HPV Infections in Older Women

描述(申请人提供)：Rachel Winer博士，流行病学家，其目标是在较少研究的人群中建立HPV预防领域的独立研究生涯。获得新性伴的老年女性是否容易感染新的、持续的HPV感染在很大程度上尚不清楚。随着离婚、约会和再婚在25岁以上的女性中普遍存在，新的致癌HPV感染和肿瘤的风险现在可能比过去几十年更大。维纳博士正在对25岁至65岁女性的致癌性HPV感染进行一项试点研究。在华盛顿大学库茨基博士的指导下，拟议中的为期五年的K01奖项将允许维纳博士对老年女性的HPV感染进行纵向研究。在最初的一年半中，Winer博士将完成初步研究，为纵向研究开发研究材料和方案，并完成额外的课程工作。这项纵向研究将在未来两年内进行。300名女性(150名年龄在25岁至44岁之间的女性和150名年龄在45岁至65岁之间的女性)将通过互联网招募在过去一年中使用过在线约会网站的女性。在为期一年的时间里，女性将被要求邮寄四组自采集的阴道样本进行HPV DNA检测(在0、4、8和12个月时)，并完成关于她们的健康和性行为(在0、4、8和12个月时)以及对自采集阴道样本的态度的问卷(在参与研究结束时)。将使用基于聚合酶链式反应的方法对样本进行HPV DNA分析。这项纵向研究的具体目标是：1)确定25岁至44岁和45岁至65岁女性中特定类型致癌HPV DNA感染的行为和健康预测因素；2)确定反复检测到的致癌HPV感染的预测因素；3)评估研究参与者自我收集阴道标本的经验以及对HPV疫苗接种和宫颈癌筛查的态度。在过去的一年半里，维纳博士将准备出版手稿，并完成一项竞争性的R01申请，以进一步调查老年女性HPV感染的自然历史。这些信息对于制定HPV预防战略非常重要，包括在老年妇女人群中实施疫苗和宫颈癌筛查指南。

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.