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