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American Academy of Pediatrics
ELECTRONIC ARTICLE

Mediators of the Association Between Age of First Sexual Intercourse and Subsequent Human Papillomavirus Infection

Jessica A. Kahn, Susan L. Rosenthal, Paul A. Succop, Gloria Y. F. Ho and Robert D. Burk
Pediatrics January 2002, 109 (1) e5; DOI: https://doi.org/10.1542/peds.109.1.e5
Jessica A. Kahn
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Susan L. Rosenthal
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Paul A. Succop
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Gloria Y. F. Ho
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Robert D. Burk
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    Fig 1.

    Study sample.

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    Fig 2.

    Model of the association between age of first sexual intercourse and HPV infection, as mediated by sexual and other risk behaviors and partner characteristics.

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    TABLE 1.

    Associations Between Age of First Sexual Intercourse and Sexual Behaviors, Other Risk Behaviors, and Partner Characteristics

    Age of First Sexual Intercourse (Mean [SD])Pearson Correlation CoefficientP Value*
    Sexual risk behaviors
     Sexual partners†
      117.00 (1.7)<.0001
      >116.02 (1.9)
     Frequency of vaginal intercourse†−0.08.061
     Condom use†
      Never/rarely16.66 (1.6).014
      Sometimes16.24 (2.1)
      Most/all of the time16.90 (1.8)
     Oral contraceptive use†
      Yes16.86 (1.8).73
      No16.78 (1.6)
     History of STI
      Yes16.26 (1.7).059
      No16.77 (1.8)
     History of pregnancy
      Yes16.11 (2.2).009
      No16.79 (1.7)
    Other risk behaviors
     Current cigarette smoking
      Yes16.26 (1.7).002
      No16.86 (1.8)
     Drinking/drug use related to sexual behavior‡
      Scale score 016.91 (1.8).002
      Scale score ≥116.40 (1.7)
    Partner characteristics
     Partner’s age§0.09.079
     Partner’s race§
      White16.70 (1.7).24
      Black16.40 (2.2)
      Hispanic16.91 (1.5)
      Asian17.08 (1.9)
     Partner’s number of sexual partners§−.092.038
    • SD indicates standard deviation.

    • ↵* The P value is derived from a Pearson correlation coefficient if the behavioral/partner characteristic variable is continuous and from a t test or analysis of variance procedure if the behavioral/partner characteristic variable is categorical.

    • ↵† These variables were assessed during the 6 months before testing positive for HPV.

    • ↵‡ Self-report of risky sexual behaviors while using alcohol or illicit drugs, measured using a 9-point scale.

    • ↵§ Assessed for main sexual partner.

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    TABLE 2.

    Associations Between HPV Infection and Sexual Behaviors, Other Risk Behaviors, and Partner Characteristics*

    HPV-Positive (N [%])Mean (SD), HPV-PositiveMean (SD), HPV-NegativeP Value†
    Sexual risk behaviors
     Number of sexual partners‡
      1152 (42.2).001
      >1100 (69.4)
     Frequency of vaginal intercourse‡38.5 (47.5)27.3 (38.6).004
     Condom use‡
      Never/rarely67 (46.5).07
      Sometimes49 (61.3)
      Most/all of the time132 (47.8)
     Oral contraceptive use‡
      Yes64 (49.6).85
      No59 (50.9)
     History of STI
      Yes37 (74.0).001
      No215 (47.5)
     History of pregnancy
      Yes33 (61.1).08
      No219 (48.7)
    Other risk behaviors
     Current cigarette smoking
      Yes72 (61.5).005
      No180 (46.6)
     Drinking/drug use related to sexual behavior§
      Scale score 0140 (44.3).001
      Scale score ≥1112 (59.6)
    Partner characteristics
     Partner’s age‖21.9 (3.3)20.7 (2.3).0001
     Partner’s race‖
      White126 (42.4).001
      Black51 (87.9)
      Hispanic39 (60.9)
      Asian13 (28.3)
      Other23 (59.0)
     Partner’s number of sexual partners‖7.8 (10.2)3.3 (4.8).0001
    • SD indicates standard deviation.

    • ↵* Several of these associations have been reported previously, using different sample selection and methods of analysis, in Ho et al2 and Burk et al.18

    • ↵† The P value is derived from a χ2 statistic if the behavioral/partner characteristic variable is categorical and from a t test or analysis of variance procedure if the behavioral/partner characteristic variable is continuous.

    • ↵‡ These variables were assessed during the 6 months before testing positive for HPV.

    • ↵§ Self-report of risky sexual behaviors while using alcohol or illicit drugs, measured using a 9-point scale.

    • ↵‖ Assessed for main sexual partner.

    • View popup
    TABLE 3.

    GEE Models Examining the Association Between Age of First Sexual Intercourse and HPV Infection

    HPV infection regressed on age of first sexual intercourse
    Variableβ EstimateStandard ErrorOdds Ratio95% Confidence IntervalP Value
     Age of first sexual intercourse*−0.200.050.820.740.90.0001
    HPV infection regressed on age of first sexual intercourse controlling for risk variables, partner characteristics, and participant race
    Variableβ EstimateStandard ErrorOdds Ratio95%Confidence IntervalP Value
     Age of first sexual intercourse*−0.160.060.850.760.97.013
     Number of sexual partners†0.500.141.651.262.16.0003
     History of STI0.800.342.231.144.35.019
     Drinking/drug use related to sexual behavior‡2.950.8019.14.0191.8.0002
     Partner’s lifetime number of sexual partners§0.060.031.061.011.12.014
     Partner’s age§0.140.051.151.041.27.006
     Participant’s race‖
      White−1.000.370.370.180.76.007
      Black1.580.554.851.6314.3.004
      Hispanic0.00080.451.00.422.411.00
      Asian−1.360.480.260.100.65.004
    • ↵* Age assessed as a continuous variable; odds are per year of age.

    • ↵† This variable was assessed during the 6 months before testing positive for HPV.

    • ↵‡ Self-report of risky sexual behaviors while using alcohol or illicit drugs, measured using a 9-point scale: scale dichotomized into ever versus never practiced risky behaviors while using alcohol or illicit drugs.

    • ↵§ Assessed for main sexual partner.

    • ↵‖ “Other” race served as the reference group.

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1 Jan 2002
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Mediators of the Association Between Age of First Sexual Intercourse and Subsequent Human Papillomavirus Infection
Jessica A. Kahn, Susan L. Rosenthal, Paul A. Succop, Gloria Y. F. Ho, Robert D. Burk
Pediatrics Jan 2002, 109 (1) e5; DOI: 10.1542/peds.109.1.e5

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Mediators of the Association Between Age of First Sexual Intercourse and Subsequent Human Papillomavirus Infection
Jessica A. Kahn, Susan L. Rosenthal, Paul A. Succop, Gloria Y. F. Ho, Robert D. Burk
Pediatrics Jan 2002, 109 (1) e5; DOI: 10.1542/peds.109.1.e5
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