The relationship between contraceptives, sexual practices, and cervical human papillomavirus infection among a college population

Burkett, Barbara; Peterson, Christine; Birch, Linda; Brennan, Constance; Nuckols, Margaret L.; Ward, Benjamin D.; Crum, Christopher P.

doi:10.1016/0895-4356(92)90170-r

Cited by 40 publications

(27 citation statements)

References 19 publications

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“…Our analyses confirmed the findings of previous studies that demonstrated that age of first sexual intercourse is significantly associated with subsequent HPV infection, [13][14][15][16] but extended previous findings in that we specifically examined which risk behaviors and partner characteristics mediate the association between age of first sexual intercourse and subsequent HPV infection. As previously discussed, a risk behavior or partner characteristic acts as a mediator of the association between age of first sexual intercourse and HPV infection if age of first sexual intercourse is causally associated with the potential mediator and the potential mediator is causally associated with HPV infection.…”

Section: Discussionsupporting

confidence: 89%

“…A number of studies have demonstrated that sexual risk behaviors are associated with HPV infection, particularly with high oncogenic risk types. These behaviors include multiple 14,15,[32][33][34][35] Other risk behaviors that have been associated with HPV infection include smoking and alcohol use. 14,15 Black race has also been associated with HPV infection.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Recent studies have demonstrated that risk factors include number of sexual partners, partner's number of sexual partners, and early age of first sexual intercourse. 2,[13][14][15][16][17][18] Although several investigators have reported a significant association between early age of first sexual intercourse and subsequent HPV infection, the mechanisms by which early age of first sexual intercourse leads to HPV infection; ie, the mediators of the association, are unknown.Behavioral variables, biological variables, or both may play key roles in mediating the association between early age of first sexual intercourse and subsequent HPV infection. A behavioral or biological variable acts as a mediator of this association if early age of first sexual intercourse is causally associated with the mediating variable, which in turn is causally associated with HPV infection.…”

mentioning

confidence: 99%

“…The variables were chosen on the basis of findings of previous studies. 2,[13][14][15][16][17][18]20,21 Sexual risk behaviors and associated outcomes included number of sexual partners during the past 6 months, frequency of vaginal intercourse during the past 6 months (per participant, averaged across all partners), condom use during the past 6 months, oral contraceptive use during the past 6 months, history of STI other than HPV, and history of pregnancy. Other risk behaviors assessed were current cigarette smoking, alcohol use as it relates to risky sexual behaviors, and drug use as it relates to risky sexual behaviors.…”

mentioning

confidence: 99%

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Mediators of the Association Between Age of First Sexual Intercourse and Subsequent Human Papillomavirus Infection

et al. 2002

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ABSTRACT.Objective. Previous studies have demonstrated that early age of first sexual intercourse is associated with human papillomavirus (HPV) infection. The objective of this study was to identify a set of risk behaviors and partner characteristics that mediate the association between age of first sexual intercourse and subsequent HPV infection in adolescent and young adult women.Methods. Female university students completed surveys and underwent HPV testing every 6 months for up to 3 years. HPV-positive participants were matched to HPV-negative participants (252 pairs, total N ‫؍‬ 504). Associations were examined between risk behaviors/partner characteristics and both age of first sexual intercourse and HPV infection. Those variables associated with either age of first sexual intercourse or HPV infection were entered into a generalized estimating equation (to account for the matched study design) modeling the association between age of first sexual intercourse and HPV infection.Results. Mean age of first sexual intercourse was 16.7 (؎1.8) years, and early age of first sexual intercourse was associated significantly with HPV infection (␤ ‫؍‬ ؊0.20; odds ratio: 0.82; 95% confidence interval: 0.74 -0.90). The association was mediated by number of sexual partners in the past 6 months, history of sexually transmitted infection, alcohol and drug use related to sexual behaviors, and partner's number of sexual partners.Conclusion. A set of behavioral risk factors and partner characteristics partially mediate the association between age of first sexual intercourse and subsequent HPV infection. Pediatrics 2002;109(1). URL: http://www. pediatrics.org/cgi/content/full/109/1/e5; human papillomavirus, sexual intercourse, adolescent, risk behaviors, mediator.ABBREVIATIONS. HPV, human papillomavirus; STI, sexually transmitted infection; GEE, generalized estimating equation. G enital human papillomavirus (HPV) infection is one of the most common sexually transmitted infections in the United States, with a prevalence of approximately 50% in sexually active adolescent and young adult women. 1,2 Infection with certain HPV types, particularly types 6 and 11, is associated with the development of anogenital warts, which has a prevalence of approximately 2% in sexually active men and women. 3 HPV infection with high-risk oncogenic types, such as 16, 18, 31, and 45, may progress from infection to cervical dysplasia, carcinoma in situ, and invasive cervical cancer. 4 -8 Although HPV infection is frequently transient in adolescent and young adult women and the natural history of HPV infection and cytologic abnormalities is still being defined, 9 this population has a relatively high incidence of abnormal Papanicolaou (Pap) smears. Mount and Papillo 10 reported that the incidence of Pap smears with squamous intraepithelial lesion was higher in adolescents 10 to 19 years of age than in adult women, and other investigators 11,12 have proposed that the prevalence of abnormal Pap smears and cervical dysplasia is increasing worldwide in y...

