Human Papillomavirus Infection Among Sexually Active Young Women in the United States: Implications for Developing a Vaccination Strategy

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Abstract
Objectives: Population-level data on prevalence and distribution of human papillomavirus (HPV) types in the United States are necessary to guide optimal vaccination strategies. Study: Urine specimens from 3262 women ages 18 to 25 in the National Longitudinal Study of Adolescent Health (Wave III) were tested and typed for HPV. Poststratification sampling weights generated nationally representative estimates. Results: Overall HPV prevalence was 26.9% and as high as 14.3% among women with 1 lifetime partner but did not vary by geographic region. High-risk types were detected in 20%; ∼10% were infected with types in current candidate vaccines. HPV infection was independently associated with mixing sex with alcohol, a black partner, >3 lifetime sex partners, being single, and illegal drug use. Having a current sex partner and receptive oral sex were inversely associated with HPV. Conclusion: HPV prevalence was high throughout the country, even among women with only 1 lifetime partner, suggesting early and widespread rather than targeted immunization of young women.