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HPV infection among a population-based sample of sexual minority women from USA
  1. Paul L Reiter1,
  2. Annie-Laurie McRee2
  1. 1Division of Cancer Prevention and Control, College of Medicine, The Ohio State University, Columbus, Ohio, USA
  2. 2Division of General Pediatrics and Adolescent Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA
  1. Correspondence to Dr Paul L Reiter, Division of Cancer Prevention and Control, The Ohio State University, 1590 North High Street, Suite 525, Columbus, OH 43201, USA; Paul.Reiter{at}


Objectives Sexual minority women are at risk for infection with human papillomavirus (HPV); yet, relatively little is known about the prevalence of HPV infection among this population.

Methods We analysed data from the 2003–2012 National Health and Nutrition Examination Survey among women aged 20–59 (n=7132). We examined two dimensions of sexual orientation (sexual identity and sexual behaviour) and used weighted logistic regression to determine how HPV infection outcomes (any HPV type, high-risk HPV type and vaccine HPV type) vary by dimension.

Results Similar patterns emerged for sexual identity and sexual behaviour. In bivariate analyses, HPV infection outcomes were more common among non-heterosexual women compared with heterosexual women (any type: 49.7% vs 41.1%; high-risk type: 37.0% vs 27.9%), as well as among women who reported any same-sex partners compared with women who reported only opposite-sex partners (any type: 55.9% vs 41.0%; high-risk type: 37.7% vs 28.2%; vaccine type: 19.1% vs 14.0%) (p<0.05). When we disaggregated measures of sexual orientation into subgroups, bisexual women and women who reported partners of both sexes had greater odds of HPV infection outcomes (p<0.05 in bivariate analyses). Multivariate models attenuated several of these differences, though lesbian women and women who reported only same-sex partners had lower odds of most HPV infection outcomes in multivariate analyses (p<0.05).

Conclusions HPV infection is common among sexual minority women, though estimates vary depending on how sexual orientation is operationalised. Results can help inform targeted HPV and cervical cancer prevention efforts for sexual minority women.

  • HPV

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  • This work was presented at the 2016 annual meetings for the American Society of Preventive Oncology and Society of Behavioural Medicine.

  • Handling editor Jackie A Cassell

  • Contributors PLR conceived the study, performed data analysis and wrote the initial manuscript draft. A-LM conceived of the study and provided direction for data analysis and manuscript writing. Both authors helped to conceptualise ideas, interpret findings and review drafts of the manuscript.

  • Funding Supported by the National Cancer Institute of the National Institutes of Health under Award Number R03CA198115.

  • Competing interests PLR has received research grants from Merck Sharp & Dohme and Cervical Cancer-Free America, via an unrestricted educational grant from GlaxoSmithKline. These funds were not used to support this research study.

  • Ethics approval The Ohio State University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data analysed for this study were public-use data from the National Health and Nutrition Examination Survey (NHANES).