title: Methods in HPV Surveillance: Experiences from a Population-Based Study of HPV Infection among Women in the San Juan Metropolitan Area of Puerto Rico.
abstract: This article describes the methodology of the first population-based study of human papillomavirus (HPV) infection among women aged 16-64 years residing in the San Juan Metropolitan Area of Puerto Rico (PR). The sample was identified through a complex sampling design of households. The sampling frame was selected in four stages, using census tracts maps from the Census Bureau. Women completed a face-to-face interview and a computer-assisted self-interview using the Audio CASI system, for the collection of demographic, clinical, and lifestyle variables, and sampling acceptability. Anal, cervical, and oral specimens were collected through self-collection methods for HPV DNA testing using a modified pool of MY09/MY11 consensus HPV L1 and human ß-globin amplification primers. Anthropometric measurements were taken using the Third National Health and Nutrition Examination Survey methodology. Blood samples were collected to create a bio-repository for future HPV-related studies. Fifty census tract blocks were randomly selected. We recruited 566 women, with a response rate of 83.4%. Response rates did not vary by age-group (p>0.05); although they varied by socioeconomic (SES) census block stratums (p<0.05), response rates were good (>75%) in all SES strata. All participants agreed to respond to the surveys and provide the requested anogenital and oral samples. Overall, more than 98% understood and more than 50% felt comfortable with the cervical, anal, and oral self-collection methods used. This article documents the feasibility of performing population-based studies for HPV surveillance in women in PR.
authors.affiliation: Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR; Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Ana Patricia
authors.initials: AP
authors.lastname: Ortiz
authors.affiliation: Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR; Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Edmir
authors.initials: E
authors.lastname: Marrero
authors.affiliation: Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR; Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Cristina
authors.initials: C
authors.lastname: Muñoz
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Pérez
authors.affiliation: Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Tortolero-Luna
authors.affiliation: Department of OBGYN, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Josefina
authors.initials: J
authors.lastname: Romaguera
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Nahir
authors.initials: N
authors.lastname: Rodríguez
authors.affiliation: School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan PR.
authors.forename: Andrea
authors.initials: A
authors.lastname: González-Falero
authors.affiliation: University of California, San Francisco (UCSF).
authors.forename: Joel
authors.initials: J
authors.lastname: Palefsky
authors.affiliation: Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
authors.forename: Erick
authors.initials: E
authors.lastname: Suárez
mesh_terms: D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000302:isolation & purification*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009749:Nutrition Surveys; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D011159:Population Surveillance / Q000379:methods; D011647:Puerto Rico / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: HPV; Infection; Methods; Puerto Rico; Women