The Association Between Female Hormonal Contraceptive Use and HPV Prevalence in Female Participants, Rakai, Uganda
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Date
2015-04-22
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Johns Hopkins University
Abstract
A cross-sectional analysis that included 1378 HIV-uninfected
female participants aged 15-49 was conducted to investigate the association between hormonal contraceptive use and high-risk human
papilloma virus (HR-HPV) prevalence in Rakai, Uganda. Hormonal
contraception (HC) use consisted of injectable DMPA (n=126), oral
contraception (n=25) and implants (n=3) in this study.
The analysis was stratified by age into two groups 15 to 29 and 30
to 49 years, because HR-HPV in the older women was most relevant to
the risk of cervical neoplasia. The overall prevalence rate of infection
with HR-HPV decreased with older age for both the HC users (exposure
group) and non-pregnant and non-HC users (reference group).
The results showed that the use of hormonal contraceptive was not
associated with increased prevalence rate of HR-HPV after controlling
for other covariates including age, number of sexual partners in the
previous year, condom use in previous year, educational level and current
pregnancy or breastfeeding status. (Crude prevalence risk ratio
(PRR)=1.064, P-value=0.57). After adjusting for other covariates in the
log-binomial model, the association between HC use and the risk of
infection with HR-HPV was not statistically significant for the two age
groups. Female participants aged 15 to 29 had an adjusted PRR=1.043, Piii
value=0.73 and participants aged 30 to 49 had an adjusted PRR=1.059
with P-value=0.83.
Conclusion: Hormonal contraceptive use by female participants
was not significantly associated with increased prevalence of infection
with HR-HPV and the effect of interaction between HC use and age on
the risk of infection with HR-HPV is not statistically significant.
More research is needed to examine the effect of HC use on HPV
incidence and persistence.
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Keywords
high-risk human papilloma virus, HR-HPV, hormonal contraceptive, cross-sectional, Uganda, female