Differences between African-American adolescent females with and without human papillomavirus infection

Background: An important policy question is whether high-risk populations can be identified and prioritised for human papillomavirus (HPV) immunisation. Methods: Data collection included an audio computer-assisted survey interview and testing of Trichomonas vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, and HPV among 295 African-American adolescent females. Results: The results indicated that 43.1% tested positive for HPV. Logistic regression analyses indicated that HPV prevalence was not associated with other sexually transmissible infections (prevalence ratio (PR) = 0.85, 95% confidence interval (CI) = 0.51-1.41), unprotected vaginal sex (PR = 1.04, 95% CI = 0.56-1.92), having sex with an older male partner (PR = 1.12, 95% CI = 0.64-1.96), and having a casual partner (PR = 0.89, 95% CI = 0.54-1.48). Additionally, t-tests indicated that HPV prevalence was not associated with frequency of vaginal sex (t = 0.17, P = 0.87), protected sex (t = -0.16, P = 0.87), number of recent (t = 0.40, P = 0.69) or lifetime (t = 1.45, P = 0.15) sexual partners. However, those testing positive for HPV were younger (t = 1.97, P = 0.05) and reported current use of birth control pills (PR = 2.38, 95% CI = 1.00-5.63). Conclusions: It may not be possible to identify those with elevated risk of HPV acquisition. Thus, HPV vaccination, regardless of risk indicators, may be the most efficacious public health strategy.