The natural history of type-specific human papillomavirus (HPV) infections was examined in a cohort of 331 women aged 18-35 years who self-referred for routine gynecological care. Participants underwent a gynecological examination at baseline and at approximately 4 and approximately 10 months after baseline. Cervical samples were collected for HPV testing and genotyping at each visit, as was information on reproductive, sexual, and medical histories. The rate of new HPV infections was 2.9% per month; the highest rates were observed for HPV types 16, 39, 84, and 51. Among women who tested negative for HPV at baseline, the cumulative probability of acquiring an oncogenic HPV strain during a 12-month follow-up period was 0.32, compared with 0.18 for nononcogenic strains. Women who had had >/=1 new male sex partner in the recent past were significantly more likely to acquire a new HPV infection (relative hazard, 2.39; 95% confidence interval, 1.20-4.76). The median time to clearance of infection was significantly longer for oncogenic strains (9.8 months) than for nononcogenic strains (4.3 months).
Human papillomavirus (HPV) is the main etiologic agent of anogenital cancers, including cervical cancer, but little is known about the type-specific prevalence of HPV in men. Participants were men aged 18-70 years attending a sexually transmitted disease clinic. Penile skin swabs were assessed for HPV DNA using polymerase chain reaction with reverse line-blot genotyping. Of 436 swabs collected, 90.1% yielded sufficient DNA for HPV analysis. Men with inadequate swab samples were significantly more likely to be white and circumcised than men with adequate swab samples. The prevalence of HPV was 28.2%. Oncogenic HPV types were found in 12.0% of participants, nononcogenic types were found in 14.8% of participants, multiple types were found in 6.1% of participants, and unknown types were found in 5.9% of participants. The most prevalent subtypes were nononcogenic 6, 53, and 84. HPV positivity was not associated with age. These results indicate that HPV infection among men at high risk is common but that characteristics of male HPV infection may differ from those of female infection.Human papillomavirus (HPV) infection is the necessary, sexually transmitted cause of invasive cervical cancer and its precursor lesion, cervical intraepithelial neoplasia [1][2][3]. HPV has also been closely linked with other anogenital cancers, including anal cancer and certain penile cancers [4][5][6]. HPV infection in men is over- whelmingly subclinical, which has resulted in a potentially large number of asymptomatic carriers who serve as reservoirs and vectors for the virus.Although HPV has been studied extensively in women, data on male infection are limited. Studies of HPV in men are necessary to improve our understanding of HPV transmission and HPV-related carcinogenesis and to prevent disease in both men and women. The success of future cancer prevention strategies, such as prophylactic HPV vaccination, will be limited without a basic epidemiological understanding of HPV in men.Earlier studies of papillomavirus infection in men used a variety of clinical and histological techniques to establish a diagnosis of HPV, but polymerase chain reaction (PCR) has emerged as the most sensitive method available for the detection of latent HPV [7][8][9]. Among studies that have used PCR to detect penile HPV DNA in healthy men, sampling methodologies have been inconsistent. Nonetheless, results from these diverse investigations have suggested that penile HPV in sexually active men is at least as prevalent as cervical HPV is among women [10][11][12][13][14][15].HPV prevalence in men has been shown to vary by
While health care providers are serving this patient population, they do not consistently identify them as victims of human trafficking.
Despite the disproportionate prevalence of incarceration in communities of color, few studies have examined its contribution to health disparities. We examined whether a lifetime history of incarceration is associated with recent access to medical and dental care. We performed a secondary data analysis of the 2007 Los Angeles County Health Survey, a population-based random-digit-dialing telephone survey of county households. Any history of incarceration in a prison/jail/detention center as an adult was assessed for a random subsample. Bivariate and multivariate logistic regression analyses examined whether incarceration history was associated with access to care, controlling for other characteristics. Ten percent of our study population reported a history of incarceration. While persons with an incarceration history were similar to their peers with regard to health and insurance status, their access to medical and dental care was worse. Incarceration history was independently associated with disparities in access to care. Interventions to improve the health of communities affected by high rates of incarceration could include efforts that enable access to care for formerly incarcerated adults.
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