Amongst sexually skilled adults, prevalence of human papillomavirus (HPV) an infection was primarily reflective of upper variety of lifetime sexual companions, particularly >5 lifetime sexual companions, in line with research outcomes revealed in Medical Infectious Ailments.
Utilizing information from the 2013-2016 Nationwide Well being and Vitamin Examination Survey (NHANES), researchers examined the connection between present and previous sexual behaviors on prevalent burden of HPV an infection stratified by intercourse, age group, and variety of lifetime sexual companions. The evaluation included 5093 individuals aged 18-59 years who had an evaluable HPV check, reported not less than 1 lifetime sexual companion, and had not acquired an HPV vaccination.
The first outcomes included the crude prevalence of genital vaccine-type HPV, outlined because the detection of ≥1 genotype within the Gardasil-9 vaccine (6, 11, 16, 18, 31, 33, 45, 52, or 58), genital high-risk HPV an infection outlined because the detection of ≥1 high-risk HPV genotype (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, or 68), and any genital HPV an infection outlined because the detection ≥1 of the 37 doable genotypes. For the reason that HPV vaccine is presumed to forestall solely newly acquired infections, the crude prevalence of every consequence was additionally calculated after excluding individuals at highest threat for newly acquired an infection, outlined as those that reported a brand new sexual companion throughout the previous 12 months.
Amongst each males (n=2495) and ladies (n=2598), the distribution of race/ethnicity, marital standing, and cigarette smoking standing assorted considerably by age group. Amongst males, the median variety of lifetime sexual companions elevated with age: 5 for individuals aged 18 to 26 years, 8 for individuals aged 27 to 45 years, and 10 for individuals aged 45 to 59 years (interquartile vary [IQR] 3-12, 3-19, and 5-20, respectively). Amongst girls, the median variety of lifetime sexual companions was 5 throughout all age teams. Conversely, the proportion reporting a brand new sexual companion prior to now 12 months considerably decreased with older age in each women and men: 40.7% and 28.4% amongst individuals aged 18 to 26 years, 16.6% and 10.5% amongst individuals aged 27 to 45 years, and 9.3% and three.5% amongst individuals aged 45 to 59 years, respectively.
In every age group, genital HPV prevalence was increased amongst individuals with >5 lifetime sexual companions in contrast with 1 to five lifetime sexual companions in each women and men. There have been solely slight reductions in HPV prevalence after eradicating individuals who reported a brand new sexual companion prior to now 12 months. Amongst males with >5 lifetime sexual companions, the adjusted prevalence of 9-valent vaccine sort HPV an infection was 20% within the full group (95% CI, 16.6-23.3) in contrast with 18.8% (95% CI, 15.0-22.6) amongst these with no new sexual companions. Amongst girls with >5 lifetime sexual companions, the adjusted prevalence of 9-valent vaccine-type HPV an infection was 13.4% within the full group (95% CI, 9.9-17.0) in contrast with 12.1% (95% CI, 8.8-15.4) amongst these with no new sexual companions.
Regardless of having a big nationally consultant pattern, there have been some notable limitations. Not all people supplied genital samples or questionnaire information. Whereas NHANES is the biggest population-based survey of HPV prevalence, the pattern measurement was nonetheless inadequate to permit for extra granular stratification of lifetime sexual companions and age. Plus, since DNA extraction methodology utilized in NHANES leads to an elevated check sensitivity, this “could clarify why HPV prevalence is comparatively excessive in older adults, akin to post-menopausal girls, who could also be extra more likely to have low viral load infections,” famous the researchers.
“Thus, when discussing the dangers/advantages to vaccination of grownup women and men for medical resolution making, it is going to be necessary to include the probably ongoing threat of HPV an infection on account of recurrence of beforehand acquired and managed infections in addition to dangers of recent acquisitions,” concluded the researchers.
Rositch AF, Patel EU, Petersen MR, Quinn TC, Gravitt PE, Tobian AAR. Significance of lifetime sexual historical past on the prevalence of genital human papillomavirus amongst unvaccinated adults in NHANES: implications for grownup HPV vaccination [published online July 25, 2020]. Clin Infect Dis. doi:10.1093/cid/ciaa1050