A prospective study of absolute risk and determinants of human papillomavirus incidence among young women in Costa Rica
BACKGROUND: High risk human papillomaviruses (HR-HPV) are known to be extremely common, sexually transmitted infections, but more information is needed regarding the absolute risks of type-specific HR-HPV infections in the years following sexual debut.
METHODS: We conducted a survival analysis of 3,737 women aged 18-25 from the control group of the Costa Rican Vaccine trial to determine the absolute risks of HR-HPV infections at 12 months, 24 months, and end of follow-up (average of 50.7 months). To corroborate determinants of infection, we used Cox proportional hazards methods to assess associations between demographics and sexual risk behaviors and incident HR-HPV.
RESULTS: Cumulative incidence for HR-HPV infections was 51.3% at the end of the study period. The most common incident types were HPV52 (15.4%), HPV51 (13.6%), and HPV16 (12.4%). Type-specific cumulative incidence corresponded closely with type-specific prevalences, except that HPV16 was more prevalent than predicted by incidence, suggesting greater persistence. The strongest predictors of incident HR-HPV infections as a group in a multivariate analysis were the expected correlates of sexual behavior of the woman and her partner, such as being single (HR 1.6, 95% CI 1.4-1.8) or divorced/widowed (HR: 2.1, 95% CI: 1.7-2.7), having multiple HPV infections at enrollment (HR: 1.5, 95% CI: 1.3-1.7), and current smoking (HR: 1.2, 95% CI: 1.0-1.3). In women who reported being having only one lifetime sexual partner (being in a monogamous relationship), the strongest predictors of HR-HPV included not living with sex partner (HR: 2.1, 95% CI 1.7-2.5) and age of sex partner (HR: 1.4, 95% CI: 1.0-1.8).
CONCLUSION: We confirm the extremely high incidence of HR-HPV in young women, emphasizing the importance of vaccinating young girls before sexual debut.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2013 |
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| Erschienen: |
2013 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
BMC infectious diseases - 13(2013) vom: 08. Juli, Seite 308 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Clarke, Megan [VerfasserIn] |
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| Links: |
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| Themen: |
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| Anmerkungen: |
Date Completed 03.03.2014 Date Revised 21.10.2021 published: Electronic ClinicalTrials.gov: NCT00128661 Citation Status MEDLINE |
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| doi: |
10.1186/1471-2334-13-308 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM228981468 |
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| 041 | |a eng | ||
| 100 | 1 | |a Clarke, Megan |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A prospective study of absolute risk and determinants of human papillomavirus incidence among young women in Costa Rica |
| 264 | 1 | |c 2013 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 03.03.2014 | ||
| 500 | |a Date Revised 21.10.2021 | ||
| 500 | |a published: Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT00128661 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: High risk human papillomaviruses (HR-HPV) are known to be extremely common, sexually transmitted infections, but more information is needed regarding the absolute risks of type-specific HR-HPV infections in the years following sexual debut | ||
| 520 | |a METHODS: We conducted a survival analysis of 3,737 women aged 18-25 from the control group of the Costa Rican Vaccine trial to determine the absolute risks of HR-HPV infections at 12 months, 24 months, and end of follow-up (average of 50.7 months). To corroborate determinants of infection, we used Cox proportional hazards methods to assess associations between demographics and sexual risk behaviors and incident HR-HPV | ||