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Mediators of the Association Between Age of First Sexual Intercourse and Subsequent Human Papillomavirus Infection

et al. 2002

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Cervical intraepithelial neoplasia

Crum

McLachlin

1995

J. Cell. Biochem.

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Cervical intraepithelial neoplasia (CIN) has been traditionally defined as a continuum of intraepithelial squamous abnormalities which exhibit nuclear atypia in all epithelial layers and possess some potential for progression to invasive carcinoma if not removed. Efforts to subdivide this spectrum into categories of low and high cancer risk have been based previously on the strong association between CJN I11 (carcinoma in situ) and subsequent invasive carcinoma. However, in practice, this distinction has been discouraged because CIN I and I1 may be associated with CIN I11 and a small proportion may progress to invasive carcinoma. As human papillomaviruses (HPV) have emerged as potential markers for subdividing precursor lesions, so-called "high-risk" HPV types have been associated with all grades of CIN, whereas "low-risk" HPV types have segregated primarily in lesions closely resembling condylomata. The place of condyloma in the spectrum of CIN, as well as the precise definition of CIN I, has been controversial. Some authors distinguish condyloma from CIN I and others use similar criteria for the diagnosis of both. Currently, the trend among pathologists and cytopathologists is to classify CIN I as a process either identical to or closely resembling condyloma (low-grade), and CIN 11 and Ill as lesions falling within the spectrum of CIN as classically described (high-grade). As new etiologic perspectives (HPV), classifications (Bethesda) and outpatient managements (LEEP) evolve, morphologic definitions of CIN will remain important to patient care, particularly if management decisions are based on nuances of histologic or cytologic grade. When using cervical lesion morphology as an endpoint in chemoprevention studies, investigators must understand that "morphologic progression" of CIN may not be synonymous with biologic progression, that discrepancies between HPV type and morphology exist, and that cytology and histology provide variable, and at times conflicting, information.0 1995 Wiley-Liss, Inc.Strategies aimed at chemoprevention of cervical cancer include preventing its precursor lesion, cervical intraepithelial neoplasia (CIN). Because cervical carcinomas are presumably preceded by CIN in most cases, carcinomas could be prevented by preventing either the development of CIN or its progression to invasive carcinoma. This discussion will focus on three aspects of CIN which may be relevant to prevention: the rela tionship of papillomaviruses to CIN; grading systems for CIN and their biologic validity; and other aspects of cervical biology which may influence the natural history of cervical neoplasia and should be considered when devising strategies for prevention.

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Papillomaviruses and Cervical Neoplasia

Nuovo¹,

Crum²

1991

Clinical Perspectives in Obstetrics and Gynecology

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The relationship between contraceptives, sexual practices, and cervical human papillomavirus infection among a college population

Cited by 40 publications

References 19 publications

Mediators of the Association Between Age of First Sexual Intercourse and Subsequent Human Papillomavirus Infection

Mediators of the Association Between Age of First Sexual Intercourse and Subsequent Human Papillomavirus Infection

Cervical intraepithelial neoplasia

Papillomaviruses and Cervical Neoplasia

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