Association between recent genital infections and prevalent detection of high-risk HPV (N=1046)
| Total study population a | Study population stratified by use of contraceptives in the past 2 years* | |||||||||
| Detection of any HR-HPV | Detection of any HR-HPV | |||||||||
| Non-hormonal contraceptive users (n=339) | COC users (n= 294) | DMPA users (n= 413) | ||||||||
| N = 1046, N (col %) | HR-HPV+ n=91 (8.7%), n (row %) | PR (95% CI) | aPR‡ (95% CI) | PR (95% CI) | aPR§ (95% CI) | PR (95% CI) | aPR§ (95% CI) | PR (95% CI) | aPR§ (95% CI) | |
| Detection of the following in the past 2 years† | ||||||||||
| Genital chlamydia | ||||||||||
| No | 925 (88.4) | 72 (7.8) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Yes | 121 (11.6) | 19 (15.7) | 2.02 (1.26 to 3.22) | 2.93 (1.33 to 6.47) | 3.73 (1.69 to 8.26) | 2.74 (1.18 to 6.34) | 1.70 (0.84 to 3.47) | 1.14 (0.54 to 2.39) | 1.22 (0.44 to 3.35) | 1.08 (0.35 to 3.28) |
| Genital gonorrhea | ||||||||||
| No | 1020 (97.5) | 84 (8.2) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Yes | 26 (2.5) | 7 (26.9) | 3.27 (1.68 to 6.36) | 3.40 (1.73 to 6.65) | 2.31 (0.37 to 14.46) | 1.87 (0.34 to 10.29) | 4.24 (1.79 to 10.03) | 6.22 (2.18 to 17.73) | 3.29 (1.13 to 9.60) | 3.51 (1.13 to 10.93) |
| Bacterial vaginosis | ||||||||||
| No | 875 (83.7) | 74 (8.5) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Yes | 171 (16.4) | 17 (9.9) | 1.18 (0.71 to 1.94) | 1.05 (0.63 to 1.75) | 1.03 (0.40 to 2.66) | 0.75 (0.31 to 1.82) | 1.04 (0.46 to 2.36) | 0.90 (0.40 to 2.03) | 1.57 (0.66 to 3.68) | 1.46 (0.57 to 3.70) |
| Positive for HSV-2 serology | ||||||||||
| No | 626 (59.9) | 47 (7.5) | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Yes | 420 (40.2) | 44 (10.5) | 1.40 (0.94 to 2.07) | 1.26 (0.83 to 1.91) | 1.99 (0.90 to 4.38) | 1.75 (0.78 to 3.90) | 1.53 (0.84 to 2.80) | 1.67 (0.89 to 3.15) | 0.88 (0.41 to 1.88) | 0.73 (0.30 to 1.79) |
The following covariates were not found to be statistically significantly associated with the outcomes (P>0.05) and did not significantly influence the effect size of the primary association of interest (<10%), and hence were not included in the final models: parity, smoking status, as well as other parameters assessed for sexual behavior, including age of sexual debut, having new partner in the past year, number of sex partners in the past year, frequency of sex in last 6 months.
HR-HPV: High-risk HPV, defined as HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 (IARC 2007).
* Subjects were formerly enrolled in a 2-year study addressing the effects of hormonal contraceptive use on HIV acquisition (HC-HIV). These subjects were required to adhere to the self-selected contraceptive method for at least 1 year of follow-up in that study (Morrisonet al. AIDS. 2010;24:1778–81). These subjects were reconsented at the end of that study for inclusion in the current study.
† Genital infections were detected in pelvic exams and confirmed by laboratory assays.
‡ Estimates adjusted for age at baseline of the current study, number of lifetime partners, partners having sex with others in last 6 months, male partner using condom in last 6 months, other concurrent genital infections, types of contraceptive use in the past 2 years.
§ Estimates adjusted for age at enrollment of the current study, number of lifetime partners, partners having sex with others in last 6 months, male partner using condom in last 6 months, other concurrent genital infections.
COC, combined oral contraceptives; DMPA, depot medroxyprogesterone acetate; HSV-2, Herpes simplex virus 2; PR, Prevalence ratio.