Association between exposure to sexual abuse and acquisition of high-risk HPV among a random sample of young African-American women

Background/Significance: Noticeably absent from the risk factors for high-risk HPV infection is women's history of sexual abuse. Objective/Purpose: To examine the association between sexual abuse and incident high-risk HPV among African-American women, 18 – 29, a subgroup with the highest rate of high-risk HPV. Methods: A random sample of 665 African-American women completed a computerized survey assessing HPV risk factors, including, history of nonviral STIs, oral contraceptive use, smoking, multiple sexual partners, having a risky male sexual partner and history of sexual abuse. Participants provided specimens that were assayed for high-risk HPV at baseline and 12-month follow-up. Participants testing negative for high-risk HPV at baseline and positive for high-risk HPV at 12-month follow-up were defined as having an incident infection of high-risk HPV. Multivariate logistic regression analyses, stratified by age, examined sexual abuse that occurred over the 12 month follow-up and acquisition of high-risk HPV; known risk factors were entered as covariates. Results: The prevalence of high-risk HPV was 38.9%. Women, 18-24, with a recent sexual abuse history, relative to participants without a sexual abuse history, were 4.5 times more likely to test positive for an incident high-risk HPV infection (p= .007), controlling for risk factors. This relationship was not significant for the overall sample (p= .06) and for women 25-29 (p= .99). Discussion/Conclusions: This is one of the first analyses demonstrating exposure to sexual abuse as a predictor of high-risk HPV, even after adjusting for risk factors. Providers should routinely test young women with a sexual abuse history for HPV.