Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women
Rachel L. Winer, Ph.D., James P. Hughes, Ph.D., Qinghua Feng, Ph.D., Sandra O'Reilly, B.S., Nancy B. Kiviat, M.D., King K. Holmes, M.D., Ph.D., and Laura A. Koutsky, Ph.D.
Background To evaluate whether the use of male condoms reducesthe risk of male-to-female transmission of human papillomavirus(HPV) infection, longitudinal studies explicitly designed toevaluate the temporal relationship between condom use and HPVinfection are needed.
Methods We followed 82 female university students who reportedtheir first intercourse with a male partner either during thestudy period or within two weeks before enrollment. Cervicaland vulvovaginal samples for HPV DNA testing and Papanicolaoutesting were collected at gynecologic examinations every fourmonths. Every two weeks, women used electronic diaries to recordinformation about their daily sexual behavior. Cox proportional-hazardsmodels were used to evaluate risk factors for HPV infection.
Results The incidence of genital HPV infection was 37.8 per100 patient-years at risk among women whose partners used condomsfor all instances of intercourse during the eight months beforetesting, as compared with 89.3 per 100 patient-years at riskin women whose partners used condoms less than 5 percent ofthe time (adjusted hazard ratio, 0.3; 95 percent confidenceinterval, 0.1 to 0.6, adjusted for the number of new partnersand the number of previous partners of the male partner). Similarassociations were observed when the analysis was restrictedto high-risk and low-risk types of HPV and HPV types 6, 11,16, and 18. In women reporting 100 percent condom use by theirpartners, no cervical squamous intraepithelial lesions weredetected in 32 patient-years at risk, whereas 14 incident lesionswere detected during 97 patient-years at risk among women whosepartners did not use condoms or used them less consistently.
Conclusions Among newly sexually active women, consistent condomuse by their partners appears to reduce the risk of cervicaland vulvovaginal HPV infection.
Source Information
From the Departments of Epidemiology (R.L.W., S.O., L.A.K.), Biostatistics (J.P.H.), and Pathology (Q.F., N.B.K.), and the Center for AIDS and STD (K.K.H.), University of Washington, Seattle.
Address reprint requests to Dr. Winer at the University of Washington HPV Research Group, Lake Union Place, Suite 300, 1914 N. 34th St., Seattle, WA 98103, or at rlw{at}u.washington.edu.
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