Early smoking initiation, sexual behavior and reproductive health — a large population-based study of Nordic women

Hansen, Bo T.; Kjær, Susanne K.; Munk, Christian; Tryggvadóttír, Laufey; Sparén, Pär; Hagerup-Jenssen, Maria; Liaw, Kai Li; Nygård, Mari

doi:10.1016/j.ypmed.2010.03.014

Cited by 46 publications

(32 citation statements)

References 33 publications

(35 reference statements)

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“…Confounding is a problem in analyses of hormonal contraception use and smoking because both are associated with other risk-taking behaviors [42][43][44]. However, both factors were independently significant in our multivariable analysis, suggesting a true effect.…”

Section: Discussionmentioning

confidence: 76%

Prevalence and risk factors for cervical HPV infection and abnormalities in young adult women at enrolment in the multinational PATRICIA trial

Bahmanyar

Paavonen

Naud

et al. 2012

Gynecologic Oncology

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Section: Discussionmentioning

confidence: 76%

Prevalence and risk factors for cervical HPV infection and abnormalities in young adult women at enrolment in the multinational PATRICIA trial

Bahmanyar

Paavonen

Naud

et al. 2012

Gynecologic Oncology

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“…Smoking has been associated with earlier onset of sexual activity, greater number of sexual partners, and other risky sexual behaviors. [36, 37]…”

Section: Discussionmentioning

confidence: 99%

Human papillomavirus vaccine-related risk perceptions and subsequent sexual behaviors and sexually transmitted infections among vaccinated adolescent women

Mullins

Zimet

Rosenthal

et al. 2016

Vaccine

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Objective To examine the association between risk perceptions after human papillomavirus (HPV) vaccination and sexual behaviors and sexually transmitted infection (STI) diagnosis over 30 months following vaccination. Methods Participants included 112 sexually experienced girls aged 13–21 years who were enrolled at the time of first HPV vaccination and completed ≥2 of 4 follow-up visits at 2, 6, 18, 30 months and including 30 months. At each visit, participants completed surveys assessing risk perceptions (perceived need for safer sexual behaviors, perceived risk of STIs other than HPV) and sexual behaviors. STI testing was done at 6, 18, and 30 months. Outcomes were condom use at last intercourse with main male partner, number of sexual partners since last study visit, and STI diagnosis. Associations between risk perceptions and sexual behaviors/STIs were examined using generalized linear mixed models. Results Mean age was 17.9 years; 88% were Black; 49% had a history of STI at baseline. Scale scores for perceived need for safer sexual behaviors did not change significantly over time. Scale scores for perceived risk of STIs other than HPV significantly changed (p=0.027), indicating that girls perceived themselves to be more at risk of STIs other than HPV over 30 months following vaccination. Multivariable models demonstrated that greater perceived need for safer sexual behaviors following vaccination was associated with condom use (p=0.002) but not with number of partners or STI diagnosis. Perceived risk of STIs other than HPV was not associated with the three outcomes. Conclusions The finding that perceived risk for STIs other than HPV was not associated with subsequent sexual behaviors or STI diagnosis is reassuring. The association between perceived need for safer sexual behaviors and subsequent condom use suggests that the HPV vaccination visit is an important opportunity to reiterate the importance of safer sexual behaviors to sexually experienced girls.

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“…We hypothesize that smoking may have behavioral and biological mechanisms, as earlier initiation of smoking has been linked to riskier sexual behaviors and more STIs;(18) and smoking is correlated to depressed levels of cervical cytokines (IFN-γ, IL-10, IL-6, IL-1β). (19) Of note, IL-6 and IFN-gamma are key cytokines in C trachomatis defense.…”

Section: Discussionmentioning

confidence: 99%

Biological and Behavioral Risks for Incident Chlamydia trachomatis Infection in a Prospective Cohort

Hwang

Moscicki

2014

Obstetrics &Amp; Gynecology

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Objective To identify biological and behavioral risks for incident Chlamydia trachomatis among a prospective cohort of young women followed frequently. Methods Our cohort of 629 women from two outpatient sites was seen every 4 months (October 2000 through April 2012) for behavioral interviews and infection testing. C trachomatis was tested annually, and anytime patients reported symptoms or possible exposure using commercial nucleic acid amplification tests. Analyses excluded baseline prevalent C trachomatis infections. Risk factors for incident C trachomatis were assessed using Cox proportional hazards models. Significant risks (p<0.10) from bivariate models were entered in a multivariate model, adjusted for four covariates chosen a priori (age, race or ethnicity, condom use, study site). Backwards step-wise elimination produced a final parsimonious model retaining significant variables (p<0.05) and the four adjustment variables. Results The 629 women attended 9,594 total visits. Median follow-up time was 6.9 years (interquartile range 3.2-9.8), during which 97 (15%) women had incident C trachomatis . In the final multivariate model, incident C trachomatis was independently associated with HPV at the preceding visit (p<0.01), smoking (p=0.02), and weekly use of substances besides alcohol and marijuana (p<0.01) since prior visit. Among 207 women with available colpophotographs (1,742 visits), cervical ectopy was not a significant risk factor (p range=0.16-0.39 for ectopy as continuous and ordinal variables). Conclusion Novel risks for C trachomatis include preceding HPV, smoking, and substance use, which may reflect both biological and behavioral mechanisms of risk, such as immune modulation, higher-risk sexual networks, or both. Improved understanding of the biological bases for C trachomatis risk would inform our strategies for C trachomatis control.

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Early smoking initiation, sexual behavior and reproductive health — a large population-based study of Nordic women

Cited by 46 publications

References 33 publications

Prevalence and risk factors for cervical HPV infection and abnormalities in young adult women at enrolment in the multinational PATRICIA trial

Prevalence and risk factors for cervical HPV infection and abnormalities in young adult women at enrolment in the multinational PATRICIA trial

Human papillomavirus vaccine-related risk perceptions and subsequent sexual behaviors and sexually transmitted infections among vaccinated adolescent women

Biological and Behavioral Risks for Incident Chlamydia trachomatis Infection in a Prospective Cohort

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