The role of sexual behavior and human papillomavirus persistence in predicting repeated infections with new human papillomavirus types.
BACKGROUND
Although human papillomavirus (HPV) infections are common in young women, the rate of and risk for repeated new infections are not well documented. We examined the rate of and risks for new HPV detection in young women.


METHODS
We used data from an ongoing study of HPV, initiated in 1990. Sexually active women ages 12 to 22 years were eligible. Interviews on behaviors and HPV testing were done at 4-month intervals; sexually transmitted infection (STI) testing was annual or if symptomatic. Starting with first HPV detection, time to the next (second) visit (event) with detection of new HPV types, and then the second event to time to third event was calculated. Risks were determined using Cox proportional hazard model.


RESULTS
Sixty-nine percent of 1,125 women had a second event, and of those with a second event, 63% had a third event by 3 years, respectively. Women with HPV persistence from initial visit to second event [hazard ratio (HR) = 4.51 (3.78-5.37)], an STI [HR = 1.47 (1.00-2.17)], bacterial vaginosis [HR = 1.60 (1.07-2.39)], and number of new sex partners [HR = 1.10 (1.05-1.15 per partner/mo)] were independent associations for HPV. Risks for third event were similar.


CONCLUSIONS
This study documents the repeated nature of HPV infections in young women and their association with sexual risk behaviors.


CONCLUSIONS
This finding underscores the lack of clinical utility of HPV testing in young women. Further studies are needed to examine host factors that lead to HPV acquisition and persistence.
Moscicki
Anna-Barbara
AB
Division of Adolescent Medicine, Department of Pediatrics, University of California-San Francisco, 3333 California Street, San Francisco, CA 94118, USA. moscickia@peds.ucsf.edu
Ma
Yifei
Y
Jonte
Janet
J
Miller-Benningfield
Susanna
S
Hanson
Evelyn
E
Jay
Julie
J
Godwin de Medina
Cheryl
C
Farhat
Sepideh
S
Clayton
Lisa
L
Shiboski
Stephen
S
D000293:Adolescent; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D027383:Papillomaviridae / Q000145:classification*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D036301:Qualitative Research; D012008:Recurrence; D018570:Risk Assessment; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D013997:Time Factors; D055815:Young Adult
D004279:DNA, Viral