Risk factors for HPV infection among American Indian and white women in the Northern Plains

Abstract

Objective American Indian (AI) women living in the Northern Plains have high incidence and mortality rates for cervical cancer. We assessed risk factors for human papillomavirus (HPV) infection among AI and White women. Methods We tested cervical samples for HPV infection obtained from women ages 18-65 years attending 2 rural AI reservation clinics in South Dakota (n = 235) and an urban clinic serving predominantly White women (n = 246). Patients self-reported information on HPV risk factors. We used percentages and chi-square tests to compare risk factors, and logistic regression with HPV status as the outcome to quantify the association between HPV and risk factors. Results AI women had more risk factors than White women, including younger age, less education, less vegetable consumption, more sexual partners, younger age at first sexual experience and first pregnancy, and more pregnancies (p values ≤ 0.003). AI women more often endorsed recreational drug use, history of sexually transmitted diseases, and current smoking; White women reported more alcohol consumption (p values < 0.001). In multivariate analysis, younger age and current smoking were associated with higher odds of HPV infection in AI women, whereas a higher number of sexual partners was associated with higher odds of HPV infection in White women. Conclusions AI women have a high burden of risk factors for HPV disease, and associations with HPV infection appear to differ by community. Knowledge of specific risk factors in AI populations may provide targets for public health officials to decrease HPV infection and disease.

Assessing Acceptability of Self-Sampling Kits, Prevalence, and Risk Factors for Human Papillomavirus Infection in American Indian Women

“…Other than age, no other risk factors evaluated were significantly associated with hrHPV infection. To our knowledge, only one other study has evaluated risk factors for prevalent HPV infection in American Indian women [15]. In that study, which assessed women in the Northern Plains, age and current smoking were the only risk factors independently associated with HPV infection, with age inversely associated and smoking positively associated.…”

“…Previous studies suggest that the epidemiology of HPV infection may differ between American Indian and non-Hispanic White women [15, 16, 17], but data on American Indian populations are scarce, and no study to date has focused specifically on Hopi women. Defining the epidemiology of hrHPV in a range of American Indian populations is essential for evaluating whether disparities in cervical cancer incidence result from differences in the prevalence of hrHPV infections.…”

Review of the current knowledge on the epidemiology, pathogenesis, and prevention of human papillomavirus infection

“…Epidemiological studies have consistently reported that the risk of genital HPV infection seems to increase with number of recent/lifetime sexual partners and age at sexual debut (Ho et al, 1998;Richardson et al, 2000;Moscicki et al, 2001;Winer et al, 2003;Bell et al, 2011;Bahmanyar et al, 2012). Increased metaplastic activity in the cervix during adolescence and its decline after menopause implica earlier age at sexual debut as a risk factor for HPV infection.…”

Prevalência de atipias citológicas e infecção pelo papilomavírus humano de alto risco em mulheres indígenas Panará, povo indígena do Brasil Central

“…Em outros estudos, a maior parte realizados com indígenas e aborí-gines de outros países, foram encontradas taxas que variaram de 19,3% a 37,5% 16,17,18,28,29 . A vulnerabilidade das mulheres Panará está relacionada ao início da atividade sexual, por volta dos 12 anos de idade, de frequentemente possuírem mais de um parceiro e terem taxa de fecundidade total de 7,3 filhos por mulher 30 .…”