Rates of New Human Papillomavirus Detection and Loss of Detection in Middle-aged Women by Recent and Past Sexual Behavior. (13th October 2020)

• Record Type: Journal Article
• Authors: Paul, Proma; Hammer, Anne; Rositch, Anne F; Burke, Anne E; Viscidi, Raphael P; Silver, Michelle I; Campos, Nicole; Youk, Ada O; Gravitt, Patti E
• Is Part Of: Journal of infectious diseases. Volume 223:Number 8(2021)
• Page Start: 1423
• Page End: 1432
• Publication Date: 2020-10-13
• Subjects: human papillomavirus -- cervical neoplasia -- epidemiology -- sexual behavior -- cervical cancer screening; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiaa557
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: Understanding the source of newly detected human papillomavirus (HPV) in middle-aged women is important to inform preventive strategies, such as screening and HPV vaccination. Methods: We conducted a prospective cohort study in Baltimore, Maryland. Women aged 35–60 years underwent HPV testing and completed health and sexual behavior questionnaires every 6 months over a 2-year period. New detection/loss of detection rates were calculated and adjusted hazard ratios were used to identify risk factors for new detection. Results: The new and loss of detection analyses included 731 women, and 104 positive for high-risk HPV. The rate of new high-risk HPV detection was 5.0 per 1000 woman-months. Reporting a new sex partner was associated with higher detection rates (adjusted hazard ratio, 8.1; 95% confidence interval, 3.5–18.6), but accounted only for 19.4% of all new detections. Among monogamous and sexually abstinent women, new detection was higher in women reporting ≥5 lifetime sexual partners than in those reporting <5 (adjusted hazard ratio, 2.2; 95% confidence interval, 1.2–4.2). Conclusion: Although women remain at risk of HPV acquisition from new sex partners as they age, our results suggest that most new detections in middle-aged women reflect recurrence of previously acquired HPV. Abstract : New human papillomavirus (HPV) detection in adult women is a mixture of newly acquired infection and recurrent detection of past infection. These data are important for shared decision making regarding HPV screening and vaccination throughout the life span.