Risk factors for type-specific concurrent anogenital HPV detection, comparing young women with concurrent infection with women with genital-only infection, recruited at sexual health clinics in 2009–2019 in the Netherlands
| Factor | n/N* (%) | Unadjusted OR (95% CI) | P value | Adjusted OR (95% CI) | P value |
| Year of participation† | |||||
| 2009, 2011 or 2013 | 195/466 (41.9) | 1 | 0.80 | ||
| 2015 | 262/692 (37.9) | 0.9 (0.6 to 1.2) | |||
| 2017 | 309/782 (39.5) | 0.9 (0.7 to 1.2) | |||
| 2019 | 309/791 (39.1) | 0.9 (0.7 to 1.2) | |||
| Age (years) | |||||
| 16–18 | 69/166 (41.6) | 1.2 (0.8 to 1.7) | |||
| 19–21 | 456/1128 (40.4) | 1.1 (0.9 to 1.3) | |||
| 22–24 | 550/1437 (38.3) | 1 | 0.60 | ||
| Education level‡ | |||||
| Low/Middle | 232/569 (40.8) | 1 | 0.45 | ||
| High | 0.9 (0.7 to 1.2) | ||||
| Self-defined country of birth | |||||
| The Netherlands | 932/2376 (39.2) | 1 | 0.90 | ||
| Other | 834/2146 (38.9) | 1.0 (0.7 to 1.3) | |||
| Smoking§ | |||||
| (Almost) never | 443/1133 (39.1) | 1 | 0.76 | ||
| Previously | 49/128 (38.3) | 1.0 (0.6 to 1.6) | |||
| Currently | 357/929 (38.4) | 0.9 (0.7 to 1.2) | |||
| Unknown | 226/541 (41.8) | 1.1 (0.8 to 1.4) | |||
| Received at least one dose of HPV vaccine (self-reported) | |||||
| No | 579/1410 (41.1) | 1 | 0.27 | 1 | 0.20 |
| Yes | 416/1085 (38.3) | 0.9 (0.7 to 1.1) | 0.9 (0.7 to 1.1) | ||
| Unknown | 80/236 (33.9) | 0.8 (0.5 to 1.1) | 0.7 (0.5 to 1.1) | ||
| Age of sexual debut (years) | |||||
| ≤14 | 144/363 (39.7) | 0.9 (0.7 to 1.3) | |||
| 15–16 | 501/1317 (38.0) | 0.9 (0.7 to 1.1) | |||
| ≥17 | 412/1016 (40.6) | 1 | 0.38 | ||
| No. of sex partners past 6 months | |||||
| 0–1 | 240/592 (40.5) | 1 | 0.43 | ||
| 2–3 | 522/1285 (40.6) | 1.0 (0.8 to 1.3) | |||
| ≥4 | 312/850 (36.7) | 0.9 (0.7 to 1.2) | |||
| No. of sex partners lifetime | |||||
| 0–4 | 168/418 (40.2) | 1 | 0.59 | ||
| 5–9 | 396/970 (40.8) | 1.1 (0.8 to 1.4) | |||
| ≥10 | 487/1286 (37.9) | 0.9 (0.7 to 1.3) | |||
| Condom use with steady partner previous 6 months | |||||
| Mostly not using condom | 576/1445 (39.9) | 1.2 (0.8 to 2.0) | |||
| Sometimes using condom | 185/436 (42.4) | 1.4 (0.8 to 2.4) | |||
| Always using condom | 36/109 (33.0) | 1 | 0.61 | ||
| No steady partner | 272/724 (37.6) | 1.2 (0.7 to 2.0) | |||
| Condom use with casual partner previous 6 months | |||||
| Mostly not using condom | 272/673 (40.4) | 1.2 (0.9 to 1.8) | |||
| Sometimes using condom | 537/1374 (39.1) | 1.1 (0.8 to 1.6) | |||
| Always using condom | 88/255 (34.5) | 1 | 0.60 | ||
| No casual partners | 170/405 (42.0) | 1.3 (0.8 to 1.9) | |||
| STI-related symptoms | |||||
| No | 762/1951 (39.1) | 1 | 0.53 | ||
| Yes | 308/766 (40.2) | 1.1 (0.9 to 1.3) | |||
| History of STI | |||||
| No | 497/1259 (39.5) | 1 | 0.91 | ||
| Yes | 426/1086 (39.1) | 1.0 (0.8 to 1.2) | |||
| Never tested before | 144/368 (39.1) | 0.9 (0.7 to 1.3) | |||
| Current chlamydia, genital¶ | |||||
| No | 860/2278 (37.8) | 1 | 0.003 | 1 | 0.003 |
| Yes | 215/452 (47.6) | 1.5 (1.2 to 1.9) | 1.5 (1.1 to 1.9) | ||
| Receptive anal intercourse ever** | |||||
| No | 469/1243 (37.7) | 1 | 0.56 | 1 | 0.60 |
| Yes | 586/1435 (40.8) | 1.1 (0.9 to 1.3) | 1.1 (0.9 to 1.3) |
The analyses are based on 1149 women with detected genital infection, of which 607 had at least one type-specific concurrent anogenital detected infection, contributing 2731 type-specific genital HPV infections. The final multivariable model is based on 2677 type-specific genital detected infections, due to some missing data, comparing 1055 concurrent anogenital infections with 1622 genital-only infections.
*N=concurrent anogenital infections.
†Due to small numbers of inclusion for anal examination in the first three rounds, these rounds are combined for the analysis.
‡High education level is defined for school of higher general secondary education, pre-university education, university for applied sciences and university. Low/Middle is defined for all other levels of education.
§No information was available for those participating in 2009–2013, as the relevant question was not part of the questionnaire in that year.
¶Diagnosis made at the same visit to the sexual health clinic at which the participant was included in this study.
**No information was available for those participating in 2009, as the relevant question was not part of the questionnaire in that year.
HPV, human papillomavirus;