Introduction: To examine anal and cervical high-risk HPV (hr-HPV) infections among women having sex with women, and women having sex with men and women.

Methods: We conducted a cross-sectional study of women ages 18-70 in treatment at the largest substance use disorders center in North Texas who participated in a cancer prevention program providing well woman exams. Demographics, past trauma, sexual practices, and risky behaviors were collected using self-administered questionnaires. Chi-square tests and logistic regression controlling for age (AOR) were used to compare hr-HPV infection prevalence rates by sexual minority status.

Results: A total of 757 women with histories of trauma were included in this study; 84% were smokers, 53% self-reported previous incarceration and 25% traded sex for drugs. Nearly one-quarter reported having oral, vaginal, or anal sex with women only, or with men and women. Among this sexual minority group, 40% tested positive for anal hr-HPV vs 34% of heterosexual women (P=.18). Cervical hr-HPV was present in 31% of sexual minority women and 27% of heterosexual women (P=.20). Sexual minority status was not significantly associated with anal hr-HPV (AOR 1.23 95% CI .85-1.77) or cervical hr-HPV (AOR 1.09 95% CI .76-1.55) compared to heterosexual women. Cervical hr-HPV was significantly associated with anal hr-HPV among both groups (P<.01). Nearly 20% of sexual minority women tested positive for both anal and cervical hr-HPV.

Conclusion/Implications: These findings inform providers about HPV infections among sexual minority women, and the appropriateness of anal pap and HPV co-testing exams in this population.