Pathology

A healthy 30-year-old woman comes to the physician for a routine health maintenance examination. No abnormalities are found on physical examination. A screening Pap smear shows cells consistent with a low-grade squamous intraepithelial lesion (LSIL). Subsequent cervical biopsy specimens confirm the presence of cervical intraepithelial neoplasia (CIN) I. Which of the following risk factors is most likely related to her Pap smear findings?