title: HPV infection among a population-based sample of sexual minority women from USA.
abstract: OBJECTIVE
  Sexual minority women are at risk for infection with human papillomavirus (HPV); yet, relatively little is known about the prevalence of HPV infection among this population.
  
  
  METHODS
  We analysed data from the 2003-2012 National Health and Nutrition Examination Survey among women aged 20-59 (n=7132). We examined two dimensions of sexual orientation (sexual identity and sexual behaviour) and used weighted logistic regression to determine how HPV infection outcomes (any HPV type, high-risk HPV type and vaccine HPV type) vary by dimension.
  
  
  RESULTS
  Similar patterns emerged for sexual identity and sexual behaviour. In bivariate analyses, HPV infection outcomes were more common among non-heterosexual women compared with heterosexual women (any type: 49.7% vs 41.1%; high-risk type: 37.0% vs 27.9%), as well as among women who reported any same-sex partners compared with women who reported only opposite-sex partners (any type: 55.9% vs 41.0%; high-risk type: 37.7% vs 28.2%; vaccine type: 19.1% vs 14.0%) (p<0.05). When we disaggregated measures of sexual orientation into subgroups, bisexual women and women who reported partners of both sexes had greater odds of HPV infection outcomes (p<0.05 in bivariate analyses). Multivariate models attenuated several of these differences, though lesbian women and women who reported only same-sex partners had lower odds of most HPV infection outcomes in multivariate analyses (p<0.05).
  
  
  CONCLUSIONS
  HPV infection is common among sexual minority women, though estimates vary depending on how sexual orientation is operationalised. Results can help inform targeted HPV and cervical cancer prevention efforts for sexual minority women.
authors.affiliation: Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Reiter
authors.affiliation: Division of General Pediatrics and Adolescent Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
authors.forename: Annie-Laurie
authors.initials: AL
authors.lastname: McRee
mesh_terms: D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009749:Nutrition Surveys; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control; D053918:Papillomavirus Vaccines; D015995:Prevalence; D012307:Risk Factors; D012747:Sexual Partners; D000072339:Sexual and Gender Minorities / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV; LESBIANS; SEXUAL HEALTH; WOMEN