A9b Concurrency, Risk Behaviors, and High Risk Human Papillomavirus Among Older Women

Tuesday, March 9, 2010: 10:30 AM
Grand Ballroom C (M4) (Omni Hotel)
Marjan Javanbakht, PhD1, Pamina Gorbach, DrPH1, Peter Kerndt, MD, MPH2, Laura Koutsky, PhD3, Judith Shlay, MD, MSPH4 and S. Deblina Datta, MD5, 1Department of Epidemiology, UCLA, Los Angeles, CA, 2STD Program, Los Angeles County Department of Public Health, Los Angeles, CA, 3HPV Research Group, University of Washington, Seattle, WA, 4Denver Public Health, Denver Health, Denver, CO, 5Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA

Background: Although risk behaviors and factors associated with high-risk human papillomavirus (HR-HPV) are well described among younger women, data on older women (age ≥ 30 years) are limited.

Objectives: To examine the association between HR-HPV infection and reported risk behaviors, including concurrent partnerships among a diverse group of women ≥ 30 years.

Methods: Analysis of risk behavior data collected from women screened for HPV as part of a multi-site sentinel surveillance project. Women were eligible for this analysis if they were ≥ 30 years, needed routine cervical screening, did not have a Pap test in the past 12-months, and enrolled in three of the study sites using a survey with additional questions about sexual partners and concurrency (i.e., overlapping sexual partners).

Results:Among the 1,213 women included in this analysis, the mean age was 41 years (range: 30–65), 18% African American, 21% Asian, 18% Hispanic, and 39% White. The overall prevalence of HR-HPV was 13% and was higher among women who reported concurrency (16%) as compared to those who reported no concurrency (10%; p-value <.01).  Based on multivariate analysis adjusting for age, race/ethnicity, and lifetime number of partners concurrency was associated with HR-HPV (adjusted odds ratio [AOR]=1.51; 95% confidence interval [CI] 1.06–2.17).  In addition, women who reported a new sex partner in the past 6-months were twice as likely to have HR-HPV (AOR=2.17; 95% CI 1.51-3.12), while women in age discordant relationships (+/- 10-years) were less likely to be diagnosed with HR-HPV (AOR=0.48; 95%CI 0.21-1.10 and AOR=0.61; 95% CI 0.37-1.00 respectively).  

Conclusions: This study demonstrates that individual and partnership characteristics such as concurrency increase the risk of HR-HPV DNA detection among women ≥ 30 years.

Implications for Programs, Policy, and/or Research: These findings might help inform HR-HPV and cervical cancer prevention strategies among women 30 to 65 years of age.