻成人癌症幸存者中的性行为和人乳头瘤病毒疫苗不可生化。
DOI：
10.1007/s11764-021-01000-2
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Landier W
中科院分区：
文献类型：
--
作者：
Cherven B;Klosky JL;Chen Y;York JM;Heaton K;Childs G;Flynn JS;Connelly JA;Wasilewski-Masker K;Robison LL;Hudson MM;Wong FL;Bhatia S;Landier W
年轻的成年癌症幸存者有患后续人乳头瘤病毒（HPV）相关恶性肿瘤的风险。高风险性行为增加了HPV感染的风险; HPV疫苗接种可预防感染。我们的目的是确定性行为的患病率，与高危性行为相关的因素，以及幸存者中性行为与HPV疫苗未启动之间的关系。综合癌症中心的18-26岁和治疗后1-5年的幸存者报告了性行为和HPV疫苗启动（即，≥1剂）。采用多变量logistic回归分析，计算高危性行为相关因素（首次性交年龄<16岁、终生性伴侣≥3个或安全套使用率≤50%）的优势比（OR）和95%可信区间（95%CI），并探讨性行为与未启动疫苗接种之间的关系。在312名参与者中（48.1%为女性，癌症诊断时的中位年龄为17.2岁，调查时的中位年龄为20.9岁），63.1%的人报告了性行为。在报告性交的人中，74.6%报告了高风险性行为。与高危性行为相关的因素包括目前的约会/伴侣（OR=4.39，95%CI 2.5-7.7，P<0.001）和对HPV的易感性（OR=1.76，95%CI 1.3-2.5，P<0.001）。大多数幸存者（75.3%）报告HPV疫苗未启动;性行为与疫苗未启动无关（P=.4）。许多幸存者参与高风险性行为，但HPV疫苗启动率很低。与高危性行为相关的因素可以为干预措施提供信息，以降低幸存者获得HPV的风险。癌症幸存者参与增加HPV感染风险的性行为，并将受益于疫苗接种。
Young adult cancer survivors are at risk for subsequent human papillomavirus (HPV)-related malignancies. High-risk sexual behavior increases risk for HPV acquisition; HPV vaccination protects against infection. We aimed to determine the prevalence of sexual behaviors, factors related to high-risk sexual behaviors, and the relationship between sexual behaviors and HPV vaccine non-initiation among survivors. Survivors at comprehensive cancer centers, aged 18–26 years and 1–5 years post-treatment, reported sexual behaviors and HPV vaccine initiation (i.e., ≥1 dose). Multivariable logistic regression was performed to calculate odds ratios (OR) and 95% confidence intervals (95%CI) for factors associated with high-risk sexual behaviors (age at first intercourse <16 years, ≥3 lifetime sexual partners, or condom use ≤50% of the time) and to explore the relationship between sexual behaviors and vaccine non-initiation. Of the 312 participants (48.1% female, median age at cancer diagnosis 17.2y and at survey 20.9y) sexual intercourse was reported by 63.1%. Of those reporting intercourse, 74.6% reported high-risk sexual behavior. Factors related to high-risk sexual behavior included currently dating/partnered (OR=4.39, 95%CI 2.5–7.7, P<.001) and perceived susceptibility to HPV (OR=1.76, 95%CI 1.3–2.5, P<.001). Most survivors (75.3%) reported HPV vaccine non-initiation; sexual behaviors were not associated with vaccine non-initiation (P=.4). Many survivors participate in high-risk sexual behaviors, yet HPV vaccine initiation rates are low. Factors related to high-risk sexual behaviors can inform interventions to reduce risk for HPV acquisition among survivors. Cancer survivors participate in sexual behaviors that increase risk for HPV acquisition and would benefit from vaccination.
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