HPV Infections in Older Women

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DESCRIPTION (provided by applicant): Rachel Winer, PhD is an epidemiologist whose goal is to establish an independent research career in the area of HPV prevention in less-studied populations. Whether older women who acquire new sex partners are susceptible to new, persistent HPV infections is largely unknown. With divorce, dating, and second marriage common among women over 25 years of age, risks of new oncogenic HPV infection and neoplasia might be greater now than in previous decades. Dr. Winer is conducting a pilot study of oncogenic HPV infections in 25 to 65 year old women. Under the mentorship of Dr. Koutsky at the University of Washington, the proposed five-year K01 award will allow Dr. Winer to conduct a longitudinal study of HPV infections in older women. During the first year and a half, Dr. Winer will complete the pilot study, develop study materials and protocols for the longitudinal study, and complete additional coursework. The longitudinal study will be conducted during the next two years. 300 women (150 women aged 25 to 44 and 150 women aged 45 to 65) who report having used online dating websites in the past year will be recruited through the Internet. For one year, women will be asked to mail in four sets of self-collected vaginal specimens for HPV DNA testing (at 0, 4, 8, and 12 months), and to complete questionnaires on their health and sexual behavior (at 0, 4, 8, and 12 months) and attitudes towards self-collecting vaginal samples (at the end of study participation). Samples will be analyzed for HPV DNA using PCR-based methods. The specific aims of the longitudinal study are to 1) identify behavioral and health predictors of type-specific oncogenic HPV DNA infections in 25 to 44 year old women and in 45 to 65 year old women; 2) identify predictors of repeatedly-detected oncogenic HPV infections; and 3) evaluate study participants' experiences with self-collecting vaginal specimens and attitudes towards HPV vaccination and cervical cancer screening. During the last year and a half, Dr. Winer will prepare manuscripts for publication and complete a competitive R01 application to further investigate the natural history of HPV infections in older women. This information is important for developing HPV prevention strategies, including vaccine implementation and cervical cancer screening guidelines in populations of older women.