227384 Psychological factors and persistence of HPV infection among men participating in a natural history study

Monday, November 8, 2010

Stephanie K. Kolar, MSPH , Community and Family Health, University of South Florida College of Public Health, Tampa, FL
Ellen Daley, PhD, MPH , Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Stephanie Marhefka, PhD , College of Public Health, University of South Florida, Tampa, FL
Eric R. Buhi, MPH, PhD, CHES , Community and Family Health, University of South Florida College of Public Health, Tampa, FL
Judith Ebbert-Syfrett, MPH, RN , Community and Family Health, University of South Florida, College of Public Health, Tampa, FL
Background: Psychoneuroimmunology focuses on the link between psychological and physiological processes and suggests psychological variables could affect immune function. Persistent HPV infections are a cause of cervical cancer and are associated with oral, penile, and vulvar cancers. Few studies have evaluated factors associated with HPV persistence in men. Little is known about psychological factors and their association with HPV persistence.

Methods: Secondary analysis of males participating in a natural history study of HPV who also completed a psychosocial questionnaire including questions on defensive avoidance and negative emotions related to receiving a previous HPV test result. HPV+ participants were followed to their next study visit, approximately 6 months.

Results: Of 86 HPV+ participants, 61 remained HPV+. Avoidance was not associated with clearance of HPV infection, RR=0.98, 95%CI:0.73-1.31. Compared to participants who reported experiencing negative emotions, those who did not were significantly more likely to clear their infection, crude RR=3.16, 95%CI:1.41-7.09. There were no differences in clearance by marital status, race, ethnicity, or education. Participants who cleared their infections were younger, but not significantly. Adjusting for previous HPV test result, negative emotions remained significantly associated with clearance, adjusted RR=1.93, 95%CI:1.25-2.98.

Conclusions: Although this analysis is limited, it suggests psychological factors may be associated with HPV persistence. Further research is needed to determine the effect of other psychosocial and behavioral factors such as stress, sleep, coping, and social support which may impact HPV persistence (and thus, transmission to others). Determining factors associated with HPV clearance could lead to interventions among patients persistently HPV+.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. To identify gaps in our understanding of factors which affect the course of HPV infections. 2. To describe possible association between psychological factors and HPV persistence. 3. To discuss the need for further psychosocial research in relation to HPV infections and persistence.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work on a NIH funded study of psychosocial responses to an HPV infection in men.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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