Purpose
Acquisition
of human papillomavirus (HPV) in women occurs predominantly through vaginal
sex. However, HPV has been detected in girls reporting no previous sex. We
aimed to determine incidence and risk factors for HPV acquisition in girls who
report no previous sex in Tanzania, a country with high HPV prevalence and
cervical cancer incidence.
Methods
We
followed 503 adolescent girls aged 15–16 years in Mwanza, Tanzania, with
face-to-face interviews and self-administered vaginal swabs every 3 months
for 18 months; 397 girls reported no sex before enrollment or during
follow-up; of whom, 120 were randomly selected. Samples from enrollment, 6-,
12-, and 18-month visits were tested for 37 HPV genotypes. Incidence,
clearance, point prevalence, and duration of any HPV and genotype-specific
infections were calculated and associated factors were evaluated.
Results
Of
120 girls who reported no previous sex, 119 were included, contributing 438
samples. HPV was detected in 51 (11.6%) samples. The overall incidence of new
HPV infections was 29.4/100 person-years (95% confidence interval: 15.9–54.2).
The point prevalence of vaccine types HPV-6,-11,-16, and -18 was .9%, .9%,
2.0%, and 0%, respectively. Spending a night away from home and using the
Internet were associated with incident HPV, and reporting having seen a
pornographic movie was inversely associated with HPV incidence.
Conclusions
Incident
HPV infections were detected frequently in adolescent girls who reported no
previous sex over 18 months. This is likely to reflect under-reporting of
sex. A low-point prevalence of HPV genotypes in licensed vaccines was seen,
indicating that vaccination of these girls might still be effective.
| Reported behavior | Number of girls reporting the behavior among all (n = 396) who did not report sexa (%) | Number of girls reporting behavior among (n = 119) who did not report sexaand who have HPV results (%) |
|---|---|---|
| At enrollment | ||
| Ever drank alcohol | ||
| Yes | 1 (.3) | 0 (0) |
| Ever smoked | ||
| Yes | 0 (0) | 0 (0) |
| Ever took drugs | ||
| Yes | 0 (0) | 0 (0) |
| Ever-cleansed vagina | ||
| Yes | 68 (17.2) | 20 (16.8) |
| Ever-kissed a boy | ||
| Yes | 0 (0) | 0 (0) |
| Boy ever touched breasts | ||
| Yes | 22 (5.6) | 8 (6.7) |
| Ever touched boy's genitals or boy touched girl's genitals | ||
| Yes | 2 (.5) | 0 (0) |
| Ever had oral sex | ||
| Yes | 0 (0) | 0 (0) |
| During follow-upb | ||
| Spent a night away since last visit | ||
| Yes | 272 (68.7) | 86 (72.3) |
| Used Internet everc | ||
| Yes | 95 (24.0) | 35 (29.4) |
| Ever watched a pornographic moviec | ||
| Yes | 62 (15.7) | 17 (14.3) |
| Drank alcohol since last visit | ||
| Yes | 4 (1.0) | 1 (.8) |
| Practiced vaginal cleansing since last visit | ||
| Yes | 141 (35.6) | 42 (35.3) |
| Kissed a boy since last visit | ||
| Yes | 6 (1.5) | 3 (2.5) |
| Boy touched breasts since last visit | ||
| Yes | 12 (3.0) | 3 (2.5) |
| Touched boy's genitals/boy touched girl's genitals since last visit | ||
| Yes | 2 (.5) | 1 (.8) |
aGirls who did not report sex at enrollment or during the study up to and including the final visit (18 months).
bGirls were asked at every visit whether they had experienced any of these behaviors since they were last seen in the study.
cGirls were asked during follow-up if they had ever used the Internet or seen a pornographic movie, but they were not asked when they had done that. After a girl reported ever having used the Internet or having seen a pornographic movie, all subsequent visits are counted as “yes.”
Full article at: http://goo.gl/7befQe
By:
Affiliations
Clinical Research Department, London School of Hygiene and
Tropical Medicine, London, United Kingdom
Mwanza Intervention Trials Unit, Mwanza, Tanzania
Correspondence
Address correspondence to: Catherine F. Houlihan, M.B.Ch.B.,
M.Sc., Clinical Research Department, London School of Hygiene and Tropical
Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
More at: https://twitter.com/hiv
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