Article Text

Download PDFPDF

P822 Factors associated with oncogenic human papillomavirus prevalence among australian women following vaccine introduction
  1. Dorothy Machalek1,
  2. Hannah Shilling1,
  3. Steph Atchison1,
  4. Alyssa Cornall1,
  5. Julia Brotherton2,
  6. Deborah Bateson3,
  7. Kathleen Mcnamee4,
  8. Jane Hocking5,
  9. John Kaldor6,
  10. Marcus Chen7,
  11. Christopher Fairley7,
  12. Eric Chow7,
  13. S Rachel Skinner8,
  14. Gerald Murray1,
  15. Monica Molano1,
  16. Sepehr Tabrizi1,
  17. Suzanne Garland1
  1. 1The Royal Women’s Hospital, Centre for Women’s Infectious Disease Research, Parkville, Australia
  2. 2VCS Population Health, VCS Foundation, East Melbourne, Australia
  3. 3Family Planning New South Wales, Ashfield, Australia
  4. 4Family Planning Victoria, Box Hill, Australia
  5. 5University of Melbourne, Melbourne School of Population and Global Health, Parkville, Australia
  6. 6University of New South Wales, The Kirby Institute for Infection and Immunity in Society, Kensington, Australia
  7. 7Alfred Health, Melbourne Sexual Health Centre, Carlton, Australia
  8. 8University of Sydney, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Camperdown, Australia

Abstract

Background In Australia, high and widespread uptake of the quadrivalent human papillomavirus (HPV) vaccine has led to substantial population-level reductions in the prevalence of HPV16/18 in women aged ≤35 years. We assessed risk factors for oncogenic HPV detection among 18–35 year old women in 2015–2018.

Methods Women attending health services across Australia provided a self-collected (vaginal) or clinician-collected (cervical) specimen for HPV genotyping (Roche Linear Array) and completed a questionnaire. HPV vaccination status was validated against the National HPV Vaccination Program Register. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated for factors associated with detection of any oncogenic HPV (HPV16/18/31/33/35/39/45/51/52/56/58/59/66/68).

Results Among 1,643 women, vaccine coverage (≥one dose) was 61.5% (69.1%, 58.7% and 41.1% among those 18–24, 25–29 and 30+ years, respectively). Oncogenic HPV prevalence was 25.4% (95% CI: 23.2–27.6%). In univariable analysis, risk factors for detection included younger age (p-trend<0.001), being a current smoker (p=0.05), and reporting more lifetime (p-trend<0.001) and recent (last 12 months) sexual partners (p-trend<0.001). In multivariable analysis, younger age (adjusted OR=1.33 [1.17–1.52]), more lifetime (adjusted OR=1.33 [1.16–1.52]) and recent sexual partners (adjusted OR=2.37 [1.77–3.16]) remained significant. There were no associations with socioeconomic status, area of residence or vaccination history. HPV16/18 prevalence was 1.4% (0.9–2.1%). In univariable analysis, risk factors for detection included older age (p=0.05), being non-Australian born (p=0.05), and being unvaccinated (p<0.001). In multivariable analysis, being unvaccinated remained the only factor significantly associated with HPV16/18 detection (adjusted OR=8.61 [2.45–30.25]). There were no associations with area of residence, socioeconomic status, or sexual behaviour.

Conclusion Oncogenic HPV was commonly detected among young Australian women; prevalence was influenced by risk factors related to sexual behaviour. In contrast, prevalence of quadrivalent vaccine-targeted types 16/18 was very low and influenced only by vaccination status. Vaccination has changed the epidemiology of HPV infection in Australia.

Disclosure No significant relationships.

  • HPV
  • risk factors
  • prevention
  • intervention and treatment

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.