Progestin-Only Contraceptive Use Is Independent Predictor of HPV Prevalence in Women Aged Over 35 Years

Abstract

s / Annals of Epidemiology 22 (2012) 661e680 672 P50-S. Progestin-Only Contraceptive Use Is Independent Predictor of HPV Prevalence in Women Aged Over 35 Years T.R. Soong, M. Silver, K. Chang, W. Shen, R. Howard, A. Burke, P.E. Gravitt. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Purpose:We assessed the associations of progestin-only contraceptive (POC) use and combined oral contraceptive (COC) use with cervical HPV prevalence in preand perimenopausal women aged over 35 years. Methods: Data came from a prospective study conducted in 530 women aged between 35 and 59 years with normal cervical cytology in the U.S. Prevalence ratios (PRs) with 95% confidence intervals (CIs) were estimated using generalized linear models with poisson function and robust variance. Results: Baseline prevalence of any HPV and high-risk (HR)-HPV were 16.4% and 6.4% respectively. Relative to never POC users, more than 5 years of cumulative POC use was associated with increased HPV prevalence after controlling for current and past sexual behaviors, days since last menstrual period, marital status and recent diagnoses of other sexually transmitted infections [adjusted prevalence ratio (aPR): 2.78 (95% CI: 1.55-4.97)]. No significant association was observed between last time of use of POCs and HPV prevalence. HPV detection was not associated with the recency or duration of COC use in our study population. Conclusions: Our findings suggest that long-term use of POCs is associated with increased risk of prevalent HPV infection independent of sexual behavior in older women. POC use may have impact on the natural history of HPV infection before development of clinical cervical disease. P51-S. History of HIV Testing Among Men Who Have Sex With Men in a Chinese Metropolitan City L. Zhang, Y. Xiao, H. Qian, Y. Ruan, S.H. Vermund. Vanderbilt Institute for Global Health, Vanderbilt University School of Medicine, Nashville, TN Purpose: HIV testing is the getaway of prevention and care. However, the HIV testing rate is still low in men who have sex with men (MSM) in urban Chinese cities. We explored HIV testing behaviors and the associated factors among Chinese MSM. Methods: Atotalof492MSMwererecruitedusingrespondentdrivensampling approach in Chongqing City in 2010. Demographic and behavioral data were collected by a computer-assisted self-interview approach. Blood specimens were tested for HIV and syphilis. Univariate andmultivariate logistic regression analyses were performed to identify factors for past experience of HIV testing. Results: The adjusted HIV prevalence was 11.7% (95% confidence interval [CI]: 8.6%-11.6%) and syphilis prevalence was 4.7% (95% CI: 2.6%-7.3%). Fiftyeight percent of participants had ever taken a HIV test prior to the study, of whom 73% had taken within the last 12 months. MSM who had a college degree [adjusted odds ratio (AOR): 1.7; 95% CI: 1.2-2.6; P < 0.05] or those who preferred an insertive role over a receptive one in anal sex (AOR: 0.6; 95%CI: 0.36-0.93; P < 0.05) were more likely to take HIV tests. Fear of knowing a positive result, being afraid of discrimination if tested positive, and unwillingness of going to a clinic were the top 3 perceived barriers for taking a test; a low perceived risk of HIV infection, not knowing where to take testing and concern about being found out positivewere the top 3 actual reasons for not taking a HIV test. Conclusion: Mental and psychological supports along with education are urgently needed to improve HIV testing among Chinese MSM.