title: Cervical Cancer Screening and Sexual Risky Behaviors among a Population of Hispanic Origin.
abstract: OBJECTIVE
  To assess the prevalence of cervical cancer screening through Papanicolaou (Pap) test utilization and its association with sexual behaviors among a population-based sample of Hispanic women in Puerto Rico (PR).
  
  
  METHODS
  This study was a secondary data analysis of the database of a cross-sectional study of HPV infection in PR (2010-2013; n = 554 women). Pap test utilization (past 3 years) was self-reported and sexual risky behavior was defined as an index that considered the following sexual behaviors: early age of sexual debut (≤16 years), 11 or more lifetime sexual partners, and 2 or more sexual partners in the last year. Multivariable logistic regression was used to estimate the magnitude of the association between sexual risk behavior and Pap test utilization, after adjusting for socioeconomic and lifestyles characteristics.
  
  
  RESULTS
  The overall prevalence of Pap test utilization was 78.0%. Pap test screening varied with sexual behavior, with women with none or one risky sexual behavior having higher odds of Pap test utilization in the past 3 years (odds ratio [OR], 1.74; 95% CI, 1.03-2.93) compared with those with two or three risky sexual behaviors. This difference remained marginally significant (p < .10) after adjusting for age, educational attainment, smoking status and STI history (OR, 1.72; 95% CI, 0.96-3.08).
  
  
  CONCLUSIONS
  The prevalence of cervical cancer screening in this population (78%) is still below Healthy People 2020 recommendations (93%). Also, women with risky sexual behaviors are less likely to have been screened. Efforts to promote cervical screening programs should focus on these high-risk women as a method for cervical cancer prevention and control.
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico. Electronic address: daisy.gonzalez3@upr.edu.
authors.forename: Daisy
authors.initials: D
authors.lastname: González
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Erick L
authors.initials: EL
authors.lastname: Suárez
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico; Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.
authors.forename: Ana Patricia
authors.initials: AP
authors.lastname: Ortiz
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D065006:Papanicolaou Test; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D012307:Risk Factors; D012309:Risk-Taking; D057566:Self Report; D012725:Sexual Behavior / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control*; D014626:Vaginal Smears / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult