title: HPV infection and cervical neoplasia: associated risk factors.
abstract: BACKGROUND
  Behavioral risks such as age at first sexual intercourse, number of sexual partners and partner's sexual behavior are associated with an increased risk of HPV infection, persistence of the infection and the development of neoplastic precursor lesions. The objective of this study was to evaluate the risk factors associated with HPV positivity and with a diagnosis of cervical neoplasia in women referred with an abnormal cervical smear.
  
  
  METHODS
  This study evaluated a series of 198 women referred with an abnormal cervical smear. Risk factors for HPV infection were investigated using a questionnaire. All cervical specimens were tested for 27 HPV genotypes using the Roche polymerase chain reaction reverse line blot assay.
  
  
  RESULTS
  The overall prevalence of HPV was 87 %. First sexual intercourse before 16 years of age was significantly associated with a positive HPV test (OR 4.41; 95 %CI: 1.20 - 19.33; p = 0.01). A significant association was also found between this risk factor and CIN 1 lesions or worse (OR 2.2; 95 %CI 0.94 - 5.08; p = 0.03).
  
  
  CONCLUSIONS
  The age at which a woman begins to be sexually active is associated with HPV infection and with a diagnosis of cervical neoplasia.
authors.affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO Brazil ; Pontifical Catholic University of Goiás, Goiânia, GO Brazil.
authors.forename: Andrea Alves
authors.initials: AA
authors.lastname: Ribeiro
authors.affiliation: Santa Casa de São Paulo, INCT-HPV at Santa Casa Research Institute, School of Medicine, São Paulo, Brazil.
authors.forename: Maria Cecília
authors.initials: MC
authors.lastname: Costa
authors.affiliation: Santa Casa de Misericórdia de Goiânia, Goiânia, GO Brazil ; Pontifical Catholic University of Goiás, Goiânia, GO Brazil ; School of Medicine, Federal University of Goiás, Goiânia, GO Brazil.
authors.forename: Rosane Ribeiro Figueiredo
authors.initials: RR
authors.lastname: Alves
authors.affiliation: Santa Casa de São Paulo, INCT-HPV at Santa Casa Research Institute, School of Medicine, São Paulo, Brazil ; Department of Radiology and Oncology, School of Medicine, University of São Paulo and Cancer Institute of the State of São Paulo, ICESP, São Paulo, Brazil.
authors.forename: Luísa Lina
authors.initials: LL
authors.lastname: Villa
authors.affiliation: Pontifical Catholic University of Goiás, Goiânia, GO Brazil ; Program in Environmental Sciences and Health, Pontifical Catholic University of Goiás, Goiânia, GO Brazil ; Laboratory of Oncogenetics and Radiology, Associação de Combate ao Câncer, Goiás, Goiânia, GO Brazil.
authors.forename: Vera Aparecida
authors.initials: VA
authors.lastname: Saddi
authors.affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO Brazil.
authors.forename: Megmar Aparecida Dos Santos
authors.initials: MA
authors.lastname: Carneiro
authors.affiliation: State University of Campinas (UNICAMP), Campinas, SP Brazil.
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Zeferino
authors.affiliation: Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, GO Brazil ; School of Pharmacy, Federal University of Goiás, Goiânia, GO Brazil.
authors.forename: Sílvia Helena
authors.initials: SH
authors.lastname: Rabelo-Santos
keywords: Abnormal cervical smear; Human papillomavirus; Risk factors