Teen Sexual Behavior Does Not Predict HPV Risk


A teen’s sexual activity doesn’t predict her future risk for HPV, and
shouldn’t determine whether she receives the HPV vaccine, according to
University of Michigan researchers.

The U of M study conducted by C.S. Mott Children’s Hospital’s Child
Health Evaluation and Research Unit found that the sexual activity of
adolescents did not predict future contraction of HPV as adults. HPV,
genital human papillomavirus, is the most common sexually transmitted
infection, according to the Centers for Disease Control and Prevention.

The findings support the CDC’s recommendation for universal vaccination
for all women ages 11 to 26, regardless of sexual experience, said Dr.
Amanda Dempsey, the study’s lead researcher.

"We couldn’t find any discernible adolescent behavior, including sexual
activity, that was associated with an increased risk of HPV infection
as a sexually active young adult," Dempsey said. "HPV is so prevalent
that everyone who becomes sexually active is at risk."

Dempsey says she and her colleagues undertook
the study because of a continued "reluctance among parents to be okay
with vaccinating their younger female adolescent children. In clinic, I
hear some parents expressing that their adolescent child wouldn’t need
the vaccine because she’s not at risk. We wanted to examine more
closely a girl’s risk for HPV during adolescence based on her
behaviors."

They also wanted to address conflicting recommendations about who
should get the vaccine, Dempsey said. While the CDC recommends it for
all women age 11 to 26, the American Cancer Society recommends that
women 18 and older talk with their doctors about whether they’re at
risk for the virus based on their sexual history.

The problem with that approach, the study results indicate, is that
"you really can’t pick out one or two behaviors that predict if you’ve
been exposed to HPV," Dempsey said. "HPV is just so common and so
easily transmitted from person to person that it doesn’t take more than
one partner to get exposed. It doesn’t matter what you did as an
adolescent. Most people are going to become sexually active and at that
point are going to be at risk."

The prospective study — one that relies on information gathered at the
time of a person’s life being studied rather than asking participants
to remember information retrospectively — examined data on 3,181
adolescents who participated in a long-term study. Researchers were
able to use data collected on participants from early adolescence on to
link their HPV status with the behaviors the girls reported several
years earlier.

The U of M researchers found no correlation between an adult woman’s
HPV infection and her number of sexual partners, her history of having
an older male sexual partners and/or a new sex partner with the past
year, her illegal drug use, her history of sex while alcohol-impaired
or her regular use of cigarettes or alcohol.

HPV infection generally occurs shortly after a woman becomes sexually
active. Most women never know they have the virus because it usually
goes away on its own and may not cause any symptoms.

The HPV vaccine guards against four types of HPV: two that cause 70 out
of 100 cases of cervical cancer and two that cause 90 out of 100 cases
of genital warts. There are more than 100 types of HPV, but only some
types lead to cervical cancer or genital warts.

Because the vaccine protects against only four strains, even women who
have tested positive for HPV should still get vaccinated, Dempsey
said.

The study appears in the July issue of Pediatrics.

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