Safaeian M, Kiddugavu M, Gravitt P E, Gange S J, Ssekasanvu J, Murokora D, Sklar M, Serwadda D, Wawer M J, Shah K V, Gray R
Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA.
Sex Transm Infect. 2008 Aug;84(4):306-11. doi: 10.1136/sti.2007.027318. Epub 2008 Apr 2.
To investigate self-administered vaginal swabs for assessing prevalence and correlates of carcinogenic human papillomavirus (HPV) infection in rural Rakai, Uganda.
1003 sexually experienced women enrolled in a community cohort provided self-administered vaginal swabs collected at annual, home-based surveys. Carcinogenic HPV prevalence, adjusted odds ratios (AOR), 95% confidence intervals (CI) and associated risk factors were determined.
Carcinogenic HPV prevalence was 19.2%: 46.6% among HIV positive and 14.8% among HIV negative women (p<0.001). Type-specific prevalence ranged from 2.0% (HPV 16 and 52) to 0.2% (HPV 31). Age-specific HPV prevalence decreased significantly (p<0.001) among HIV negative women; however, the decrease among HIV positive women was not as pronounced (p = 0.1). Factors independently associated with carcinogenic HPV infection were HIV (AOR 4.82, CI 3.10 to 7.53), age (AOR 4.97, 95% CI 2.19 to 11.26 for 15-19 year olds compared to 40+ years), more than two sex partners in the past year (AOR 2.21, CI 1.10 to 4.43) and self-reported herpes zoster, candidiasis or tuberculosis (AOR 4.52, CI 1.01 to 20.31). Married women were less likely to have prevalent carcinogenic HPV (AOR 0.46, CI 0.30 to 0.70).
HPV prevalence and correlates measured using self-administered vaginal swabs were similar to studies that use cervical samples. Thus, self-collection can be used as a substitute for cervical specimens and provide an important tool for research in populations unwilling to undergo pelvic exam.
在乌干达拉凯农村地区，研究自我采集的阴道拭子用于评估致癌性人乳头瘤病毒（HPV）感染的患病率及其相关因素。
1003名参与社区队列研究的有性经历女性，在每年的家庭调查中自行采集阴道拭子。确定致癌性HPV的患病率、调整后的优势比（AOR）、95%置信区间（CI）及相关危险因素。
致癌性HPV患病率为19.2%：HIV阳性女性中为46.6%，HIV阴性女性中为14.8%（p<0.001）。型特异性患病率从2.0%（HPV 16和52）到0.2%（HPV 31）不等。HIV阴性女性中，特定年龄的HPV患病率显著下降（p<0.001）；然而，HIV阳性女性中的下降并不明显（p = 0.1）。与致癌性HPV感染独立相关的因素有HIV（AOR 4.82，CI 3.10至7.53）、年龄（15 - 19岁者与40岁以上者相比，AOR 4.97，95% CI 2.19至11.26）、过去一年中有两个以上性伴侣（AOR 2.21，CI 1.10至4.43）以及自我报告的带状疱疹、念珠菌病或结核病（AOR 4.52，CI 1.01至20.31）。已婚女性患致癌性HPV的可能性较小（AOR 0.46，CI 0.30至0.70）。
使用自我采集的阴道拭子测量的HPV患病率及其相关因素与使用宫颈样本的研究相似。因此，自我采集可作为宫颈样本的替代方法，并为不愿接受盆腔检查的人群提供重要的研究工具。
