To analyse the epidemiological aspects contributing to the transmission of human papillomavirus (HPV) lesions (flat, inverted, and papillomatous condylomas) of the uterine cervix, we recorded the sexual behaviour of 146 women who consecutively attended the department of obstetrics and gynaecology of Kuopio University Central Hospital with a cervical HPV lesion (with or without concomitant cervical intraepithelial neoplasia (CIN]. Similar data were collected from an age matched group of women with no signs of gynaecological infection. The sexual habits of the women infected with HPV differed from those of healthy controls in most aspects studied, including an earlier onset of sexual activity (p less than 0.05), lower number of deliveries (p less than 0.05), less regular use of contraceptive measures (p less than 0.05), and use of the condom instead of intrauterine contraceptive device (IUCD) (p less than 0.0001). They also differed from controls in giving histories of more frequent episodes of: CIN (p less than 0.005), abnormal Pap (Papanicolaou) smears (p less than 0.0001), sexually transmitted disease (STD) (p less than 0.05), and genital warts (p less than 0.001). Furthermore, they had more multiple sexual partnerships (both past and current) than the controls (p less than 0.0001 and 0.005 respectively), they had not established permanent partnerships as often as the controls (p less than 0.001), and they had a higher frequency of casual relationships (p less than 0.0001). In addition, their own and their partners' sexual hygiene was poorer than in the control subjects (p less than 0.05 and 0.001 respectively). The results show the dramatic influence of sexual behaviour on the transmission of cervical HPV lesions, which are known to be intimately associated with CIN in many cases.
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