The clinical triad of a firstborn delivered vaginally to a young (teenage) mother has been previously noted among juvenile onset recurrent respiratory papillomatosis (JO-RRP) patients. This study was based on a questionnaire survey of JO-RRP patients, adult onset recurrent respiratory papillomatosis (AO-RRP) patients, and juvenile and adult controls. The survey results revealed that the complete or partial triad was observed in 72% of JO-RRP patients, 36% of AO-RRP patients, 29% of juvenile controls, and 38% of adult controls. As compared with juvenile controls, JO-RRP patients were more often firstborn (P less than .05), delivered vaginally (P less than .05), and born to a teenage mother (P less than .01). Among adult participants, AO-RRP patients reported more lifetime sex partners (P less than .01) and a higher frequency of oral sex (P less than .05) than reported by adult controls. AO-RRP and JO-RRP appear to have distinguishable epidemiologic features indicating that the mode of human papillomavirus (HPV) transmission is different in these two disorders.