The main risk factors for Human papillomavirus (HPV) infection, and the development of associated diseases are related to sexual behavior and health literacy of the population. The study aimed to investigate the impact of risk and protective factors for HPV infection and the development of associated diseases in adult women. A case-control study was conducted from January 2020 to May 2022A. Respondents had sought outpatient and/or inpatient obstetric-gynecological care in the city of Pleven. The significance of results, findings, and conclusions was determined at p< 0.05, and the odds ratio (OR) was calculated. Data analysis identified three out of the 15 factors as significant: lower education (primary and secondary) OR=2.36 95% CI (0.97-5.74), lack of vaccination against HPV OR=2.05, 95% CI (0.86-4.92), and urban residence OR of 1.29 95% CI (1.11-1.52). Two factors with a protective effect on HPV infection were statistically significant: education (secondary and higher) (p=0.05) and rural residence (p=0.001). Improving health literacy among the population and enhancing preventive measures related to HPV and its associated diseases would reduce the impact of risk factors.
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