Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Race is Associated With Sexual Behaviors and Modifies the Effect of Age on Human Papillomavirus Serostatus Among Perimenopausal Women

TitleRace is Associated With Sexual Behaviors and Modifies the Effect of Age on Human Papillomavirus Serostatus Among Perimenopausal Women
Publication TypeJournal Article
Year of Publication2016
AuthorsRettig, EM, Fakhry, C, Rositch, AF, Burke, AE, Chang, K, Silver, MI, Viscidi, R, Gravitt, P
JournalSex Transm Dis
Date PublishedApr
ISBN Number0148-5717
Accession Number26967299
Keywords*Sexual Behavior, Adult, African Americans/statistics & numerical data, Age Factors, Cohort Studies, Cross-Sectional Studies, European Continental Ancestry Group/statistics & numerical data, Female, Humans, Maryland/epidemiology, Middle Aged, Oropharyngeal Neoplasms/*epidemiology/ethnology, Papillomaviridae/*immunology, Papillomavirus Infections/*epidemiology/ethnology, Perimenopause, Seroepidemiologic Studies, Surveys and Questionnaires, Uterine Cervical Neoplasms/*epidemiology/ethnology

BACKGROUND: Human papillomavirus (HPV) causes oropharyngeal and cervical cancers. Oropharyngeal cancer primarily affects whites, but cervical cancer is more common among blacks. Reasons for this distinct epidemiology are unclear. METHODS: Serum was collected from women aged 35 to 60 years in the HPV in Perimenopause cohort and evaluated for antibodies to 8 HPV types. Demographic and behavioral data were collected by telephone questionnaire. Associations between sexual behaviors, race, age, HPV serostatus, and strength of serologic response to HPV were evaluated. RESULTS: There were 781 women in this analysis, including 620 white (79%) and 161 (21%) black women. Whites were less likely to report 5+ vaginal sex partners (prevalence ratio [PR], 0.86; 95% confidence interval [CI], 0.77-0.97), but more likely to report 5+ oral sex partners (PR, 2.38; 95% CI, 1.62-3.49) compared with blacks. Seropositivity to most individual HPV types and at least 3 types was significantly lower in whites than in blacks (PR, 0.62; 95% CI, 0.47-0.80). Human papillomavirus seropositivity was independently associated with younger age among blacks, but with sexual exposures among whites. Furthermore, strength of serologic response to most HPV types significantly decreased with older age among blacks, but not among whites. CONCLUSIONS: Racial differences in immune markers of HPV exposure and the epidemiology of HPV-related cancers may be linked to differences in patterns of sexual behaviors.