Prevalence of Human Papillomavirus Infection in Young Women Receiving the First Quadrivalent Vaccine Dose
Abstract
Methods Participants were 13- to 21-year-old females receiving their first HPV vaccine dose, recruited from an adolescent primary care clinic between June 2008 and June 2010. These data are from the baseline visit of a longitudinal study that was approved by the hospital's institutional review board. Each participant completed a questionnaire assessing sociodemographic factors and behaviors. History of sexual contact was assessed using the following item: “Have you ever had sexual contact with a male or female (by sexual contact we mean genital, skin-to-skin contact only)?” Sexual experience was defined as a response of yes to the following item: “Have you ever had sex with a male or female (by sex we mean vaginal or anal sex)?” Cervicovaginal swabs were self- or clinician-collected and tested for HPV DNA.1,2 Logistic regression models were estimated to determine variables associated with HPV infection in sexually experienced and inexperienced females. The outcome measure was infection with 1 or more HPV types. Results Results Of the 259 eligible females, 190 (73.4%) were sexually experienced. Sexually experienced females were older than sexually inexperienced females (mean [SD] age, 17.6 [2.2] years vs 14.8 [1.3] years; P < .001); there were no significant differences by race or health insurance coverage. Seventy-eight percent of females were African American, 16.6% reported having no health insurance, and 75.2% had public insurance. Among sexually experienced females, the mean (SD) number of lifetime male sexual partners was 5.7 (7.3), 40.7% reported a history of Chlamydia, and 24.3% reported a history of gonorrhea. Thirteen percent of sexually inexperienced females reported a history of sexual contact, and none reported a history of Chlamydia or gonorrhea. Results All swabs tested for HPV DNA were adequate for analyses, defined as positive for β-globin. The prevalence of HPV in sexually experienced and inexperienced females is shown in the Table. Among sexually experienced females, 70.0% (133 of 190) were HPV positive (≥1 type): 17.4% (33 of 190) for HPV-16 and 6.3% (12 of 190) for HPV-18. The only variable independently associated with HPV in a multivariable model was history of multiple sexual partners (2-5 partners vs 1: odds ratio, 6.2; 95% CI, 2.1-18.1 and ≥6 partners vs 1: odds ratio, 10.3; 95% CI, 2.6-41.5).