Genital Human Papillomavirus Infection in Women

OBJECTIVE: To enhance nurse clinicians' knowledge of genital human papillomavirus infection in women. DATA SOURCES: Several literature searches using the following terms, dating back to 1986: human papillomavirus (HPV), females, human, cervical neoplasia, risk factors, condylomata acuminata, detection, epidemiology, pathology, psychology, Papanicolaou test, immunosuppression, HIV infection, and AIDS. STUDY SELECTIONS: Forty-three formal research studies regarding the association of various types of HPV infection with cervical intraepithelial lesions, the putative precursor lesions for cervical neoplasia; the outcomes of diagnostic techniques for HPV types; the outcomes of diagnostic/screening techniques for abnormal cervical cells; the association of risk factors for acquiring HPV infection; or the outcomes of therapy. Some additional references were chosen for their presentation of epidemiologic or surveillance data, others for their scientific discussions on related topics. DATA EXTRACTION: Data were abstracted according to summary measures of the parameter of interest in the sample studied. In most instances, it was the prevalence of HPV, cervical neoplasia, or frequency of use of screening tests. DATA SYNTHESIS: Immunosuppressed clients are at particular risk for HPV-mediated cervical neoplasia. CONCLUSION: Because Papanicolaou tests are an effective screening tool, cervical cancer is easily detectable. The nurse may facilitate treatment. This is an especially important issue for young women, among whom sexual activity is growing--with attendant increases of HPV and HIV infection.