Mediators of the association between age of first sexual intercourse and subsequent human papillomavirus infection
Kahn, J.A.; Rosenthal, S.L.; Succop, P.A.; Ho, G.Y.F.; Burk, R.D.
Pediatrics 109(1): E5
2002
ISSN/ISBN: 0031-4005 PMID: 11773573 DOI: 10.1542/peds.109.1.e5Document Number: 199571
Objective: Previous studies have demonstrated that early age of first sexual intercourse is associated with human papillomavirus (HPV) infection. The objective of this study was to identify a set of risk behaviours and partner characteristics that mediate the association between age of first sexual intercourse and subsequent HPV infection in adolescent and young adult women. Methods: Female university students completed surveys and underwent HPV testing every 6 months for up to 3 years. HPV-positive participants were matched to HPV-negative participants (252 pairs, total n=504). Associations were examined between risk behaviours/partner characteristics and both age of first sexual intercourse and HPV infection. Those variables associated with either age of first sexual intercourse or HPV infection were entered into a generalized estimating equation (to account for the matched study design) modelling the association between age of first sexual intercourse and HPV infection. Results: Mean age of first sexual intercourse was 16.7 (+or-1.8) years, and early age of first sexual intercourse was associated significantly with HPV infection ( beta =-0.20; odds ratio: 0.82; 95% confidence interval: 0.74-0.90). The association was mediated by number of sexual partners in the past 6 months, history of sexually transmitted infection, alcohol and drug use related to sexual behaviours, and partner's number of sexual partners. Conclusion: A set of behavioural risk factors and partner characteristics partially mediate the association between age of first sexual intercourse and subsequent HPV infection.