Association of Condom Use, Sexual Behaviors, and Sexually Transmitted Infections With the Duration of Genital Human Papillomavirus Infection Among Adolescent Women

Department of Pediatrics, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States
Archives of Pediatrics and Adolescent Medicine (Impact Factor: 5.73). 03/2006; 160(2):151-6. DOI: 10.1001/archpedi.160.2.151
Source: PubMed


To examine the association of potentially modifiable factors such as condom use, sexual behaviors, and concurrent sexually transmitted infections with duration of genital human papillomavirus (HPV) infections among adolescent women.
Longitudinal observational study.
Study conducted at 3 inner-city clinics in Indianapolis, Ind.
Forty-nine HPV-positive adolescents were tested frequently for HPV infection and provided sexual behavior diaries. Main Exposures Condom use, sexual behaviors, number of partners, and concurrent infections with Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis.
Time from onset to clearance of type-specific HPV infections was analyzed with proportional hazard models. Adjusted hazard ratios (AHRs) were used to assess the effects of risk factors on the duration of HPV infection. Because viral clearance is a preferred outcome, a variable with an AHR less than 1 was considered a risk factor (ie, associated with reduced chance of viral clearance and prolonged infection).
Prolonged HPV infection was associated with oncogenic HPV types (AHR, 0.58 [95% confidence interval (CI), 0.39-0.84]) less than median level of condom use during an HPV infection (AHR, 0.53 [95% CI, 0.33-0.84]) and coinfection with C trachomatis (AHR, 0.58 [95% CI, 0.31-0.89]) or T vaginalis (AHR, 0.32 [95% CI, 0.16-0.64]). Not having multiple sexual partners during an HPV infection was associated with early HPV clearance (AHR, 5.52 [95% CI, 3.28-9.30]).
These findings support public health messages of reducing the number of sexual partners, promoting routine condom use, and frequent sexually transmitted infection screening that may be beneficial with HPV infections.

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Available from: Beth Elisa Juliar, Jun 10, 2014
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    • "However, the association between HPV clearance and hormonal contraceptive use has been found to be inconsistent across studies. Studies involving college-aged women (Richardson et al., 2005; Sycuro et al., 2008) and high-risk adolescent women (Shew et al., 2006), which had limited sample sizes (N = 400), found no association between HPV persistence and current oral contraceptive use; however, other large population-based studies on women did report an association between current oral contraceptive use and an increased risk of viral persistence (Marks et al., 2011). "
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    ABSTRACT: Human papillomavirus (HPV) infection is a central and necessary, although not sufficient, cause of cervical cancer. Besides HPV, the additional multiple risk factors related with the onset of cervical cancer are early-age sexual activities; high number of sexual partners, which is the most salient risk factor; suppression and alteration of the immune status; long-term use of oral contraceptives; and other hormonal influences. The tumor-suppressor proteins p53 and pRb are degraded and destabilized through ubiquitination by viral oncoproteins E6 and E7. Over 95% of cervical cancer cases worldwide test positive for oncogenic HPV DNA. Although cervical screening procedures have been successful in reducing the disease burden associated with HPV infection because of lack of resources or inadequate infrastructure many countries have failed to reduce cervical cancer mortality. Therefore, prevention may be a valuable strategy for reducing the economic and disease burden of HPV infection. At present, two successful prophylactic HPV vaccines are available, quadrivalent (HPV16/18/6/11) 'Gardasil' and bivalent (HPV16/18) 'Cervarix' for vaccinating young adolescent girls at or before the onset of puberty. Recent data indicate that vaccination prevents the development of cervical lesions in women who have not already acquired the vaccine-specific HPV types. Moreover, several therapeutic vaccines that are protein/peptide-based, DNA-based, or cell-based are in clinical trials but are yet to establish their efficacy; these vaccines are likely to provide important future health benefits. The therapeutic vaccination mode of prevention is a promising area of research, as revealed in preclinical trials; however, clinical trials based on large populations are warranted before reaching a valid conclusion. This review summarizes the studies on the epidemiology of HPV infection, the pathogenesis of viral oncoproteins in the oncogenesis of cervical cancer, the economic and health burden of HPV-related diseases, and, finally, focuses on the results of recent clinical vaccination trials.
    European journal of cancer prevention: the official journal of the European Cancer Prevention Organisation (ECP) 10/2013; 23(3). DOI:10.1097/CEJ.0b013e328364f273 · 3.03 Impact Factor
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    • "As some studies have shown, C.trachomatis increases the risk of HPV infection becoming persistent by increasing HPV’s access to the basal epithelium due to microabrasions of the cervical epithelium or changing its characteristics, or by preventing efficient clearance of the viral infection [50,51]. Also a study by Lehtinen et al. [44] demonstrated that C.trachomatis infection was an independent risk factor for cervical neoplasia. "
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    ABSTRACT: Since the late 1990s, infectious agents have been thought to play a role in the pathogenesis of approximately 15% of cancers. It is now widely accepted that infection of stomach tissue with the bacteria Helicobacter pylori is an important cause of stomach adenocarcinoma. In addition, oncogenic viruses, such as papilloma viruses, herpes viruses, and hepadnaviruses are strongly associated with increased risk of cervical cancer, lymphomas, liver cancer, amongst others. However, in the scientific community the percentage of cancers caused by pathogens is believed to be far higher than 15%. A significant volume of data collected to date show an association between infectious agents and urogenital cancers. These agents include Chlamydia trachomatis, Neisseria gonorrhoea, Mycoplasma genitalium and certain viruses that have been implicated in ovarian cancer. Other pathogens include the hepatitis C and Epstein-Barr viruses, which are potentially involved in kidney cancer. In addition, infections with Schistosoma haematobium, the human papillomavirus, and human polyomaviruses are strongly associated with an increased risk of urinary bladder cancer. This article reviews publications available to date on the role of infectious agents in urogenital cancers. A greater understanding of the role of such agents could aid the identification of novel methods of urogenital cancer treatment.
    Infectious Agents and Cancer 12/2012; 7(1):35. DOI:10.1186/1750-9378-7-35 · 2.36 Impact Factor
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    • "The percentage was low (8.6%) in women whose spouses used condoms as compared to the others. This indicates that using barrier contraceptives (condoms) is the most effective mechanical barrier to various microorganisms [18]. Women using either barrier or oral contraceptives six months before becoming pregnant had decreased rates to be colonized by T. vaginalis as previously described [19]. "
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    ABSTRACT: Background. Trichomoniasis is a common sexually transmitted disease caused by Trichomonas vaginalis. It is a major health problem worldwide. The World Health Organization (WHO) has estimated that 180 million infections are acquired annually worldwide. Methodology. Vaginal swabs (1207) were cultured for T. vaginalis on Trichomonas Medium no. 2 (Oxoid) soon after specimen collection. The cultures were examined daily using a light microscope to detect the presence of T. vaginalis. Results. The prevalence of T. vaginalis was 13.6% (164/1207). The infection rate was the highest during pregnancy, 28.1%, and the lowest among women whose spouses use condoms, 8.6%. Conclusions. The culture method was used in this study to accurately determine the prevalence of this parasite in the West Bank, Palestine. The results of the study will eliminate ambiguities concerning trichomoniasis in this country and will contribute to better management and proper treatment.
    12/2011; 2011:872358. DOI:10.5402/2011/872358
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