Abstract B42: Factors associated to Chlamydia trachomatis and HPV co-positivity in women aged 16-64 years old living in metropolitan area of San Juan, Puerto Rico
Authors: Castaneda Maira Alejandra , Suárez Erick , Ortiz Ana Patricia 
Published: May 2016

Background and Objectives: Human papillomavirus (HPV) and Chlamydia trachomatis (CT) are among the most common sexually transmitted infections (STIs) world-wide. HPV is the etiologic agent of genital warts and some types of cancer, including cervical cancer. On the other hand, CT seropositivity has been strongly associated with the risk of developing cervical cancer. Furthermore it has been found that the risk of cervical neoplasia and cancer increases linearly with the increase of STIs. Recent studies suggest an association between CT and HPV infection, and suggest that CT could lead to an increased risk of HPV infection and persistence. However, these results remain inconclusive because the time sequence between CT and HPV is not well established. In addition, data on factors associated to HPV/CT co-positivity are limited. The aim of this study is to examine the risk factors that affect the co-positivity between HPV and CT antibodies in serum among women aged 16-64 years living in the San Juan Metropolitan area of Puerto Rico. Methods: This is a secondary data analysis from a population based study of HPV infection in Puerto Rico. A total of 530 (93.6%) women from the parent study were eligible for analysis. Enzyme linked immunosorbent assays were used to detect serum antibodies to CT and HPV (6, 11, 16 and 18). The dependent variable was defined as a combination of CT and HPV seroprevalence using four categories: (1) HPV- and CT-, (2) HPV- and CT+ (3) HPV+ and CT- y (4) HPV+ and CT+. Results: Overall, 10.9% of women in our study were seropositive to both HPV and CT. Results from multinomial logistic regression models showed that after adjusting for other covariates, the possibility of HPV/CT co-positivity was higher in women who reported current use of tobacco (PORadj: 2.72 , 95 % CI = 1.3-5.7) , previous use of alcohol (PORadj: 4.31, 95 % CI = 1.2-15.6), more than four lifetime sexual partners (PORadj: 3.7, 95 % CI = 2.0-6.8), history of anal sex (PORadj: 3.3 95 % CI = 1.5-7.3) and age of sexual onset less than 15 years (PORadj: 3.1 95 % CI = 1.7-5.6) using CT- and HPV- as the reference outcome. Conclusions: This study is the first one to examine the risk factors that affect the co-positivity between HPV and CT among Puerto Rican women. We found that risk factors such as the use of tobacco, alcohol, number of sexual partners, and age of onset of sexual activity increase the possibility for these women of being HPV and CT seropositive. Future longitudinal studies should further evaluate the association between CT and HPV in serum and anogenital anatomic sites, their risk factors and investigate whether infection with CT influence the acquisition and persistence of HPV in men and women of this population; this information will be essential to help further understand the potential interactions between HPV and CT and their impact on HPV-related cancer occurrence. Acknowledgements: Study was approved by the UPRMSC IRB (#A1810414) and partially funded by the National Institute of Allergy and Infectious Diseases Grant (NIAID Grant #: 1SC2AI090922-01) and the University of Puerto Rico Comprehensive Cancer Center.

Citation Format: Maira Alejandra Castaneda, Erick Suárez, Ana Patricia Ortiz. Factors associated to Chlamydia trachomatis and HPV co-positivity in women aged 16-64 years old living in metropolitan area of San Juan, Puerto Rico. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr B42.