Sexual behaviors and intention for cervical screening among HPV-vaccinated young Chinese females

Gilbert T. CHUA, Frederick K. HO, Keith T. TUNG, Rosa Sze Man WONG, Kai Ning CHEONG, Paul S. YIP, Susan Y. FAN, Wilfred H. WONG, Youlin QIAO, Celine S. CHUI, Shirley X. LI, Patrick IP

Research output: Contribution to journalArticlespeer-review

4 Citations (Scopus)


Background and objectives: Human papillomavirus (HPV) vaccination and cervical screening prevent cervical cancer effectively. However, there are concerns whether vaccination leads to high-risk sexual behaviors and less intention for cervical screening. We aimed to evaluate the influence of HPV vaccination on high-risk sexual behaviors, and intention for cervical screening among young Chinese females. We also reported the latest HPV vaccination uptake in Hong Kong. 

Methods: A population-based survey was conducted between September 2016 and January 2017. Subjects were school-age girls from twenty-five secondary schools (in-school) and community females between 18 and 27 years (out-school). Demographics, vaccine-related attitudes, intention for cervical screening and participants’ sexual behaviors were examined. 

Results: We surveyed 2260 females from in-school (n = 1664) and out-school (n = 596) settings. 11.5% in-school and 23.5% out-school participants received at least one dose of HPV vaccine. Vaccination was not associated with age (in-school Odds Ratio [OR] 0.99, p = 0.87; out-school OR 1, p = 0.94), ethnicity (in-school OR 0.82, p = 0.72; out-school OR 0, p = 0.98), maternal education (in-school OR for secondary school 1.19, p = 0.43; for post-secondary school 1.28, p = 0.48), underage sex (in-school OR 1.22, p = 0.80; out-school OR 0.63, p = 0.67), earlier sexual exposure (in-school β 0.01, p = 0.99; out-school β 0.13, p = 0.68), multiple sex partners (in-school OR 3.27, p = 0.22; out-school OR 1.16, p = 0.43), and unprotected sex (in-school OR 1.14, p = 0.78; out-school OR 0.60, p = 0.10). Out-school females with higher personal education level was associated with higher vaccine uptake (post-secondary OR 3.4, p < 0.001; bachelor's degree or above OR 3.71, p < 0.001). More vaccinated females intended for cervical screening (in-school 23.6% vs. 21.1%; out-school 53.6% vs. 43.6%). Costs and knowledge were important factors for non-vaccination and non-intention for cervical screening. 

Conclusions: HPV vaccination was not associated with earlier and high risk sexual behavior among Chinese young females. Vaccinated Chinese young females had a higher intention for cervical screening. Copyright © 2019 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)1025-1031
Issue number5
Early online dateNov 2019
Publication statusPublished - Jan 2020


Chua, G. T., Ho, F. K., Tung, K. T., Wong, R. S., Cheong, K. N., Yip, P. S., Fan, S. Y., Wong, W. H., Qiao, Y., Chui, C. S., Li, S. X., & Ip, P. (2020). Sexual behaviors and intention for cervical screening among HPV-vaccinated young Chinese females. Vaccine, 38(5), 1025-1031.


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