ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Importance of Lifetime Sexual History on the Prevalence of Genital Human Papillomavirus (HPV) Among Unvaccinated Adults in the National Health and Nutrition Examination Surveys: Implications for Adult HPV Vaccination.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 16 citations in OpenAlex.
- Community-Based HPV Self-Sampling to Enhance Access to Cervical Cancer Prevention: A Continuum-of-Care Model from Urban Nepal.Current oncology (Toronto, Ont.) · 2026Article
- Immunogenicity of Human Papillomavirus Virus Vaccine in a High-risk and Understudied Group: Female Sex Workers.The Journal of infectious diseases · 2026Article
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- Adapting Sexual Behavior Survey Data to Parameterize an Agent-Based Model of Human Papillomavirus (HPV) Transmission.Medical decision making : an international journal of the Society for Medical Decision Making · 2026Article
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- U-shaped association of the stress hyperglycemia ratio with all-cause mortality and premature death in patients with cardiovascular disease: a cohort study.Diabetology & metabolic syndrome · 2025Article
- The global disease burden attributable to unsafe sex among women from 1990 to 2021 with forecasts to 2035: a systematic analysis based on the global burden of disease 2021.BMC public health · 2025Article
- "Easy women get it": pre-existing stigma associated with HPV and cervical cancer in a low-resource setting prior to implementation of an HPV screen-and-treat program.BMC public health · 2023Article
- Prevalence of Human Papillomavirus Among Women Older than Recommended Age for Vaccination by Birth Cohort, United States 2003‒2016.The Journal of infectious diseases · 2022Article
- Gut Helminth Infection-Induced Immunotolerance and Consequences for Human Papillomavirus Persistence.The American journal of tropical medicine and hygiene · 2021Review
- Rates of New Human Papillomavirus Detection and Loss of Detection in Middle-aged Women by Recent and Past Sexual Behavior.The Journal of infectious diseases · 2021Article
- Association between dietary folate intake and severe abdominal aorta calcification in adults: A cross-sectional analysis of the national health and nutrition examination survey.Diabetes & vascular disease researchArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAlthough the United States Food and Drug Administration recently approved the human papillomavirus (HPV) vaccine for individuals aged 27-45 years, the Centers for Disease Control and Prevention did not change its guidelines for routine HPV vaccination. Since recommendations for adult vaccination emphasize shared clinical decision-making based on risk of new infections, we examined the relationship between HPV prevalence and sexual behavior.
methodsThis study was conducted among 5093 HPV-unvaccinated, sexually experienced adults aged 18-59 years in the National Health and Nutrition Examination Surveys (2013-2016). For each sex and age group, adjusted prevalences of 9-valent vaccine-specific, high-risk, and any HPV infection were estimated by number of lifetime sexual partners (LTSPs) using logistic regression. An analysis restricted to persons who did not have a new sexual partner in the past year (ie, removing those at highest risk of newly acquired HPV) was also conducted.
resultsIn each age group, genital HPV prevalence was higher among persons with >5 LTSPs compared with 1-5 LTSPs in both males and females. There were only slight reductions in HPV prevalence after removing participants who reported a new sexual partner in the past year. For example, among females aged 27-45 years with >5 LTSPs, the adjusted prevalence of 9-valent vaccine-type HPV infection was 13.4% (95% confidence interval [CI], 9.9%-17.0%) in the full population compared to 12.1% (95% CI, 8.8%-15.4%) among those with no new sexual partners.
conclusionsPrevalent HPV infection was primarily reflective of cumulative exposures over time (higher LTSPs). New exposures had limited impact, emphasizing the need to consider sexual history in the decision-making process for adult HPV vaccination.
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Registered trials
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.