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    Early Sex Doesn't Predict HPV Infection

    Study Fuels Debate Over the Best Vaccination Strategy

    HPV Risk Examined continued...

    "Few studies have evaluated the ability of specific risk factors to predict future HPV infection prospectively," Dempsey and colleagues write in the July issue of Pediatrics. "This is an important distinction, given that HPV vaccines must be provided before vaccine type-specific infection to be effective."

    In an effort to determine the value of adolescent risk factors for predicting future HPV infection, Dempsey and colleagues examined data on more than 3,000 women who had participated in a nationwide study of adolescent health.

    The girls were in middle school and high school when they were enrolled in the study; the analysis included health evaluations and surveys conducted over a six-year period.

    Researchers selected six behaviors suggestive of a higher HPV risk in previous studies: number of sexual partners; having had an older male sexual partner and/or a new partner within the past year; illegal drug use; regular use of alcohol or cigarettes; and having sex while under the influence of alcohol.

    Nearly half (43%) of the young women were sexually active when they entered the study between the ages of 13 and 18.

    Six years later there was little difference seen in HPV infection based on the early risk factors.

    Fifty-three percent of the participants who tested positive for HPV six years after entering the study were not yet sexually active when first surveyed.

    "This underscores the fact that HPV is very common in our society and you don't have to do anything outside the realm of what is considered nonrisky sexual behavior to acquire it," Dempsey says. "That is why the HPV should to be given to everyone who is eligible."

    But Saslow says this would place a big burden on low-income young women who may derive little benefit if they have been sexually active for many years. The Federal Entitlement Vaccine Program covers the cost of the vaccine series for women who are 18 and under, but not for older women.

    "You are talking about an awful lot of low-income women between the ages of 19 and 26 who would be asked to pay anywhere from $500 to $1,000 out of pocket," she says.

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