Race Is Associated with Sexual Behaviors and Modifies the Effect of Age on Human Papillomavirus Serostatus among Perimenopausal Women
BACKGROUND:
Human
papillomavirus (HPV) causes oropharyngeal and cervical cancers. Oropharyngeal
cancer primarily affects whites, but cervical cancer is more common among
blacks. Reasons for this distinct epidemiology are unclear.
METHODS:
Serum was
collected from women aged 35 to 60 years in the HPV in Perimenopause cohort and
evaluated for antibodies to 8 HPV types. Demographic and behavioral data were
collected by telephone questionnaire. Associations between sexual behaviors,
race, age, HPV serostatus, and strength of serologic response to HPV were
evaluated.
RESULTS:
There
were 781 women in this analysis, including 620 white (79%) and 161 (21%) black
women. Whites were less likely to report 5+ vaginal sex partners (prevalence
ratio [PR], 0.86; 95% confidence interval [CI], 0.77-0.97), but more likely to
report 5+ oral sex partners (PR, 2.38; 95% CI, 1.62-3.49) compared with blacks.
Seropositivity to most individual HPV types and at least 3 types was
significantly lower in whites than in blacks (PR, 0.62; 95% CI, 0.47-0.80).
Human papillomavirus seropositivity was independently associated with younger
age among blacks, but with sexual exposures among whites. Furthermore, strength
of serologic response to most HPV types significantly decreased with older age
among blacks, but not among whites.
CONCLUSIONS:
Racial
differences in immune markers of HPV exposure and the epidemiology of
HPV-related cancers may be linked to differences in patterns of sexual
behaviors.
- 1From the *Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; †Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of ‡Gynecology and Obstetrics and §Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD; and ¶Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, NM.
- Sex Transm Dis. 2016 Apr;43(4):231-7. doi: 10.1097/OLQ.0000000000000426.
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