title: Behavioral and sociodemographic risk factors for serological and DNA evidence of HPV6, 11, 16, 18 infections.
abstract: BACKGROUND
  Risk for HPV6/11/16/18 infections in young sexually active, behaviorally low-risk females is not well described and may inform public policy.
  
  
  METHODS
  To assess exposure risk for HPV/6/11/16/18 among 16-23 year old low-risk females, data for 2409 female clinical trial participants were evaluated. Baseline visit self-reported sexual, behavioral and demographic characteristics; and results from HPV genotyping and serology, and other clinical laboratory assays were analyzed. All subjects reported <5 lifetime male sexual partners and no prior abnormal cytology at baseline.
  
  
  RESULTS
  While 98% (2211/2255) were naïve to HPV16 or 18 and 99.6% (2246/2255) were naïve for 1-3 index HPVs, 27% (616/2255) showed antibody, DNA or both for ≥1 index HPV. While 18% (409/2255) tested HPV16- or -18-antibody- or -DNA-positive, only 2% (44/2255) tested positive for both types. Against this high background, other sexually transmitted infections (STIs) were uncommonly detected, suggesting low sexual risk-taking behavior. The adjusted analyses showed race, age, alcohol consumption, current Chlamydia trachomatis (chlamydia) and Trichamonas vaginalis (trichomoniasis), bacterial vaginosis (BV), number of lifetime male sex partners predicted positive index-HPV antibody test results. However, only the number of male sex partners predicted positivity for HPV6/11- and 16/18-DNA, and chlamydia infection predicted positivity for HPV6/11-DNA alone.
  
  
  CONCLUSIONS
  Taken together, type-specific HPV-DNA and -antibody evidence of HPV6/11/16/18 infections among behaviorally low-risk 16-23 year old females is high. Since almost all participants would have benefited by either currently available bivalent or quadrivalent vaccine strategies, delaying vaccination beyond menarche may be a missed opportunity to fully protect young females against HPV6/11/16/18 infections and related dysplasias. Early diagnosis and treatment of chlamydia and trichomonas may be important in HPV pathogenesis.
authors.affiliation: Translational Science Section, School of Nursing, University of California at Los Angeles, 700 Tiverton Avenue, Los Angeles, CA 90095-6919, United States. dwiley@ucla.edu
authors.forename: Dorothy J
authors.initials: DJ
authors.lastname: Wiley
authors.forename: Emmanuel V
authors.initials: EV
authors.lastname: Masongsong
authors.forename: Shuang
authors.initials: S
authors.lastname: Lu
authors.forename: Sings
authors.initials: S
authors.lastname: Heather L
authors.forename: Benissa
authors.initials: B
authors.lastname: Salem
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Ault
authors.forename: Richard M
authors.initials: RM
authors.lastname: Haupt
authors.forename: Darron R
authors.initials: DR
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking; D005260:Female; D005838:Genotype; D052140:Human papillomavirus 11 / Q000235:genetics / Q000302:isolation & purification; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000235:genetics / Q000302:isolation & purification; D052163:Human papillomavirus 6 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage / Q000276:immunology; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines