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Racial Disparities in Contraceptive Use and the Likelihood of Testing Positive for High-Risk Human papillomavirus (HR-HPV) Infections

Undergraduate #376
Discipline: Social, Behavioral, and Economic Sciences
Subcategory: Cancer Research
Session: 2
Room: Exhibit Hall A

Martina Hakim - Tuskegee University
Co-Author(s): Suguna Badiga, University of Alabama at Birmingham, AL; Chandrika Piyathilake, University of Alabama at Birmingham, AL



Background: Infection with High-risk human papillomaviruses (HR-HPVs) is the causative factor for pre-cancerous lesions of the cervix and invasive cervical cancer. In the United States (US), 79 million Americans are already infected with HPV and every year there is an estimated 14 million new cases of HPVs. Many risky sexual behaviors including, age at first intercourse, use of douche and contraceptives, parity and history of other STDs have been studied in relation with HR-HPV infections but the results have been inconsistent. Further, to our knowledge, no comprehensive studies have been conducted to evaluate racial differences in the relationship between risky sexual behaviors and risk of being infected with HR-HPVs in the US. Purpose: The purpose of this study was to determine the racial differences in the relationship between risky sexual behaviors and risk of being infected with HR-HPVs. Methods: The study included 852 women (African American (AA)=434, Caucasian American (CA)=414) of childbearing age who were tested for HPV infections (HR-HPV positive=667, negative=181) using Roche linear array assay and were diagnosed with high grade cervical intraepithelial neoplasia (CIN 2+) or ?CIN1. A validated risk factor questionnaire was used to obtain demographic, lifestyle and sexual behavior related information. Information regarding fruit and vegetable intake was obtained using Block fruit, vegetable and fiber screener. Unconditional Logistic regression models stratified by race were used to test the associations. Results: We observed racial differences in the determinants of HR-HPV infections. AA women who were <24 years and users of hormonal contraceptives were more likely to test positive for HR-HPV infections (OR=1.70 P=0.0410 and OR=1.80 P=0.0441 respectively). Among CA, none of the risk factors were significantly associated with the likelihood of testing positive for HR-HPVs. Conclusion: Younger AA women were more likely to be HR-HPVs positive. The plausible reasons for this observation could be as follows: lower socio-economic status related factors such as lower exposure to sex education, lack of HPV knowledge, lower immune response due to poor nutritional status and lower likelihood of clearance of HR-HPV. It is likely that AA women who used contraceptives may be practicing risky sexual behavior that increases their risk for HR-HPV infections. Acknowledgements: Morehouse School of Medicine/Tuskegee University/University of Alabama Birmingham Comprehensive Cancer Center Partnership [NCI]: Tuskegee University ? U54 CA118623

Funder Acknowledgement(s): Morehouse School of Medicine/Tuskegee University/University of Alabama Birmingham Comprehensive Cancer Center Partnership [NCI]: Tuskegee University ? U54 CA118623

Faculty Advisor: Richard Whittington, rwhittington1@tuskegee.edu

Role: The study included 852 women who were tested for HPV infections (HR-HPV positive, n=667, negative, n=181). Information on demographic, lifestyle factors, sexual behavior factors were obtained from interviewer administered validated risk factor questionnaire. Information regarding fruit and vegetable intake was obtained using Block fruit, vegetable and fiber screener.

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This material is based upon work supported by the National Science Foundation (NSF) under Grant No. DUE-1930047. Any opinions, findings, interpretations, conclusions or recommendations expressed in this material are those of its authors and do not represent the views of the AAAS Board of Directors, the Council of AAAS, AAAS’ membership or the National Science Foundation.

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