Whittemore Dana, Ding Lili, Widdice Lea E, Brown Darron A, Bernstein David I, Franco Eduardo L, Kahn Jessica A
1 University of Cincinnati College of Medicine , Cincinnati, Ohio.
2 Department of Pediatrics, Cincinnati Children's Hospital Medical Center , Cincinnati, Ohio.
J Womens Health (Larchmt). 2016 Nov;25(11):1153-1158. doi: 10.1089/jwh.2015.5674. Epub 2016 Oct 18.
Previous studies have demonstrated racial and ethnic differences in the distribution of human papillomavirus (HPV) types among adult women with cervical precancers. The aim of this study was to determine whether the distribution of vaccine-targeted HPV types varies by race/ethnicity among unvaccinated young women.
A secondary analysis was performed using data from four studies of sexually experienced, unvaccinated, 13-26-year-old women. Participants completed surveys and provided a cervicovaginal swab for HPV DNA testing. Multivariable logistic regression analyses were performed to examine whether race, ethnicity, and other factors were associated with type-specific HPV infection among the overall sample and among HPV-infected participants. Models controlled for age, HPV knowledge, sexual behaviors, substance use, and random study effect.
The mean age of participants (N = 841) was 19.3 years; 64.4% were black and 8.9% Hispanic. Black women were more likely than white women to be positive for ≥1 HPV type (odds ratio [OR] 1.83, 95% CI 1.30-2.58) and Hispanic women were less likely than non-Hispanic women to be positive for ≥1 HPV type (OR 0.47, 95% CI 0.24-0.92). However, among all young women and HPV-infected women, neither race nor ethnicity was associated with positivity for HPV types targeted by the following vaccines: 2-valent (HPV16 and/or 18), 4-valent (HPV6, 11, 16, and/or 18), or 9-valent (HPV6, 11, 16, 18, 31, 33, 45, 52, and/or 58).
The prevalence of HPV types targeted by the 2-valent, 4-valent, and 9-valent vaccines did not differ by race or ethnicity among all and among HPV-infected women in this sample.
先前的研究已证明,患有宫颈癌前病变的成年女性中,人乳头瘤病毒(HPV)各型别的分布存在种族和民族差异。本研究的目的是确定在未接种疫苗的年轻女性中,疫苗所针对的HPV型别的分布是否因种族/民族而异。
利用四项针对有性经历、未接种疫苗、年龄在13至26岁女性的研究数据进行二次分析。参与者完成问卷调查,并提供宫颈阴道拭子用于HPV DNA检测。进行多变量逻辑回归分析,以检验种族、民族和其他因素与总体样本以及HPV感染参与者中特定型别HPV感染之间的关联。模型对年龄、HPV知识、性行为、物质使用情况和随机研究效应进行了控制。
参与者(N = 841)的平均年龄为19.3岁;64.4%为黑人,8.9%为西班牙裔。黑人女性比白人女性更有可能至少有一种HPV型别呈阳性(优势比[OR]为1.83,95%置信区间为1.30 - 2.58),而西班牙裔女性比非西班牙裔女性至少有一种HPV型别呈阳性的可能性更小(OR为0.47,95%置信区间为0.24 - 0.92)。然而,在所有年轻女性和HPV感染女性中,种族和民族均与以下疫苗所针对的HPV型别呈阳性无关:二价(HPV16和/或18)、四价(HPV6、11、16和/或18)或九价(HPV6、11、16、18、31、33、45、52和/或58)。
在本样本的所有女性以及HPV感染女性中,二价、四价和九价疫苗所针对的HPV型别的流行率在种族或民族方面并无差异。