O1-S02.01 Epidemiology of, and behavioural risk factors for, sexually transmitted human papilloma virus infection in a sample of the British Population
- C H Mercer1,
- A M Johnson1,
- N de Silva2,
- S Beddows2,
- S Desai2,
- R Howell-Jones2,
- C Carder3,
- P Sonnenberg1,
- C M Lowndes2,
- K Soldan2
Background Persistent infection with high-risk sexually transmitted human papilloma viruses (HR-HPV) can lead to development of cervical and other cancers while low-risk types (LR-HPV) may cause genital warts, the most commonly-diagnosed viral STI in the UK. An HPV immunisation programme, using the bivalent vaccine protecting against types 16 and 18, was introduced in the UK in 2008. The frequency of HPV types is important baseline information against which to monitor the direct and indirect effects of vaccination. Here we examine the proportion of the population with detectable infection with HPV in urine collected in 1999–2001 for the National Survey of Sexual Attitudes and Lifestyles (Natsal-2) and the relationship with demographic and behavioural variables.
Methods Natsal-2 was a probability sample survey of men and women aged 16–44 resident in Britain involving computer-assisted personal interviewing. Half of all sexually-experienced respondents aged 18–44 were invited to provide a urine sample. 3436 samples were tested using an in-house Luminex-based HPV genotyping system.
Results HPV DNA was detected in 29.0% (95% CI 26.7% to 31.3%) of samples from women and 17.4% (95% CI 15.1% to 19.8%) from men. Any of 13 HR-HPV types was detected in 15.9% (95% CI 14.1% to 17.8%) of women's samples and 9.6% (95% CI 8.0% to 11.6%) of men's. Vaccine preventable types 16 and/or 18 were found in 5.5% (95% CI 4.5% to 6.8%) of women and 3.0% (95% CI 2.1% to 4.3%) of men; and types 6 and/or 11 in 4.7% (95% CI 1.8% to 3.3%) of women and 2.2% (95% CI 1.5% to 3.1%) of men. 4.1% (95% CI 3.1% to 5.2%) of women had HPV 16 and/or 18 without any other HR-HPV. In multivariate analysis, HR-HPV was associated with number of new partners, in women with younger age, single status, and partner concurrency, and in men with number of unprotected partnerships and age at first intercourse.
Conclusion This is the first population-based probability sample study of the distribution of sexually transmissible HPV types in Britain. It is also the first to undertake a detailed analysis of relationships with demographic and behavioural variables and to include men. HPV DNA was detectable in urine of a high proportion of the sexually active British population; the lower prevalence in males reflected lower detection sensitivity for HPV in urine from males. In both genders HPV was strongly associated with sexual risk behaviour.