Table 4.
Hazard Ratios (HRs) for the Associations Between Select Risk Factors and Incident High-Risk Human Papillomavirus (HPV) Detection Among 362 Women Aged 25–65 Years Who Report ≥1 Male Sex Partner in the Past 6 Months
| Variable | Incident Detections, No. | Person-Years at Risk, No. | Univariate HR (95% CI) | Incident Detections, No. | Person-Years at Risk, No. | Multivariate HR (95% CI)a |
|---|---|---|---|---|---|---|
| Age, y | ||||||
| 25–34 | 94 | 3688 | Reference (1.0) | … | … | … |
| 35–44 | 35 | 1369 | 0.98 (.59–1.63) | … | … | … |
| 45–54 | 20 | 883 | 0.89 (.48–1.66) | … | … | … |
| 55–65 | 3 | 260 | 0.46 (.11–1.88) | … | … | … |
| Age at first intercourse, y | ||||||
| ≤14 | 23 | 1034 | Reference (1.0) | … | … | … |
| 15–16 | 42 | 1515 | 1.27 (.59–2.76) | … | … | … |
| 17 | 29 | 1057 | 1.21 (.55–2.65) | … | … | … |
| 18–19 | 36 | 1409 | 1.17 (.57–2.37) | … | … | … |
| ≥20 | 21 | 1157 | 0.82 (.37–1.84) | … | … | … |
| Marital status | ||||||
| Unmarried or separated | 112 | 3999 | Reference (1.0) | … | … | … |
| Married or living with a partner | 39 | 2138 | 0.65 (.41–1.03) | … | … | … |
| Lifetime male sex partners, no.b | ||||||
| 1–4 | 9 | 660 | Reference (1.0) | 9 | 625 | Reference (1.0) |
| 5–8 | 31 | 1303 | 1.90 (.77–4.72) | 28 | 1240 | 1.46 (.58–3.71) |
| ≥9 | 112 | 4139 | 2.19 (1.00–4.81) | 104 | 3933 | 1.57 (.70–3.53) |
| Currently using hormonal contraceptives | ||||||
| No | 93 | 4483 | Reference (1.0) | 93 | 4400 | Reference (1.0) |
| Yes | 48 | 1412 | 1.71 (1.08–2.70) | 48 | 1398 | 1.65 (1.05–2.59) |
| Smoking status | ||||||
| Never | 86 | 3721 | Reference (1.0) | … | … | … |
| Former | 46 | 1674 | 1.22 (.73–2.04) | … | … | … |
| Current | 20 | 796 | 1.09 (.51–2.31) | … | … | … |
| Ever had an abnormal Papanicolaou test result | ||||||
| No | 76 | 3157 | Reference (1.0) | … | … | … |
| Yes | 69 | 2932 | 0.97 (.63–1.50) | … | … | … |
| Menopausal statusc | ||||||
| Premenopausal | 13 | 433 | Reference (1.0) | … | … | … |
| Perimenopausal, menopausal, or postmenopausal | 10 | 692 | 0.47 (.18–1.27) | … | … | … |
| Sexual behaviors in the past 6 mo | ||||||
| New male sex partnersd | ||||||
| No | 62 | 3523 | Reference (1.0) | … | … | … |
| Yes | 89 | 2626 | 1.90 (1.25–2.88) | … | … | … |
| Casual male sex partnersd | ||||||
| No | 68 | 3848 | Reference (1.0) | … | … | … |
| Yes | 81 | 2305 | 1.97 (1.31–2.97) | … | … | … |
| Younger male sex partnersd | ||||||
| No | 77 | 3680 | Reference (1.0) | … | … | … |
| Yes | 75 | 2519 | 1.45 (.96–2.17) | … | … | … |
| Male sex partner with ≥1 concurrent partnershipd | ||||||
| No or unknown | 77 | 4073 | Reference (1.0) | … | … | … |
| Yes | 75 | 2095 | 1.87 (1.22–2.87) | … | … | … |
| Male partner whom the subject met onlined | ||||||
| No | 65 | 3217 | Reference (1.0) | … | … | … |
| Yes | 87 | 2966 | 1.45 (.95–2.19) | … | … | … |
| Condom use with male sex partnerse | ||||||
| Always | 128 | 4795 | Reference (1.0) | … | … | … |
| Not always | 22 | 1282 | 1.57 (.93–2.63) | … | … | … |
| Circumcision status of male partnersf | ||||||
| Uncircumcised or unknown | 46 | 1516 | Reference (1.0) | … | … | … |
| Circumcised | 106 | 4640 | 0.77 (.48–1.23) | … | … | … |
| ≥2 male sex partners | ||||||
| No | 65 | 3928 | Reference (1.0) | … | … | … |
| Yes | 87 | 2271 | 2.30 (1.52–3.47) | … | … | … |
| Composite high-riskg sexual behavior variable | ||||||
| 0 high-risk behaviors | 27 | 2253 | Reference (1.0) | 26 | 2135 | Reference (1.0) |
| 1 high-risk behavior | 34 | 1336 | 2.08 (1.19–3.63) | 32 | 1219 | 2.06 (1.17–3.64) |
| ≥2 high-risk behaviors | 91 | 2611 | 2.85 (1.73–4.70) | 83 | 2443 | 2.53 (1.49–4.30) |
Analysis was restricted to women reporting sex with a male partner in the 6 months prior to oncogenic HPV assessment. Women could enter and exit the analysis multiple times if report of male partners in the prior 6 months varied among follow-up oncogenic HPV assessments.
Abbreviation: CI, confidence interval.
a The following variables were included in the multivariate model: lifetime number of male sex partners, hormonal contraceptive use, and the composite 6-month sexual behavior variable.
b Lifetime number of male partners was initially categorized into quintiles (1–4, 5–8, 9–14, 15–25, and ≥26); in all analyses, however, similar risks of incident detection among categories of >5 to 8 partners were observed. Therefore, a post hoc decision was made to collapse lifetime number of male partners into a 3-level variable.
c Restricted to women ≥45 years of age.
d The variable was coded as “yes” if at least 1 partner/partnership during the past 6 months fit the characteristic of interest.
e The variable was coded as “always” if the subject reported always using condoms with all male partners during the past 6 months. If a subject reported not always using condoms with at least 1 male partner, the variable was coded as “not always.” Otherwise, if condom use data were missing for at least 1 partner, the variable was set to missing.
f If the circumcision status of 1 partner was reported as uncircumcised or unknown, the variable was coded as “uncircumcised or unknown.” If all partners were reported as circumcised, the variable was coded as “circumcised.”
g Six-month sexual behavior variables that were statistically significant in univariate analyses (including reports of new male partners, reports of casual male partners, reports of partners with ≥1 concurrent partnership, and reports of ≥2 male partners) were classified as “high-risk” and used to create the composite 6-month sexual behavior variable.