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CMAJ • May 27, 2003; 168 (11)
© 2003 Canadian Medical Association or its licensors

Letters
Correspondance

Transmission of HPV

Sarah Giles

Class of 2005, Dalhousie University, Halifax, NS

John W. Sellors and colleagues1 have described human papillomavirus (HPV) infection in women, relating this infection to various risk factors, including number of previous sexual partners. It should be pointed out, however, that HPV is not a typical sexually transmitted infection.

As the recent paper by Winer and associates2 highlighted, sexual contact is not necessary for the transmission of HPV. Although these authors showed that the cumulative incidence of HPV over the first 4 years after first sexual intercourse was about 50%, they also showed that HPV infection was acquired by virginal women at a cumulative rate of 7.9% over 2 years. According to these authors, abstaining from penetrative sex did not protect women from HPV transmission, and they proposed that skin-to-skin contact during nonpenetrative sexual contact may be a primary mode of genital HPV transmission.

Furthermore, no protective effect has been associated with condom use.3 This failure to prevent HPV may be related to the poor validity of self- reported condom use, condom breakage, slippage and incorrect use, but it may also be caused by the ability of biological material to pass through condoms.4

Perhaps researchers should move away from collecting data on the number of previous sexual partners a woman has had, especially given that data of this type help to stigmatize HPV as a virus affecting only promiscuous women who have unprotected penetrative sex.

Sarah Giles Class of 2005 Dalhousie University Halifax, NS

References

  1. Sellors JW, Karwalajtys TL, Kaczorowski J, Mahony JB, Lytwyn A, Chong S, et al, for the Survey of HPV in Ontario Women (SHOW) Group. Incidence, clearance and predictors of human papillomavirus infection in women. CMAJ 2003;168(4):421-5.[Abstract/Free Full Text]
  2. Winer RL, Lee SK, Hughes JP, Adam DE, Kiviat NB, Koutsky LA. Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students. Am J Epidemiol 2003;157:218-26.[Abstract/Free Full Text]
  3. Steiner MJ, Feldblum PJ, Padian N. Invited commentary: condom effectiveness — will prostate-specific antigen shed new light on this perplexing problem? Am J Epidemiol 2003; 157: 298-300.[Free Full Text]
  4. Macaluso M, Lawson ML, Duerr A, Hortin G. Macaluso et al. respond to "Condom effectiveness and prostate specific antigen." Am J Epidemiol 2003;157:301-2.[Free Full Text]




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