Exposure to high-risk genital human papillomavirus and its association with multiple sexual partners, condom use and biologically-confirmed Chlamydia among African-American women

Background/Significance: Genital HPV, which can cause cervical cancer, is the most common STI in the United States. African-American women have the highest prevalence of high-risk HPV infections. Objective/Purpose: To examine exposure to high-risk HPV in African-American women and its relation to risky sexual practices and biologically-confirmed Chlamydia. Methods: A random sample of 665 African-American women, 18-29 years old, completed an Audio Computer Assisted Survey Interview (ACASI) assessing sociodemographics and STI/HIV-associated sexual behaviors and provided vaginal swab specimens assayed for STIs and high-risk HPV. Results: The overall prevalence of HPV was 38.9%. Among women 18-24 and 25-29, it was 42.4% and 31%, respectively. Logistic regression analyses indicated that women testing positive for HPV, relative to those testing negative, were significantly more likely to have multiple partners over the past 12 months (OR= 1.81), have multiple partners over the past 6 months (OR= 1.94), not use a condom during last casual encounter (OR= 1.54), and test positive for Chlamydia (OR= 1.89). In age stratified analyses, women 18-24 years old testing positive for HPV were significantly more likely to have multiple partners over the past 12 months (OR= 2.22), have multiple partners over the past 6 months (OR= 2.16), not use a condom during last casual encounter (OR= 1.60), and test positive for Chlamydia (OR= 1.90). However, no significant correlates were identified among women 25-29 years old. Discussion/Conclusions: High-risk HPV infection is associated with multiple partners, poor condom use, and biologically-confirmed Chlamydia. HPV vaccination recommendations for African-American women 18–24 warrant special consideration.