Change in Human Papillomavirus Prevalence Among U.S. Women Aged 18-59 Years, 2009-2014

Obstet Gynecol. 2017 Oct;130(4):693-701. doi: 10.1097/AOG.0000000000002193.


Objective: To examine changes in prevalence of vaginal human papillomavirus (HPV) between 2009-2010 and 2013-2014 among both vaccinated and unvaccinated U.S. women.

Methods: We evaluated HPV prevalence among women 18-59 years old using cross-sectional survey data from three different cycles of the National Health and Nutrition Examination Survey. Data were stratified into four age groups (18-26, 27-34, 35-44, and 45-49 years) to examine trends over time among women of different ages in the postvaccine era. Multivariable analyses, which controlled for descriptive variables, were used to examine the prevalence of quadrivalent vaccine-type HPV by vaccination status.

Results: We observed a significant decrease in the prevalence of vaccine-type HPV among women 18-59 years of age from 2009-2010 to 2013-2014. This decline was only significant in those 18-26 years old when the sample was stratified into the four age groups. Among vaccinated 18-26 year olds, HPV prevalence remained low from 2009-2010 (3.9%) to 2013-2014 (2.0%; prevalence ratio 0.51, 95% CI 0.18-1.46). Unvaccinated women 18-26 years old also demonstrated a significant decrease over time from 19.5% in 2009-2010 to 9.7% in 2013-2014 (prevalence ratio 0.44, 95% CI 0.22-0.91). Prevalence did not significantly change among unvaccinated women 26 years old or older.

Conclusions: The decline in HPV infections among unvaccinated 18- to 26-year-old women suggests that young women in the United States are beginning to benefit from herd immunity resulting from the introduction of the HPV vaccine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Immunity, Herd
  • Middle Aged
  • Nutrition Surveys
  • Papillomaviridae*
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / prevention & control
  • Papillomavirus Infections / virology
  • Papillomavirus Vaccines / therapeutic use
  • Prevalence
  • United States / epidemiology
  • Vaccination / statistics & numerical data
  • Vagina / virology
  • Young Adult


  • Papillomavirus Vaccines