Sexual orientation is irrelevant in HPV screening: Infection rates in heterosexual vs. lesbian/bisexual women (135)

Abstract

Objectives: To evaluate the difference in HPV positive prevalence in heterosexual women compared to lesbian and bisexual women in the United States between 2011 and 2016. Methods: Data on female respondents were obtained from the National Health and Nutrition Examination Survey from 2011 to 2016. Sexual orientation was self-reported by respondents. HPV infection was detected through vaginal swab samples and analyzed using the Roche Linear Array HPV genotyping test. Results: Of 3,656 respondents, 3,461 (94.5%) self-identified as straight/heterosexual and 195 (5.5%) as lesbian or bisexual. A total of 35.7% (n=1,379) of heterosexual women tested positive for any genital HPV compared to 41.6% (n=91) of lesbian or bisexual women (p=0.2). For heterosexual respondents, factors associated with positive HPV status included young age versus old age (40.0% vs 31.6%, p=0.002), more than four lifetime partners (47.1% vs 25.2%, p<0.0001), lower education (41.9% vs 33.2%, p<0.0001), below poverty line and low income versus middle and high income (44.3% and 43.5% vs 33.8% and 28.3%, p<0.0001), and divorced/separated and single versus married/living with partner (57.3% and 48.6% vs 27.8%, p<0.0001). For lesbian or bisexual respondents, the only factor associated with positive HPV was four or more lifetime partners (49.4% vs 29.9%, p=0.02). On multivariate analysis, we found that younger age (OR: 1.52, 95% CI: 1.2-1.93), divorced/separated (OR: 1.71, 95% CI: 1.21-2.43), and more than four lifetime sexual partners (OR: 2.5, 95% CI: 2.04-3.17) were independent predictors for testing positive for genital HPV. There was no difference by self-identified sexual orientation. On intersection analysis, we found that younger women who were divorced/separated and had more than four lifetime sexual partners were at the highest risk, with a prevalence of 72.3% testing positive for any genital HPV and 35.2% for any high-risk HPV. Conclusions: There was no difference in the prevalence of HPV infection based on sexual orientation. Age, marital status, and the number of lifetime sexual partners were independent factors associated with HPV infection. Objectives: To evaluate the difference in HPV positive prevalence in heterosexual women compared to lesbian and bisexual women in the United States between 2011 and 2016. Methods: Data on female respondents were obtained from the National Health and Nutrition Examination Survey from 2011 to 2016. Sexual orientation was self-reported by respondents. HPV infection was detected through vaginal swab samples and analyzed using the Roche Linear Array HPV genotyping test. Results: Of 3,656 respondents, 3,461 (94.5%) self-identified as straight/heterosexual and 195 (5.5%) as lesbian or bisexual. A total of 35.7% (n=1,379) of heterosexual women tested positive for any genital HPV compared to 41.6% (n=91) of lesbian or bisexual women (p=0.2). For heterosexual respondents, factors associated with positive HPV status included young age versus old age (40.0% vs 31.6%, p=0.002), more than four lifetime partners (47.1% vs 25.2%, p<0.0001), lower education (41.9% vs 33.2%, p<0.0001), below poverty line and low income versus middle and high income (44.3% and 43.5% vs 33.8% and 28.3%, p<0.0001), and divorced/separated and single versus married/living with partner (57.3% and 48.6% vs 27.8%, p<0.0001). For lesbian or bisexual respondents, the only factor associated with positive HPV was four or more lifetime partners (49.4% vs 29.9%, p=0.02). On multivariate analysis, we found that younger age (OR: 1.52, 95% CI: 1.2-1.93), divorced/separated (OR: 1.71, 95% CI: 1.21-2.43), and more than four lifetime sexual partners (OR: 2.5, 95% CI: 2.04-3.17) were independent predictors for testing positive for genital HPV. There was no difference by self-identified sexual orientation. On intersection analysis, we found that younger women who were divorced/separated and had more than four lifetime sexual partners were at the highest risk, with a prevalence of 72.3% testing positive for any genital HPV and 35.2% for any high-risk HPV. Conclusions: There was no difference in the prevalence of HPV infection based on sexual orientation. Age, marital status, and the number of lifetime sexual partners were independent factors associated with HPV infection.