The goal of the STRIPE study, Sexually TRansmitted Infections and human Papillomavirus (HPV) Epidemiology, is to use state-of-the-art methods to determine the prevalence, incidence, and natural history of HPV infection in 60 young, high-risk minority women who participated in Project SAFE 2, a 5-year randomized controlled trial (RCT) for the prevention of sexually transmitted infections (STI). These data will be used to design a subsequent large-scale etiology study of cervical cancer, identifying the role of novel cofactors that are likely to influence the persistence of high-risk HPV and thus cancer risk. In Project SAFE 2, 820 low-income Mexican-American and African-American women, aged 14-45, were enrolled into an RCT of a cognitive-behavioral intervention designed to reduce STI. All women had an active non-viral STI at baseline. At annual visits, plus Month 6 and Year 4.5, all women were administered detailed interviews with behavioral and clinical questions, and given targeted physical exams including testing for many STIs. HPV was not tested; however, stored vaginal secretions are available beginning in Year 3. Abbreviated questionnaires and optional physical exams were given at Years 1.5, 2.5, and 3.5. In the STRIPE study, we will perform HPV testing at 6-month intervals during Years 3-5 for 60 women aged <20 years at baseline; 20 women without Chlamydia trachomatis (GT) or Neisseria gonorrhea (NG) infection during follow-up; 20 women infected with CT or NG at Year 3 but not afterwards; and 20 women with recurrent infection episodes during follow-up. Our primary aims are to 1) determine type-specific and variant-specific HPV natural history, including prevalence, incidence, viral load, persistence, and time to clearance; 2) assess the impact of other STIs on HPV infection characteristics (prevalence, incidence, persistence, time to clearance, and viral load); and 3) comprehensively examine the impact of sexual risk behaviors, including condom use and partner characteristics, and HPV infection characteristics.
