title: Incident Detection of High-Risk Human Papillomavirus Infections in a Cohort of High-Risk Women Aged 25-65 Years.
abstract: The risk of incident high-risk human papillomavirus (HR-HPV) infection associated with recent sexual behaviors is undefined in mid-adult women (defined as women aged 25-65 years).
  
  
  
  Triannually, 420 female online daters aged 25-65 years submitted vaginal specimens for HPV testing and completed health and sexual behavior questionnaires. The cumulative incidence of and risk factors for incident HR-HPV detection were estimated by Kaplan-Meier and Cox proportional hazards methods.
  
  
  
  The 12-month cumulative incidence of HR-HPV detection was 25.4% (95% confidence interval [CI], 21.3%-30.1%). Current hormonal contraceptive use was positively associated with incident HR-HPV detection. Lifetime number of male sex partners was also positively associated but only among women not recently sexually active with male partners. In analysis that adjusted for hormonal contraceptive use and marital status, women reporting multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership had a hazard of incident HR-HPV detection that was 2.81 times (95% CI, 1.38-5.69 times) that for women who reported no male sex partners in the past 6 months. Thus, among women with multiple male partners or male partners who were new, casual, or had ≥1 concurrent partnership, approximately 64% of incident HR-HPV infections were attributable to one of those partners.
  
  
  
  Among high-risk mid-adult women with recent new male partners, multiple male partners, or male partners who were casual or had ≥1 concurrent partnership, about two thirds of incident HR-HPV detections are likely new acquisitions, whereas about one third of cases are likely redetections of prior infections.
authors.affiliation: Department of Epidemiology.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Winer
authors.affiliation: Department of Biostatistics.
authors.forename: James P
authors.initials: JP
authors.lastname: Hughes
authors.affiliation: FIDALAB, Seattle, Washington.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Feng
authors.affiliation: Department of Global Health.
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Stern
authors.affiliation: Department of Epidemiology Department of Pathology, University of Washington.
authors.forename: Long Fu
authors.initials: LF
authors.lastname: Xi
authors.affiliation: Department of Epidemiology.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Koutsky
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology*; D012307:Risk Factors; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014621:Vagina / Q000821:virology
keywords: HPV; human papillomavirus; incidence; mid-adult; risk factors; women