The association of seropositivity to human papillomavirus (HPV) capsids of types 11, 16, 18, or 33 with sexual behavior was investigated. Among 1002 women visiting family planning or youth clinics in Sweden, an age-matched subsample of 274 women stratified according to lifetime number of sex partners was analyzed. The proportion of HPV-16-seropositive subjects increased linearly at approximately 4% per partner (P < .001), from 4% among those with 1 lifetime partner to 35% among those with >5 lifetime partners. Also, HPV-33 and HPV-18 seroprevalences were linearly dependent on the number of partners (P < .001, increase with 4% per partner, and P = .008, increase with approximately 3% per partner, respectively), providing serologic confirmation that the important mode of transmission of HPV-16, -18, or -33 infection in women is sexual. HPV serology appears to be suitable as a marker of sexual behavior in populations.

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Objectives: To investigate the signs, symptoms and changes in the vaginal milieu that could be associated with cervical human papillomavirus infection (CHPI). Study design: Women (n = 972) attending for contraceptive advice were tested for human papillomavirus in cervical samples. Results of gynecological history, examination, and vaginal wet smear findings were compared between CHPI patients and negative women. Results: Sixty-six (6.8%) of the women had a CHPI. Bacterial vaginosis was more common among those with, than without, CHPI, but the significance of this association was abolished after adjustment for age and for markers of sexual risk-taking. Vaginal discharge with a fishy odor, a positive amine test, and genital fissures showed significant correlations with CHPI, which persisted after adjustments. Symptoms of proctitis also correlated with CHPI, and remained significant after adjustment for anal sex. Conclusion: Bacterial vaginosis is associated with the presence of CHPI, possibly due to sexual behavioral factors. However, several other features, in particular the presence of amines, may be independently associated with CHPI.

In a study of 972 women, sexual characteristics of 66 women with a cervical human papillomavirus infection (CHPI) were compared to the remaining study population. Among a number of sexual variables that were significantly correlated with CHPI were number of lifetime sexual partners, short partnerships, many recent partners, infidelity, casual travel sex, sexual début abroad, oral and anal sex, and sexual abuse. In multifactorial analyses four variables remained significantly correlated with CHPI, i.e., number of lifetime sexual partners, casual travel sex, sexual début abroad, and infidelity. It is concluded that CHPI shows most of the epidemiological characteristics of a sexually transmitted disease.