Journal Article

Genital Human Papillomavirus Infection: Incidence and Risk Factors in a Cohort of Female University Students

Rachel L. Winer, Shu-Kuang Lee, James P. Hughes, Diane E. Adam, Nancy B. Kiviat and Laura A. Koutsky

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 157, issue 3, pages 218-226
Published in print February 2003 | ISSN: 0002-9262
Published online February 2003 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwf180
Genital Human Papillomavirus Infection: Incidence and Risk Factors in a Cohort of Female University Students

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Incidence data on human papillomavirus (HPV) infection are limited, and risk factors for transmission are largely unknown. The authors followed 603 female university students in Washington State at 4-month intervals between 1990 and 2000. At each visit, a sexual and health questionnaire was completed and cervical and vulvovaginal samples were collected to detect HPV DNA. At 24 months, the cumulative incidence of first-time infection was 32.3% (95% confidence interval: 28.0, 37.1). Incidences calculated from time of new-partner acquisition were comparable for enrolled virgins and nonvirgins. Smoking, oral contraceptive use, and report of a new male sex partner—in particular, one known for less than 8 months before sex occurred or one reporting other partners—were predictive of incident infection. Always using male condoms with a new partner was not protective. Infection in virgins was rare, but any type of nonpenetrative sexual contact was associated with an increased risk. Detection of oral HPV was rare and was not associated with oral-penile contact. The data show that the incidence of HPV associated with acquisition of a new sex partner is high and that nonpenetrative sexual contact is a plausible route of transmission in virgins.

Keywords: cohort studies; incidence; papillomavirus, human; sexual abstinence; sexual partners; sexually transmitted diseases; Abbreviations: CI, confidence interval; HPV, human papillomavirus; HR, hazard ratio; PCR, polymerase chain reaction.

Journal Article.  5577 words.  Illustrated.

Subjects: Public Health and Epidemiology

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