title: Association Between Cumulative Psychosocial Risk and Cervical Human Papillomavirus Infection Among Female Adolescents in a Free Vaccination Program.
abstract: OBJECTIVE
  This study investigated the association of cervical human papillomavirus (HPV) infection with cumulative psychosocial risk reflecting family disadvantage, psychological distress, and unhealthy lifestyle.
  
  
  METHODS
  The sample (N = 745) comprised sexually active female adolescent patients (12-19 yr), primarily ethnic minorities, enrolled in a free HPV vaccination program. Subjects completed questionnaires and provided cervical swabs for HPV DNA testing. Unweighted and weighted principal component analyses for categorical data were used to derive multisystemic psychosocial risk indices using 9 indicators: low socioeconomic status, lack of adult involvement, not attending high school/college, history of treatment for depression/anxiety, antisocial/delinquent behavior, number of recent sexual partners, use of alcohol, use of drugs, and dependency risk for alcohol/drugs. The association between cervical HPV (any type, high-risk types, vaccine types) assayed by polymerase chain reaction and self-reported number of psychosocial risk indicators was estimated using multivariable logistic regression.
  
  
  RESULTS
  Subjects had a median of 3 psychosocial risk indicators. Multiple logistic regression analyses showed associations with unweighted and weighted number of psychosocial indicators for HPV any type (adjusted odds ratio [aOR] = 1.1; 95% confidence interval [CI], 1.0-1.2), with the strongest associations between weighted drug/alcohol use, drug/alcohol dependency risk, and antisocial/delinquent behavior and detection of HPV vaccine types (aOR = 1.5; 95% CI, 1.1-2.0) independent of number of recent sexual partners and vaccine dose (0-3).
  
  
  CONCLUSIONS
  Increased HPV infections including HPV vaccine types were associated with greater number of psychosocial risk indicators even after controlling for demographics, sexual behavior, history of chlamydia, and vaccine dose.
authors.affiliation: *Department of Pediatrics, Mount Sinai Adolescent Health Center, Icahn School of Medicine at Mount Sinai, New York, NY; †Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY; ‡Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; §Departments of Pediatrics, Microbiology & Immunology, and Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY; ‖Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Lourdes Oriana
authors.initials: LO
authors.lastname: Linares
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Shankar
authors.forename: Angela
authors.initials: A
authors.lastname: Diaz
authors.forename: Anne
authors.initials: A
authors.lastname: Nucci-Sack
authors.forename: Howard D
authors.initials: HD
authors.lastname: Strickler
authors.forename: Ken
authors.initials: K
authors.lastname: Peake
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Weiss
authors.forename: Robert D
authors.initials: RD
authors.lastname: Burk
authors.forename: Nicolas F
authors.initials: NF
authors.lastname: Schlecht
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D030361:Papillomavirus Infections / Q000453:epidemiology*; D053918:Papillomavirus Vaccines; D012306:Risk; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines