Prevalence of Human Papillomavirus Genotypes and Abnormal Pap Smears Among Women in the Military Health System

Abstract

Human papillomavirus infection (HPV) is the most common sexually transmitted infection among United States Military Servicemembers, and present in the majority of cervical cancers. Many of these infections are preventable, but HPV immunization is not mandatory during military service. The objective of this study was to examine the prevalence of vaccine-preventable cervical disease among women enrolled in the San Antonio Military Health System. This is a retrospective cross-sectional study of Pap smear results and HPV genotyping data among Military Servicewomen and beneficiaries. Simple descriptive statistics and logistic regression were used to assess the association between demographics, cervical pathology and high-risk HPV (hrHPV) infection. Pap smears were obtained by 16.9% of women and cervical pathology was present in 28.8% of samples. Compared to the 25-34 year group, 35-44 year-olds were more likely to have an abnormal Pap smear (OR 1.25, CI 1.05-1.50). Of the samples tested, 10.5% were positive for hrHPV. Adjusted multivariable analysis revealed that hrHPV infection was more likely among the 23-34 year group when compared to 35-44 (OR 0.50, CI 0.38-0.67), 45-54 (0.40. CI 0.28-0.59) and 55-65 year groups (0.46, CI 0.30-0.71). Active Duty Servicewomen were more likely to test positive for hrHPV when compared to Active Duty Family Members (OR 0.59, CI 0.45-0.79) and Retiree Family Members (OR 0.59, CI 0.41-0.83). Younger women and Active Duty Servicewomen are significantly more likely to have cervical infection with hrHPV. Future studies should assess the cost-effectiveness of mandatory HPV immunization for military members.

Prevalence of sexually transmitted infections in women of the Czech Republic Armed Forces: a cross-sectional pilot study

“…This multiplex real-time PCR-based method targets the L1 region of the viral genome and allows simultaneous genotyping of 28 HPV types and an internal control. Two PCR reactions were performed for each sample to detect the 19 HR HPV types (HPV 16,18,26,31,33,35,39,45,51,52,53,56,58,59, 66, 68, 69, 73, 82) and the 9 LR HPV types (HPV 6,11,40,42,43,44,54,61,70). Negative and positive controls were included in all PCR runs.…”

“…However, data show that the prevalence of STIs is still higher compared with the general population. [9][10][11] The prevalence of the STIs in the army is not only dependent on the military environment, but it is also influenced by the STI status of members joining the military service.…”

Cervical cancer screening compliance among active duty service members in the US military

“…Alarmingly, HPV infection, as well as HPV-related cervical dysplasia, are more common among ADSM than in the general US population, putting ADSM at an even greater risk for cervical cancer. ( Agan et al, 2013 Feb , Daly et al, 2018 ) There is very limited information regarding why HPV and cervical dysplasia are more common among ADSM; however, researchers have speculated that ADSM may be more likely to engage in risk-taking, which may influence STI incidence. ( Agan et al, 2013 Feb ) Other researchers have suggested that rates may be higher among ADSM due to greater access to STI testing among military populations.…”