title: Race is Associated With Sexual Behaviors and Modifies the Effect of Age on Human Papillomavirus Serostatus Among Perimenopausal Women.
abstract: BACKGROUND
  Human papillomavirus (HPV) causes oropharyngeal and cervical cancers. Oropharyngeal cancer primarily affects whites, but cervical cancer is more common among blacks. Reasons for this distinct epidemiology are unclear.
  
  
  METHODS
  Serum was collected from women aged 35 to 60 years in the HPV in Perimenopause cohort and evaluated for antibodies to 8 HPV types. Demographic and behavioral data were collected by telephone questionnaire. Associations between sexual behaviors, race, age, HPV serostatus, and strength of serologic response to HPV were evaluated.
  
  
  RESULTS
  There were 781 women in this analysis, including 620 white (79%) and 161 (21%) black women. Whites were less likely to report 5+ vaginal sex partners (prevalence ratio [PR], 0.86; 95% confidence interval [CI], 0.77-0.97), but more likely to report 5+ oral sex partners (PR, 2.38; 95% CI, 1.62-3.49) compared with blacks. Seropositivity to most individual HPV types and at least 3 types was significantly lower in whites than in blacks (PR, 0.62; 95% CI, 0.47-0.80). Human papillomavirus seropositivity was independently associated with younger age among blacks, but with sexual exposures among whites. Furthermore, strength of serologic response to most HPV types significantly decreased with older age among blacks, but not among whites.
  
  
  CONCLUSIONS
  Racial differences in immune markers of HPV exposure and the epidemiology of HPV-related cancers may be linked to differences in patterns of sexual behaviors.
authors.affiliation: From the *Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; †Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of ‡Gynecology and Obstetrics and §Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD; and ¶Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, NM.
authors.forename: Eleni Marie
authors.initials: EM
authors.lastname: Rettig
authors.forename: Carole
authors.initials: C
authors.lastname: Fakhry
authors.forename: Anne F
authors.initials: AF
authors.lastname: Rositch
authors.forename: Anne E
authors.initials: AE
authors.lastname: Burke
authors.forename: Kathryn
authors.initials: K
authors.lastname: Chang
authors.forename: Michelle I
authors.initials: MI
authors.lastname: Silver
authors.forename: Raphael
authors.initials: R
authors.lastname: Viscidi
authors.forename: Patti
authors.initials: P
authors.lastname: Gravitt
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000208:ethnology; D027383:Papillomaviridae / Q000276:immunology*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000208:ethnology; D047648:Perimenopause; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data