title: The role of sexual behavior and human papillomavirus persistence in predicting repeated infections with new human papillomavirus types.
abstract: 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.
authors.affiliation: Division of Adolescent Medicine, Department of Pediatrics, University of California-San Francisco, 3333 California Street, San Francisco, CA 94118, USA. moscickia@peds.ucsf.edu
authors.forename: Anna-Barbara
authors.initials: AB
authors.lastname: Moscicki
authors.forename: Yifei
authors.initials: Y
authors.lastname: Ma
authors.forename: Janet
authors.initials: J
authors.lastname: Jonte
authors.forename: Susanna
authors.initials: S
authors.lastname: Miller-Benningfield
authors.forename: Evelyn
authors.initials: E
authors.lastname: Hanson
authors.forename: Julie
authors.initials: J
authors.lastname: Jay
authors.forename: Cheryl
authors.initials: C
authors.lastname: Godwin de Medina
authors.forename: Sepideh
authors.initials: S
authors.lastname: Farhat
authors.forename: Lisa
authors.initials: L
authors.lastname: Clayton
authors.forename: Stephen
authors.initials: S
authors.lastname: Shiboski
mesh_terms: 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
chemical_list: D004279:DNA, Viral