Abstract 3609: Factors associated to concurrent anal and cervical HPV infection: Results from a population-based study among Hispanics.
Authors: Ortiz-Martinez Ana P. , Marrero-Estrada Edmir , Soto-Salgado Marievelisse , Pérez Cynthia , Suárez Erick , Romaguera Josefina , Muñoz Cristina , Da Costa Maria , Palefsky Joel , Tortolero-Luna Guillermo 
Published: August 2014

Abstract
Objective: Persistent infection with certain types of HPV is associated with cervical and anal cancer, accounting for 96% and 93% of these tumors in the US. Population-based data on anal and cervical HPV co-infection among Hispanics is limited. We aimed to estimate the concordance between cervical and anal HPV infection among a population-based sample of 600 women aged 16 to 64 years living in the San Juan Metropolitan area of Puerto Rico (PR).
Methods: The study population for this cross-sectional study (2010-2012) was identified through a cluster probability sampling design of households in the San Juan Metropolitan Area, and included non-institutionalized women aged 16-64 years old residing in this area. Women completed a face-to-face interview conducted by female trained data collectors and a computer-assisted self-interview, using the Audio CASI system for the collection of demographic and lifestyle variables. Anal and cervical specimens were collected through previously tested self-collection methods and HPV DNA testing was performed using a modified pool of MY09/MY11 consensus HPV L1 primers as well as primers for amplification of the human beta-globin gene. PCR products from positive samples were typed by dot-blot hybridization using 39 individual type-specific probes. Logistic regression models were used to assess factors associated to concurrent cervical and anal HPV infection.
Results: Mean age of participants is 42.0 years (±13.4 SD), 19.3% have &lt; 12 years of education and 9.7% had no health-care coverage. Laboratory results for the first 403 participants with complete cervical and anal results show that 21.3% were co-infected with HPV in the cervix and anus. In multivariate logistic regression models, women aged 35-49 (OR=0.45, 95% CI=0.23-0.86) and 50-64 years (0.44, 95% CI=0.21-0.93) were less like to be co-infected as compared to those aged 16-34. A trend was observed were women with 2-9 lifetime sexual partners (OR=2.47, 95% CI=0.91-6.73) and those with ≥10 sexual partners (OR=3.33, 95% CI=1.07-10.41) were more likely to be co-infected than women with one sexual partner. Also, those married/living together (OR=0.55, 95% CI=0.30-1.01) were less likely to be co-infected as compared to single women, this result was marginally significant (p&lt;0.10). No differences were observed by education, health-care coverage, smoking status, age of sexual initiation or anal sexual practices.
Conclusions: Co-infection with HPV infection in the cervix and anus is common among Hispanic women in PR, and is associated with younger age and increased number of sexual partners. Given the current low uptake of the HPV vaccine in PR, public health interventions that increase vaccine accessibility and uptake in this population are warranted, as a method for cervical and anal cancer prevention.
Citation Format: Ana P. Ortiz-Martinez, Edmir Marrero-Estrada, Marievelisse Soto-Salgado, Cynthia Pérez, Erick Suárez, Josefina Romaguera, Cristina Muñoz, Maria Da Costa, Joel Palefsky, Guillermo Tortolero-Luna. Factors associated to concurrent anal and cervical HPV infection: Results from a population-based study among Hispanics. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3609. doi:10.1158/1538-7445.AM2013-3609