Risk factors for high-risk type human papillomavirus infection among Mexican-American women

Minority women in the United States experience a disproportionately high bu rden of the more than 2 million yearly cases of squamous intraepithelial le sions of the cervix. Risk factors for squamous intraepithelial lesions of t he cervix are infection with the sexually acquired human papillomavirus (HP V), an early age at first intercourse, history of multiple sexual partners, oral contraceptive use, high parity, lower socioeconomic status, poor diet , immunosuppression, and promiscuous male sexual partners. Although Hispani cs are the largest growing minority population in the United States, few HP V risk factor studies have either included or focused on Hispanics in the U nited States. To determine risk factors for HPV infection among Mexican-Ame rican women, we conducted a cross-sectional study from 1992-1995, Nine hund red and seventy-one women, 18-47 years of age, with cytology results were i ncluded in this analysis. Overall, 13.2% of participants were HPV positive by the Hybrid Capture tube method for high-risk types 16, 18, 31, 33, 35, 4 5, 51, 52, or 56, Age [adjusted odds ratio (AOR) = 0.3 for ages >36 years c ompared with ages 18-20] and duration of oral contraceptive use (AOR = 0.4 for greater than or equal to 4 years relative to nonusers) were inversely a ssociated with these high-risk types of HPV infection. Marital status (AOR = 1.9 among single women compared with married) and lifetime number of sexu al partners (AOR = 2.3 for women greater than or equal to 5 partners relati ve to monogamous women) were positively associated with an increased risk. Participants born in Mexico were significantly (P < 0.05) older, had fewer sex partners, and older age at first intercourse. Despite this lower behavi oral risk profile, women born in Mexico were significantly more likely (AOR = 1.9; CI = 1.2-3.2) to have an HPV infection compared with United States- born, Mexican-American women after adjustment for potential confounders. Co llectively, these results suggest that an unmeasured factor, such as the se xual behavior of the male partner, may be influencing HPV risk. Further res earch is needed to define this factor and to assess cultural norms of sexua l behavior.