Incidence of and risk factors for genital human papillomavirus infection in women drug users

A total of 230 women drug users were prospectively studied. At 6-month intervals, interviews, HIV testing, and cervicovaginal lavage sampling for human papillomavirus (HPV) were performed. HPV was detected and typed using a MY09/MY11 polymerase chain reaction system. 230 women without high-risk HPV (types 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73 and 82), with or without non-high risk HPV types at baseline, were included in analyses. Incidence rates of and factors associated with HPV infections of all types and high-risk types (types 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82) were analyzed. Baseline median age was 40 years (range 24-65); 62% of women were Hispanic, 20% black, and 16% white; 54 (24%) were HIV seropositive; 172 (75%) were without detectable HPV; 58 (25%) had only low-risk or untypeable HPV. The incidence rates for any and for high-risk type HPV infection were 9.5/100 and 4.8/100 person-years, respectively. HIV-positive women had a significantly increased hazard rate for any HPV (HR_adj: 3.4; 95% CI: 1.4 to 8.0) and for high-risk HPV (HR_adj 3.0; 95% CI: 1.4 to 6.6), adjusted for race, sexual behaviors, condom use, and history of other sexually transmitted infections. HIV infection was independently associated with a substantial and significantly increased risk for any and for high-risk genital HPV infection and was the most important risk factor found.