Spectrum of Genital Human Papillomavirus Infection in a Female Adolescent Population

• Published in: Sexually transmitted diseases 1995-07, Vol.22 (4), p.236-243
• Main Authors: JAMISON, JACQUELINE H., KAPLAN, DAVID W., HAMMAN, RICHARD, EAGAR, RONALD, BEACH, ROBERTA, DOUGLAS, JOHN M.
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; Cervix Uteri - pathology; Chi-Square Distribution; Chlamydia Infections - epidemiology; Colorado - epidemiology; Condylomata Acuminata - epidemiology; Condylomata Acuminata - virology; DNA, Viral; Ethnic Groups; Female; Gonorrhea - epidemiology; Health risk assessment; Human viral diseases; Humans; Infectious diseases; Logistic Models; Medical sciences; Original Articles; Papanicolaou Test; Papillomaviridae - isolation & purification; Papillomavirus Infections - epidemiology; Papillomavirus Infections - virology; Population; Prevalence; Risk Factors; Sexual Behavior; Sexually transmitted diseases; Social research; STD; Teenagers; Trichomonas Infections - epidemiology; Tumor Virus Infections - epidemiology; Tumor Virus Infections - virology; Uterine Cervical Diseases - epidemiology; Uterine Cervical Diseases - virology; Vaginal Smears; Viral diseases; Viral diseases of the genital and urinary system; Women
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/00007435-199507000-00007

Background: Human papillomavirus infection is a sexually transmitted disease associated with cervical dysplasia and carcinoma. Goal of this Study: To determine prevalence rates of cervical human papillomavirus infection compared with other sexually transmitted diseases and risk factors associated with human papillomavirus infection among adolescent women, we evaluated 634 patients attending three urban adolescent clinics. Study Design: Patient evaluation included Pap smears; screening for chlamydia, gonorrhea, and trichomoniasis; and testing of cervical swab samples for human papillomavirus, DNA. Results: Cervical human papillomavirus was the most common STD in our population (15.6%), followed by infection with Chlamydia trachomatis (11.0%), Neisseria gonorrhoeae (7.1%), and Trichomonas vaginalis (5.4%). The most prevalent human papillomavirus types were 16/18 (7.3%), followed by 31/33/35 (4.7%) and 6/11 (3.5%). When genital waits on exam, low-grade squamous intraepithelial lesions on cytology, or cervical human papillomavirus DNA were considered as indicators of genital human papillomavirus infection, 24% of patients had any manifestation of infection, including 15% with clinically apparent infection (genital warts), 36% with cytologically apparent infection without warts, and 49% with subclinical infection only (cervical human papillomavirus DNA without low-grade squamous intraepithelial lesions or warts). Factors associated with detection of cervical human pappillomavirus DNA by multivariate analysis included number of lifetime sexual partners and genital warts on exam. Conclusion: Cervical human papillomavirus infection was the most prevalent sexually transmitted disease among an ethnically diverse group of urban adolescent females, with a large proportion of infections neither clinically nor cytologically apparent. The strong association with lifetime sexual partners substantiates that cervical human papillomavirus is acquired predominantly by sexual contact and often soon after the onset of sexual activity.