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To the Editor: In their study on the prevalence of human papillomavirus (HPV) infection among American females, Dr Dunne and colleagues¹ provided data that generate questions concerning how HPV is spread. Among the women in the study, 5.2% who reported that they never had sex tested positive for a presumably sexually transmitted disease. The authors' conclusion was that the women in the study were inaccurate in their answers. They also theorized that nonpenetrative contact could explain this finding.

The authors did not discuss other possible modes of HPV transmission. HPV can be spread vertically from mother to child.² It has been previously reported in women who have not been sexually active.³ When the data do not fit currently held beliefs, the data can be questioned, but so should those beliefs.

Financial Disclosures: None reported.

Tyler Cymet, DO
tcymet@lifebridgehealth.org
Department of Internal Medicine
Johns Hopkins School of Medicine
Baltimore, Maryland

1. Dunne EF, Unger ER, Sternberg M, et al. Prevalence of HPV infection among females in the United States. JAMA. 2007;297(8):813-819. FREE FULL TEXT 2. Sinclair KA, Woods CR, Kirse DJ, Sinal SH. Anogenital and respiratory tract human papillomavirus infections among children: age, gender, and potential transmission through sexual abuse. Pediatrics. 2005;116(4):815-825. FREE FULL TEXT 3. Pao CC, Tsai PL, Chang YL, Hsieh TT, Jin JY. Possible non-sexual transmission of genital human papillomavirus infections in young women. Eur J Clin Microbiol Infect Dis. 1993;12(3):221-222. FULL TEXT | ISI | PUBMED

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;298:38.

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