Determinants of High-Risk Human Papillomavirus Seroprevalence and DNA Prevalence in Mid-Adult Women
BACKGROUND:
The
epidemiology of high-risk human papillomavirus (hrHPV) infections in mid-adult
women is not well understood.
METHODS:
We
conducted a cross-sectional analysis of 379 women 30 to 50 years of age.
Vaginal samples were tested for type-specific HPV DNA by polymerase chain
reaction. Sera were tested for type-specific HPV antibodies by Luminex-based
assay. Assays included 13 hrHPV types (16/18/31/33/35/39/45/51/52/56/58/59/68).
Self-reported health and sexual history were ascertained. Risk factors for
seropositivity and DNA positivity to hrHPV were assessed in separate Poisson
regression models.
RESULTS:
The mean
(SD) age of participants was 38.7 (6.1) years, and the median lifetime number
of male sex partners was 7. Approximately two-thirds (68.1%) were seropositive
for any hrHPV, 15.0% were DNA positive, and 70.7% were seropositive or DNA
positive. In multivariate analyses, women who were married/living with a
partner were less likely to be seropositive than single/separated women
(adjusted prevalence ratio [aPR], 0.86; 95% confidence interval [CI],
0.75-0.98). Compared with never hormonal contraceptive users, current (aPR,
1.53; 95% CI, 1.01-2.29) or former (aPR, 1.64; 95% CI, 1.10-2.45) users were
more likely to be seropositive. Women with a lifetime number of sex partners of
12 or more were more likely to be seropositive compared with those with 0 to 4
partners (aPR, 1.29; 95% CI, 1.06-1.56). Similar associations were seen with
DNA positivity. In addition, there was a positive association between current
smoking and hrHPV DNA (aPR vs. never smokers, 2.51; 95% CI, 1.40-4.49).
CONCLUSIONS:
Seventy-one
percent of mid-adult women had evidence of current or prior hrHPV infection.
Measures of probable increased exposure to HPV infection were associated with
both seropositivity and DNA positivity to hrHPV, whereas current smoking was
positively associated with hrHPV DNA only.
- 1From the *Clinton Health Access Initiative, Yaounde, Cameroon; †Fred Hutchinson Cancer Research Center, Seattle, WA; ‡Department of Epidemiology, University of Washington, Seattle, WA; §FIDALAB, Seattle, WA; ∥University of California San Diego, La Jolla, CA; and Departments of ¶Global Health and **Microbiology, University of Washington, Seattle, WA.
- Sex Transm Dis. 2016 Mar;43(3):192-8. doi: 10.1097/OLQ.0000000000000409.
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