Cervicovaginal human papillomavirus infection in suburban adolescents and young adults

To investigate the prevalence rates of and risk factors for genital human papillomavirus (HPV) infection in white, middle-class adolescents, we obtained specimens for HPV from 107 patients undergoing pelvic examination at a suburban adolescent health service. Specimens were obtained by means of cervicovaginal lavage and were analyzed for HPV DNA by Southern blot analysis. The subjects' mean age was 18.5 (+/- 2.0 SD) years; 47% of the subjects were seen for contraception, 36% for possible pregnancy, 12% for a gynecologic complaint, and 5% for a general examination. We detected HPV in 32% of patients; HPV types included 6/11 (6%), 16 (3%), 18 (15%), 31 (3%), 42 (6%), 45 (18%), and 56 (6%). The DNA type was classified as uncharacterized in 47%, and 3% had more than one type. Univariate analysis revealed that patients found to have HPV were more likely to have more than two sexual partners, to have been sexually active for more than 2 years, to have had menarche before 12 years of age, and to have a history of sexually transmitted disease; logistic regression multivariate analysis demonstrated that number of partners and age at menarche were independent risk factors for HPV. These data indicate that HPV is common among sexually active teenagers regardless of ethnicity or socioeconomic status. The association of cervicovaginal HPV infection with sexual activity further supports the notion of the sexual transmission of this agent.