Association between smoking and anal human papillomavirus infection and among women in Puerto Rico

Background and Objectives: Human papillomavirus (HPV) is the most commonly diagnosed sexually transmitted disease worldwide. Tobacco usage is known to act as an immunosuppressant, increasing susceptibility to various diseases.  In Puerto Rico, studies assessing the burden of HPV are scarce. Recent studies have shown a possible relation between smoking and anal HPV infection; however, these results remain inconclusive. The aim of this study is to evaluate the relationship between anal HPV and smoking among women 16-64 years living in the San Juan Metropolitan area of Puerto Rico. Methods: Secondary analysis of cross-sectional data (n=536) from the study titled HPV Infection in a Population-Based Sample of Puerto Rican Women. Logistic regression was used to estimate the magnitude of the association between smoking and anal HPV. Results: Mean age of participants was 42.2 years (±SD=13.23), 39.9% had anal HPV infection and 7.6% smoked ≥10 cigarettes per day. Women who smoked ≥10 cigarettes per day had 2.64 (POR_A: 2.64, CI 95%: 1.31-5.33) times the possibility of being infected with anal HPV in comparison to their counterparts, after adjusting for potential confounders. Non-significant interaction terms were found in the logistic regression model (likelihood ratio test p>0.05). Conclusions: This study suggests a strong association between heavy smoking and anal HPV infection that warrants public health attention and further research in this area. Results reinforce the need for continued promotion of HPV vaccination in the population, including female smokers. Acknowledgements: Study was approved by the UPR-MSC IRB (#A1810213) and partially funded by NIAID Grant #1SC2AI090922-01.