Age at Sexual Debut as a Determinant of HPV Infection in Women with Clinically Normal Cervix in Indonesia

Abstract

Objective: This study examined the association between sexual debut and HPV infection in Indonesian women with a clinically normal cervix, contextualized within the Sustainable Development Goals (SDGs). Methods: This prospective cohort study utilized primary data from structured interviews and gynecological exams conducted by the Female Cancer Program (FCP) team across public and private health providers in Jakarta (January 2012–July 2018) of clinically normal cervix subjects from VIA test. Cervical cancer-related data were collected including age at sexual debut and HPV DNA results. HPV DNA testing using the HPV Xpress Matrix kit, with genotyping by PCR (SPF10-DEIA-LiPA25). Early sexual debut (≤18 years) was reported in 17.7% of participants. In both univariate and multivariate logistic regression, no examined factors including age group, early sexual debut, smoking history, marital status, contraception use, or menarche were significantly associated with HPV infection. Early sexual debut showed no meaningful association with HPV positivity (adjusted OR 0.981; 95% CI 0.491–1.882; p = 0.908). Conclusion: Early sexual debut was not significantly associated with HPV infection in women with a clinically normal cervix. Nevertheless, integration of HPV prevention, SRH education, and early screening initiatives remains pivotal to achieving SDG 3.7 and 5.6 targets in Indonesia.