| 520 | |a RESULTS: Cumulative incidence for HR-HPV infections was 51.3% at the end of the study period. The most common incident types were HPV52 (15.4%), HPV51 (13.6%), and HPV16 (12.4%). Type-specific cumulative incidence corresponded closely with type-specific prevalences, except that HPV16 was more prevalent than predicted by incidence, suggesting greater persistence. The strongest predictors of incident HR-HPV infections as a group in a multivariate analysis were the expected correlates of sexual behavior of the woman and her partner, such as being single (HR 1.6, 95% CI 1.4-1.8) or divorced/widowed (HR: 2.1, 95% CI: 1.7-2.7), having multiple HPV infections at enrollment (HR: 1.5, 95% CI: 1.3-1.7), and current smoking (HR: 1.2, 95% CI: 1.0-1.3). In women who reported being having only one lifetime sexual partner (being in a monogamous relationship), the strongest predictors of HR-HPV included not living with sex partner (HR: 2.1, 95% CI 1.7-2.5) and age of sex partner (HR: 1.4, 95% CI: 1.0-1.8) | ||
| 520 | |a CONCLUSION: We confirm the extremely high incidence of HR-HPV in young women, emphasizing the importance of vaccinating young girls before sexual debut | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Intramural | |
| 700 | 1 | |a Schiffman, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Wacholder, Sholom |e verfasserin |4 aut | |
| 700 | 1 | |a Rodriguez, Ana Cecilia |e verfasserin |4 aut | |
| 700 | 1 | |a Hildesheim, Allan |e verfasserin |4 aut | |
| 700 | 1 | |a Quint, Wim |e verfasserin |4 aut | |
| 700 | 0 | |a Costa Rican Vaccine Trial Group |e verfasserin |4 aut | |
| 700 | 1 | |a Alfaro, Mario |e investigator |4 oth | |
| 700 | 1 | |a Barrantes, Manuel |e investigator |4 oth | |
| 700 | 1 | |a Bratti, M Concepcion |e investigator |4 oth | |
| 700 | 1 | |a Cárdenas, Fernando |e investigator |4 oth | |
| 700 | 1 | |a Cortés, Bernal |e investigator |4 oth | |
| 700 | 1 | |a Espinoza, Albert |e investigator |4 oth | |
| 700 | 1 | |a Estrada, Yenory |e investigator |4 oth | |
| 700 | 1 | |a Gonzalez, Paula |e investigator |4 oth | |
| 700 | 1 | |a Guillén, Diego |e investigator |4 oth | |
| 700 | 1 | |a Herrero, Rolando |e investigator |4 oth | |
| 700 | 1 | |a Jimenez, Silvia E |e investigator |4 oth | |
| 700 | 1 | |a Morales, Jorge |e investigator |4 oth | |
| 700 | 1 | |a Morera, Lidia Ana |e investigator |4 oth | |
| 700 | 1 | |a Pérez, Elmer |e investigator |4 oth | |
| 700 | 1 | |a Porras, Carolina |e investigator |4 oth | |
| 700 | 1 | |a Rodriguez, Ana Cecilia |e investigator |4 oth | |
| 700 | 1 | |a Villegas, Maricela |e investigator |4 oth | |
| 700 | 1 | |a Freer, Enrique |e investigator |4 oth | |
| 700 | 1 | |a Bonilla, Jose |e investigator |4 oth | |
| 700 | 1 | |a Silva, Sandra |e investigator |4 oth | |
| 700 | 1 | |a Atmella, Ivannia |e investigator |4 oth | |
| 700 | 1 | |a Ramírez, Margarita |e investigator |4 oth | |
| 700 | 1 | |a Macklin, Nora |e investigator |4 oth | |
| 700 | 1 | |a Hildesheim, Allan |e investigator |4 oth | |
| 700 | 1 | |a Lowy, Douglas R |e investigator |4 oth | |
| 700 | 1 | |a Schiffman, Mark |e investigator |4 oth | |
| 700 | 1 | |a Schiller, John T |e investigator |4 oth | |
| 700 | 1 | |a Sherman, Mark |e investigator |4 oth | |
| 700 | 1 | |a Solomon, Diane |e investigator |4 oth | |
| 700 | 1 | |a Wacholder, Sholom |e investigator |4 oth | |
| 700 | 1 | |a Pinto, Ligia |e investigator |4 oth | |
| 700 | 1 | |a Garcia-Pineres, Alfonso |e investigator |4 oth | |
| 700 | 1 | |a Eklund, Claire |e investigator |4 oth | |
| 700 | 1 | |a Hutchinson, Martha |e investigator |4 oth | |
| 700 | 1 | |a Quint, Wim |e investigator |4 oth | |
| 700 | 1 | |a van Doorn, Leen-Jan |e investigator |4 oth | |
| 700 | 1 | |a Bougelet, Catherine |e investigator |4 oth | |
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