title: Coercive sexual experiences and subsequent human papillomavirus infection and squamous intraepithelial lesions in adolescent and young adult women.
abstract: OBJECTIVE
  The purpose of this study was to examine the associations between coercive sexual experiences and subsequent human papillomavirus (HPV) infection and/or squamous intraepithelial lesion (SIL) in adolescent and young adult women, and to determine whether risk behaviors mediate and sociodemographic factors moderate any observed associations.
  
  
  METHODS
  Data were obtained from a longitudinal cohort study of female university students (N = 608). chi2 and Wilcoxon rank-sum tests were used to determine associations between history of a coercive sexual experience and subsequent risk behaviors, and between risk behaviors and HPV or SIL. Logistic regression models were used to determine whether a coercive sexual experience was associated with HPV or SIL and whether the association was mediated by risk behaviors and/or moderated by sociodemographic factors.
  
  
  RESULTS
  Twenty-two percent of participants reported a prior coercive sexual experience. Report of a prior coercive sexual experience was associated with a higher lifetime number of sexual partners (p < .0001), which in turn was associated with subsequent HPV infection (p < .0001) and SIL (p < .0001). In logistic regression models, coercive sexual experience was associated significantly with HPV (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.19-2.84) and at a marginal significance level with SIL (OR, 1.90; 95% CI, .97-3.70). When the number of sexual partners was included in the first model, the association between coercive sexual experience and HPV infection became nonsignificant and the beta coefficient decreased by 49%. Race and age did not appear to moderate the association between coercive sexual experience and HPV.
  
  
  CONCLUSIONS
  The number of sexual partners is an important mechanism through which adolescent and young adult women who report a coercive sexual experience acquire HPV.
authors.affiliation: Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. jessica.kahn@cchmc.org
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Kahn
authors.forename: Bin
authors.initials: B
authors.lastname: Huang
authors.forename: Susan L
authors.initials: SL
authors.lastname: Rosenthal
authors.forename: Abbigail M
authors.initials: AM
authors.lastname: Tissot
authors.forename: Robert D
authors.initials: RD
authors.lastname: Burk
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D030361:Papillomavirus Infections / Q000150:complications* / Q000635:transmission*; D011902:Rape; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D002578:Uterine Cervical Dysplasia / Q000209:etiology / Q000821:virology*