Abnormal pap tests and human papillomavirus infections among HIV-infected and uninfected women who have sex with women

L. Stewart Massad, Xianhong Xie, Howard Minkoff, Teresa M. Darragh, Gypsyamber D'Souza, Lorraine Sanchez-Keeland, D. Heather Watts, Christine Colie, Howard Strickler

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

OBJECTIVE: To estimate the frequency of abnormal Pap and human papillomavirus (HPV) positivity among human immunodeficiency virus (HIV)-seropositive and -seronegative women who have sex with women (WSW). METHODS: Pap and HPV DNA polymerase chain reaction tests were obtained every 6 months from women in a US cohort of HIV-seropositive and -seronegative women. Women who have sex with women were women reporting no male and at least 1 female sex partner for 5 years. They were frequency matched 1:5 to women reporting sex only with men (WSM) and assessed using multivariable generalized estimating equation logistic regression models. RESULTS: Paps at study entry were abnormal in 12 (21%) of 49 HIV-seropositive WSW, 151 (64%) of 245 HIV-seropositive WSM, 3 (9%) of 24 HIV-seronegative WSW, and 16 (11%) of 120 HIV-seronegative WSM. Human papillomavirus was found at entry in 18 (42%) HIV-seropositive WSW, 109 (52%) HIV-seropositive WSM, 6 (27%) HIV-seronegative WSW, and 13 (13%) HIV-seronegative WSM. After controlling for HIV serostatus and CD4 count, WSW had marginally lower odds than WSM of Pap abnormality (odds ratio = 0.59, 95% confidence interval = 0.33-1.03) and of HPV (odds ratio = 0.53, 95% confidence interval = 0.32-0.89). After controlling for partner's gender, HIV seropositivity and lower CD4 count were associated with any HPV, oncogenic HPV, any abnormal Pap result, and high-grade squamous intraepithelial lesion or worse (p < .0001 for all). CONCLUSIONS: Although risks for abnormal Pap and HPV are modestly lower in WSW than in WSM, both are common in HIV-seropositive women regardless of sexual preference. Both WSW and WSM should be screened similarly.

Original languageEnglish (US)
Pages (from-to)50-56
Number of pages7
JournalJournal of Lower Genital Tract Disease
Volume18
Issue number1
DOIs
StatePublished - Jan 2014

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Papanicolaou Test
Papillomavirus Infections
HIV
CD4 Lymphocyte Count
Logistic Models
Odds Ratio
Confidence Intervals
DNA-Directed DNA Polymerase

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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Abnormal pap tests and human papillomavirus infections among HIV-infected and uninfected women who have sex with women. / Massad, L. Stewart; Xie, Xianhong; Minkoff, Howard; Darragh, Teresa M.; D'Souza, Gypsyamber; Sanchez-Keeland, Lorraine; Watts, D. Heather; Colie, Christine; Strickler, Howard.

In: Journal of Lower Genital Tract Disease, Vol. 18, No. 1, 01.2014, p. 50-56.

Research output: Contribution to journalArticle

Massad, L. Stewart ; Xie, Xianhong ; Minkoff, Howard ; Darragh, Teresa M. ; D'Souza, Gypsyamber ; Sanchez-Keeland, Lorraine ; Watts, D. Heather ; Colie, Christine ; Strickler, Howard. / Abnormal pap tests and human papillomavirus infections among HIV-infected and uninfected women who have sex with women. In: Journal of Lower Genital Tract Disease. 2014 ; Vol. 18, No. 1. pp. 50-56.
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abstract = "OBJECTIVE: To estimate the frequency of abnormal Pap and human papillomavirus (HPV) positivity among human immunodeficiency virus (HIV)-seropositive and -seronegative women who have sex with women (WSW). METHODS: Pap and HPV DNA polymerase chain reaction tests were obtained every 6 months from women in a US cohort of HIV-seropositive and -seronegative women. Women who have sex with women were women reporting no male and at least 1 female sex partner for 5 years. They were frequency matched 1:5 to women reporting sex only with men (WSM) and assessed using multivariable generalized estimating equation logistic regression models. RESULTS: Paps at study entry were abnormal in 12 (21{\%}) of 49 HIV-seropositive WSW, 151 (64{\%}) of 245 HIV-seropositive WSM, 3 (9{\%}) of 24 HIV-seronegative WSW, and 16 (11{\%}) of 120 HIV-seronegative WSM. Human papillomavirus was found at entry in 18 (42{\%}) HIV-seropositive WSW, 109 (52{\%}) HIV-seropositive WSM, 6 (27{\%}) HIV-seronegative WSW, and 13 (13{\%}) HIV-seronegative WSM. After controlling for HIV serostatus and CD4 count, WSW had marginally lower odds than WSM of Pap abnormality (odds ratio = 0.59, 95{\%} confidence interval = 0.33-1.03) and of HPV (odds ratio = 0.53, 95{\%} confidence interval = 0.32-0.89). After controlling for partner's gender, HIV seropositivity and lower CD4 count were associated with any HPV, oncogenic HPV, any abnormal Pap result, and high-grade squamous intraepithelial lesion or worse (p < .0001 for all). CONCLUSIONS: Although risks for abnormal Pap and HPV are modestly lower in WSW than in WSM, both are common in HIV-seropositive women regardless of sexual preference. Both WSW and WSM should be screened similarly.",
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T1 - Abnormal pap tests and human papillomavirus infections among HIV-infected and uninfected women who have sex with women

