Exposure to high-risk genital human papillomavirus and its association with risky sexual practices and laboratory-confirmed chlamydia among African-American women.
BACKGROUND
Genital human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States and African-American women have the highest prevalence of high-risk HPV. This study examined exposure to high-risk HPV in African-American women and its relation to risky sexual practices and laboratory-confirmed chlamydia.


METHODS
A sample of 665 African-American women between 18 and 29 years old, recruited from October 2002 to March 2006 in Atlanta, Georgia, completed an Audio Computer-Assisted Survey Interview assessing sociodemographics, health practices, and risky sexual practices. Participants also provided vaginal swab specimens assayed for STIs and high-risk HPV.


RESULTS
The overall prevalence of high-risk HPV was 38.9%. Among women 18 to 24 years old, it was 42.4%; it was 31% among women 25 to 29 years old. Age-stratified logistic regression analyses indicated that women between the ages of 18 and 29 and 18 and 24 who had multiple male sexual partners did not use a condom during their last casual sexual encounter and tested positive for chlamydia were significantly more likely to test positive for high-risk HPV. Women 18 to 24 years old who reported having a casual or risky sexual partner were significantly more likely to test positive for high-risk HPV. No significant correlates were identified among women 25 to 29 years old.


CONCLUSIONS
Programs should aim to educate, decrease risky sexual practices, and increase screening and treatment for STIs among women with high-risk HPV infections. HPV vaccination recommendations for young adult African-American women warrant special consideration.
Seth
Puja
P
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA. pseth@emory.edu
Wingood
Gina M
GM
Robinson
Lashun S
LS
Diclemente
Ralph J
RJ
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D052685:Alphapapillomavirus / Q000302:isolation & purification*; D002690:Chlamydia Infections / Q000175:diagnosis*; D005260:Female; D005845:Georgia; D006801:Humans; D007407:Interviews as Topic; D012749:Sexually Transmitted Diseases; D047568:Unsafe Sex; D055815:Young Adult
Int J STD AIDS. 2005 Aug;16(8):528-37
16105186
Sex Transm Dis. 2000 Sep;27(8):438-45
10987448
J Adolesc Health. 2007 Aug;41(2):109-18
17659213
J Infect Dis. 1996 Oct;174(4):679-89
8843203
N Engl J Med. 1998 Feb 12;338(7):423-8
9459645
J Infect Dis. 2004 Jan 1;189(1):46-50
14702152
Am J Prev Med. 2003 Nov;25(4):296-300
14580630
Perspect Sex Reprod Health. 2004 Jan-Feb;36(1):6-10
14982671
Lancet. 2007 Jun 2;369(9576):1861-1868
17544766
JAMA. 2000 Jan 5;283(1):81-6
10632284
MMWR Recomm Rep. 2007 Mar 23;56(RR-2):1-24
17380109
Am J Public Health. 2009 Jun;99(6):1137-42
19372507
J Adolesc Health. 2008 Oct;43(4 Suppl):S61-7
18809147
J Infect Dis. 2002 Feb 1;185(3):324-31
11807714
N Engl J Med. 2006 Jun 22;354(25):2645-54
16790697
Annu Rev Public Health. 2003;24:341-62
12471271
JAMA. 2007 Feb 28;297(8):813-9
17327523
Am J Public Health. 1991 Dec;81(12):1630-5
1746660
Int J Cancer. 2003 Oct 10;106(6):896-904
12918067
Obstet Gynecol. 2007 Jul;110(1):87-95
17601901
Int J Cancer. 2003 Dec 10;107(5):811-6
14566832
Am J Med. 1997 May 5;102(5A):3-8
9217656
J Infect Dis. 2004 Jul 1;190(1):37-45
15195241
Sex Transm Dis. 2002 Nov;29(11):725-35
12438912
Sex Transm Dis. 1997 May;24(5):293-8
9153740
Lancet. 2007 Jun 30;369(9580):2161-2170
17602732
JAMA. 1999 Oct 20;282(15):1458-65
10535437
Sex Transm Dis. 2002 Dec;29(12):763-8
12466717
Arch Pediatr Adolesc Med. 2006 Feb;160(2):151-6
16461870
Ann Intern Med. 2008 Apr 1;148(7):493-500
18378945
Prev Med. 2003 Feb;36(2):131-40
12590987
Am J Health Syst Pharm. 2008 Nov 15;65(22):2105-12
18997137
Br J Cancer. 2006 Dec 4;95(11):1459-66
17117182
Lancet. 2006 Apr 15;367(9518):1247-55
16631880
Cancer Epidemiol Biomarkers Prev. 2001 Feb;10(2):95-100
11219778
J Clin Microbiol. 1998 Oct;36(10):3020-7
9738060
Cancer. 1999 Mar 1;85(5):1139-44
10091799
Pediatrics. 2005 Apr;115(4):833-8
15805352
J Clin Microbiol. 2000 Jan;38(1):357-61
10618116
Am J Epidemiol. 2003 Feb 1;157(3):218-26
12543621
Sex Transm Dis. 2006 Aug;33(8):502-8
16572039
Sex Transm Infect. 2001 Aug;77(4):260-4
11463925
Pediatrics. 2007 Jan;119(1):1-10
17200265
J Adolesc Health. 2005 Dec;37(6 Suppl):S17-23
16310137
Br J Cancer. 2002 Jul 29;87(3):324-33
12177803
Cancer Epidemiol Biomarkers Prev. 1997 Oct;6(10):799-805
9332762
J Infect Dis. 2005 Jan 15;191(2):182-92
15609227
JAMA. 1995 Oct 25;274(16):1271-6
7563531
Prev Med. 2000 Aug;31(2 Pt 1):167-76
10938218
Ann Med. 2008;40(3):162-6
18382882
J Womens Health (Larchmt). 2007 Oct;16(8):1224-33
17937576