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. 2016 Sep 1;214(5):665-75.
doi: 10.1093/infdis/jiw074. Epub 2016 Mar 23.

Incident Detection of High-Risk Human Papillomavirus Infections in a Cohort of High-Risk Women Aged 25-65 Years

Rachel L Winer  1 , James P Hughes  2 , Qinghua Feng  3 , Joshua E Stern  4 , Long Fu Xi  5 , Laura A Koutsky  1
Affiliations

Incident Detection of High-Risk Human Papillomavirus Infections in a Cohort of High-Risk Women Aged 25-65 Years

Rachel L Winer et al. J Infect Dis. .

Abstract

Background: 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).

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: HPV; human papillomavirus; incidence; mid-adult; risk factors; women.

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Figures

Figure 1.
Figure 1.
Baseline demographic, health, and sexual history characteristics of 420 women aged 25–65 years who date online. Additional baseline characteristics are included as part of the Supplementary Table.
Figure 2.
Figure 2.
Cumulative incidence of detecting a new high-risk human papillomavirus (HPV) type that was not present at baseline. Data are for 420 women aged 25–65 years. Error bars represent 95% confidence intervals.
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