Seroprevalence of nine human papillomavirus types included in the nonavalent vaccine in unvaccinated women living in Puerto Rico: A population-based study.
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OBJECTIVES: To estimate the seroprevalence of human papillomavirus (HPV) types included in the nonavalent HPV (9vHPV) vaccine among unvaccinated women and determine factors associated with seropositivity. METHODOLOGY: Data from a population-based cross-sectional study of HPV infection among sexually active women (16-64 years) conducted in Puerto Rico from 2010 to 2013 was assessed (n = 524). Antibody responses to 9vHPV types (HPV-6/11/16/18/31/33/45/52/58) were analyzed using M9ELISA by the United States Centers for Disease Control and Prevention. Age-adjusted prevalence odds ratios (aPOR) were estimated with 95% confidence intervals (CI). RESULTS: The mean participant age was 42.4 ± 0.6 years; 69.2% were seropositive to ≥1 of the 9vHPV types and 0.5% to all types. Women who had their sexual debut at ≥18 years old (aPOR: 0.4, 95% CI: 0.2-0.8) had lower odds of seropositivity to any 9vHPV types compared to those with a younger sexual debut age. Higher odds of seropositivity were observed among women with 3-9 (aPOR: 4.4, 95% CI: 1.9-10.2) and with ≥10 (aPOR: 4.3, 95% CI: 1.5-12.6) lifetime sexual partners, and women with a history of an abnormal Pap test result (aPOR: 2.5, 95% CI: 1.1-5.6) compared to their counterparts. CONCLUSION: The high seroprevalence of 9vHPV types found in our study underscores the potential benefits of following the recommended vaccine schedule to reduce HPV and cervical cancer burden in this population.