AU - Massad, L. Stewart

AU - Xie, Xianhong

AU - Minkoff, Howard

AU - Darragh, Teresa M.

AU - D'Souza, Gypsyamber

AU - Sanchez-Keeland, Lorraine

AU - Watts, D. Heather

AU - Colie, Christine

AU - Strickler, Howard

PY - 2014/1

Y1 - 2014/1

N2 - OBJECTIVE: To estimate the frequency of abnormal Pap and human papillomavirus (HPV) positivity among human immunodeficiency virus (HIV)-seropositive and -seronegative women who have sex with women (WSW). METHODS: Pap and HPV DNA polymerase chain reaction tests were obtained every 6 months from women in a US cohort of HIV-seropositive and -seronegative women. Women who have sex with women were women reporting no male and at least 1 female sex partner for 5 years. They were frequency matched 1:5 to women reporting sex only with men (WSM) and assessed using multivariable generalized estimating equation logistic regression models. RESULTS: Paps at study entry were abnormal in 12 (21%) of 49 HIV-seropositive WSW, 151 (64%) of 245 HIV-seropositive WSM, 3 (9%) of 24 HIV-seronegative WSW, and 16 (11%) of 120 HIV-seronegative WSM. Human papillomavirus was found at entry in 18 (42%) HIV-seropositive WSW, 109 (52%) HIV-seropositive WSM, 6 (27%) HIV-seronegative WSW, and 13 (13%) HIV-seronegative WSM. After controlling for HIV serostatus and CD4 count, WSW had marginally lower odds than WSM of Pap abnormality (odds ratio = 0.59, 95% confidence interval = 0.33-1.03) and of HPV (odds ratio = 0.53, 95% confidence interval = 0.32-0.89). After controlling for partner's gender, HIV seropositivity and lower CD4 count were associated with any HPV, oncogenic HPV, any abnormal Pap result, and high-grade squamous intraepithelial lesion or worse (p < .0001 for all). CONCLUSIONS: Although risks for abnormal Pap and HPV are modestly lower in WSW than in WSM, both are common in HIV-seropositive women regardless of sexual preference. Both WSW and WSM should be screened similarly.

AB - OBJECTIVE: To estimate the frequency of abnormal Pap and human papillomavirus (HPV) positivity among human immunodeficiency virus (HIV)-seropositive and -seronegative women who have sex with women (WSW). METHODS: Pap and HPV DNA polymerase chain reaction tests were obtained every 6 months from women in a US cohort of HIV-seropositive and -seronegative women. Women who have sex with women were women reporting no male and at least 1 female sex partner for 5 years. They were frequency matched 1:5 to women reporting sex only with men (WSM) and assessed using multivariable generalized estimating equation logistic regression models. RESULTS: Paps at study entry were abnormal in 12 (21%) of 49 HIV-seropositive WSW, 151 (64%) of 245 HIV-seropositive WSM, 3 (9%) of 24 HIV-seronegative WSW, and 16 (11%) of 120 HIV-seronegative WSM. Human papillomavirus was found at entry in 18 (42%) HIV-seropositive WSW, 109 (52%) HIV-seropositive WSM, 6 (27%) HIV-seronegative WSW, and 13 (13%) HIV-seronegative WSM. After controlling for HIV serostatus and CD4 count, WSW had marginally lower odds than WSM of Pap abnormality (odds ratio = 0.59, 95% confidence interval = 0.33-1.03) and of HPV (odds ratio = 0.53, 95% confidence interval = 0.32-0.89). After controlling for partner's gender, HIV seropositivity and lower CD4 count were associated with any HPV, oncogenic HPV, any abnormal Pap result, and high-grade squamous intraepithelial lesion or worse (p < .0001 for all). CONCLUSIONS: Although risks for abnormal Pap and HPV are modestly lower in WSW than in WSM, both are common in HIV-seropositive women regardless of sexual preference. Both WSW and WSM should be screened similarly.

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