ArticleEpidemiology and infection2016
Assortative mixing as a source of bias in epidemiological studies of sexually transmitted infections: the case of smoking and human papillomavirus.
Article in Epidemiology and infection, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- Evidence of synergistic relationships between HIV and Human Papillomavirus (HPV): systematic reviews and meta-analyses of longitudinal studies of HPV acquisition and clearance by HIV status, and of HIV acquisition by HPV status.Journal of the International AIDS Society · 2018Pooled it
- Effect of HSV-2 infection on subsequent HIV acquisition: an updated systematic review and meta-analysis.The Lancet. Infectious diseases · 2017Pooled it
- Considering equity in priority setting using transmission models: Recommendations and data needs.Epidemics · 2022Review
- Assortativity and Bias in Epidemiologic Studies of Contagious Outcomes: A Simulated Example in the Context of Vaccination.American journal of epidemiology · 2021Article
- Assortative social mixing and sex disparities in tuberculosis burden.Scientific reports · 2021Article
- Global and regional estimates of the contribution of herpes simplex virus type 2 infection to HIV incidence: a population attributable fraction analysis using published epidemiological data.The Lancet. Infectious diseases · 2020Article
- Recurring infection with ecologically distinct HPV types can explain high prevalence and diversity.Proceedings of the National Academy of Sciences of the United States of America · 2017Article
- Effect of age-difference between heterosexual partners on risk of cervical cancer and human papillomavirus infection.Papillomavirus research (Amsterdam, Netherlands) · 2017Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
Abstract
For studies examining risk factors of sexually transmitted infections (STIs), confounding can stem from characteristics of partners of study subjects, and persist after adjustment for the subjects' individual-level characteristics. Two conditions that can result in confounding by the subjects' partners are: (C1) partner choice is assortative by the risk factor examined and, (C2) sexual activity is associated with the risk factor. The objective of this paper is to illustrate the potential impact of the assortativity bias in studies examining STI risk factors, using smoking and human papillomavirus (HPV) as an example. We developed an HPV transmission-dynamic mathematical model in which we nested a cross-sectional study assessing the smoking-HPV association. In our base case, we assumed (1) no effect of smoking on HPV, and (2) conditions C1-C2 hold for smoking (based on empirical data). The assortativity bias caused an overestimation of the odds ratio (OR) in the simulated study after perfect adjustment for the subjects' individual-level characteristics (adjusted OR 1·51 instead of 1·00). The bias was amplified by a lower basic reproductive number (R 0), greater mixing assortativity and stronger association of smoking with sexual activity. Adjustment for characteristics of partners is needed to mitigate assortativity bias.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.