PREVALENCE OF HUMAN PAPILLOMAVIRUS AMONG STD CLINIC ATTENDERS IN JAMAICA - ASSOCIATION OF YOUNGER AGE AND INCREASED SEXUAL-ACTIVITY

Background and Objectives: Human papillomavirus is the major etiologic agent of cervical cancer. Although the incidence of cancer of the cer vix is high in Jamaica, the prevalence of human papillomavirus among J amaican women has not been defined. Goal of the Study: To estimate the prevalence of human papillomavirus infection and associated risk fact ors in women attending an STD clinic in Kingston, Jamaica. Study Desig n: A cross-sectional survey was done of 202 women attending an STD cli nic in Kingston in 1990. Cervical and vaginal cells were collected by lavage, and human papillomavirus genomes were detected in extracted DN A using low-stringency Southern blot hybridization. Results: Fifty-eig ht (28.7%) women were identified as HPV positive. Prevalence of HPV by age group was 39% in women 15-19 years old, 33% of women 20-24 years old, 31% in women 25-29 years old, and 17% in those 30 years or older. Increasing age was significantly associated with a lower prevalence o f human papillomavirus infection (test for trend, P = 0.025). The effe ct of age was independent of years of sexual activity. Women reporting more than one sexual partner per month on average were found to have a significantly higher HPV prevalence (odds ratio 2.87, 95% confidence Interval 1.29-6.38), as were women who reported more frequent sex (te st for trend, P = 0.006). Conclusions: Sexual behavior is associated w ith risk of human papillomavirus infection. The decrease of human papi llomavirus prevalence in older women agrees with other studies that ar gue in favor of a biological effect, such as increased immunity to hum an papillomavirus with age. A better understanding of why immunity to human papillomavirus may develop in older women may provide the basis for developing an effective vaccine to prevent cancer of the cervix.