Objective:To examine the association of potentially modifiable factors such a s condom use,sexual behaviors,and concurrent sexually transmitted infections w ith duration of genital human papillomavirus(HPV)infections among adolescent w omen.Design:Longitudinal observational study.Setting:Study conducted at 3 in ner-city clinics in Indianapolis,Ind.Participants:Forty-nine HPV-positive adolescents were tested frequently for HPV infection and provided sexual behavio r diaries.Main Exposures:Condom use,sexual behaviors,number of partners,and concurrent infections with Neisseria gonorrhoeae,Chlamydia trachomatis,and Tr ichomonas vaginalis.Main Outcome Measures:Time from onset to clearance of type specific HPV infections was analyzed with proportional hazard models.Adjusted h azard ratios(AHRs)were used to assess the effects of risk factors on the durat ion of HPV infection.Because viral clearance is a preferred outcome,a variable with an AHR less than 1 was considered a risk factor(ie,associated with reduc ed chance of viral clearance and prolonged infection).Results:Prolonged HPV in fection was associated with oncogenic HPV types(AHR,0.58 [95%confidence inter val(CI),0.39-0.84])less than median level of condom use during an HPV infect ion(AHR,0.53 [95%CI,0.33-0.84])and coinfection with Ctrachomatis(AHR,0.5 8 [95%CI,0.31-0.89])or T vaginalis(AHR,0.32 [95%CI,0.16-0.64]).Not hav ing multiple sexual partners during an HPV infection was associated with early H PV clearance(AHR,5.52 [95%CI,3.28-9.30]).Conclusions:These findings suppo rt public health messages of reducing the number of sexual partners,promoting r outine condom use,and frequent sexually transmitted infection screening that ma y be beneficial with HPV infections.
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