Sexual Orientation Does Not Impact Risk of HPV Infection in Women

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Sexual orientation does not affect the prevalence of HPV infection among women, according to data presented at the SGO 2022 Annual Meeting on Women’s Cancer.

Researchers found similar rates of HPV infection among women who self-identified as heterosexual, lesbian, or bisexual. 

“Historically, in the United States, women who identify as lesbian or bisexual have been less likely to undergo cervical cancer screening, in part, due to assumptions by the public and providers that these patients have a lower risk of HPV and subsequent cervical dysplasia,” said Michael T. Richardson, MD, of the University of California, Los Angeles.


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To examine the risk HPV infection by sexual orientation, Dr Richardson and colleagues used data from female respondents to the National Health and Nutrition Examination Survey from 2011 to 2016. Sexual orientation was self-reported. HPV infection was detected with self-collected vaginal swab samples. 

The 3656 participants had a median age of 40 (range, 20-59) years, and 65% were White. The majority of patients (94%) identified as heterosexual, and 6% identified as lesbian or bisexual. 

There was no significant difference in the incidence of HPV infection between the heterosexual and lesbian/bisexual groups. The percentage of patients who tested positive for any genital HPV was 36% in the heterosexual group and 42% in the lesbian/bisexual group. The percentage of patients who tested positive for high-risk HPV was 18% and 20%, respectively.

In a multivariable analysis, the following factors were independent predictors of testing positive for genital HPV:

  • Being younger than 40 years of age (odds ratio [OR], 1.5; 95% CI, 1.2-1.9; P <.001)
  • Divorced/separated status (OR, 1.7; 95% CI, 1.2-2.4; P =.003)
  • Having more than 4 lifetime partners (OR, 2.5; 95% CI, 2.0-3.2; P <.001).

However, identifying as lesbian or bisexual was not associated with the risk of any genital HPV (OR, 0.9; 95% CI, 0.6-1.4; P =.73) or high-risk HPV (OR, 0.7; 95% CI, 0.5-1.1; P =.17).

Looking at the highest-risk populations, the researchers found that younger women who were divorced/separated and had more than 4 lifetime sexual partners were at the highest risk, with 72% testing positive for any genital HPV and 35% for high-risk HPV. 

Dr Richardson noted that this study was limited by a few factors. HPV infection was examined at a single time point, patients’ immunization status was unknown, the percentage of patients identifying as lesbian or bisexual was small, and sexual orientation was self-reported.

“Further outreach should be considered for these patients who may be less likely to undergo cervical cancer screening and immunization but are equally at risk,” Dr Richardson said. 

Disclosures: Dr Richardson reported having no conflicts of interest.

Read more of Cancer Therapy Advisor’s coverage of SGO 2022 by visiting the conference page.

Reference

Caesar MA, Richardson M, Chan C, et al. Sexual orientation is irrelevant in HPV screening: Infection rates in heterosexual vs. lesbian/bisexual women. Presented at SGO 2022; March 18-21, 2022. Abstract 135.



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