Critical Studies in Sexualities and Reproduction, Rhodes University, Makhanda, South Africa.
Department of Sociology, Rhodes University, Makhanda, South Africa.
Womens Health (Lond). 2021 Jan-Dec;17:17455065211058349. doi: 10.1177/17455065211058349.
Women who sell sex have a high prevalence of human papilloma virus, which may cause cervical cancer. The objective of this review was to collate findings on prevalence, associated factors, screening, service provision and utilization of services in relation to human papilloma virus and cervical cancer among women who sell sex in Eastern and Southern Africa.
A scoping review methodology was employed. Inclusion criteria were as follows: (1) empirical papers, (2) of studies conducted in Eastern and Southern Africa, (3) published in the last 10 years, and (4) addressing women who sell sex in relation to (5) human papilloma virus and cervical cancer. A thorough search of a range of databases surfaced 66 papers. Both authors applied inclusion and exclusion criteria, resulting in 14 papers being reviewed.
The reported prevalence of high-risk human papillomavirus virus varied between 23.6% and 70.5%. HIV sero-positivity, other sexually transmitted infections and Epstein-Barr virus were associated with human papilloma virus and high-grade cervical lesions. High-risk human papilloma virus was associated with women who reported younger age at first intercourse, non-barrier contraceptive use, and no history of condom use. For screening, there was overall agreement between physician- and self-collected samples. Contradictory results were found for visual inspection with acetic acid. Screening services utilization was associated with provider's recommendation, history of sexually transmitted infections, frequency of facility visit and history of vaginal examination. A diagonal programme led to an increase in screening, attributed to the targeted services.
Context is important in planning cervical cancer services. There is a need for enhanced sexually transmitted infections and viral management within cervical cancer prevention. Women who sell sex should be empowered in self-collection of stored-dry specimens, especially in resource-constrained regions. Cervical cancer screening services should be honed to the needs of women who sell sex.
性工作者人乳头瘤病毒感染率较高，而该病毒可能导致宫颈癌。本综述的目的是整理关于性工作者人乳头瘤病毒和宫颈癌的流行率、相关因素、筛查、服务提供和利用方面的发现，这些发现来自于东非和南非。
采用范围界定综述方法。纳入标准如下：(1) 实证论文；(2) 在东非和南非开展的研究；(3) 发表于过去 10 年；(4) 针对性工作者；(5) 涉及人乳头瘤病毒和宫颈癌。对一系列数据库进行全面搜索，共出现 66 篇论文。两位作者均应用纳入和排除标准，最终有 14 篇论文被纳入综述。
高危型人乳头瘤病毒的报告流行率在 23.6%至 70.5%之间。艾滋病毒血清阳性、其他性传播感染和爱泼斯坦-巴尔病毒与人乳头瘤病毒和高级别宫颈病变有关。人乳头瘤病毒与报告初次性交年龄较小、非屏障避孕措施和无避孕套使用史的女性有关。在筛查方面，医生和自我采集样本之间总体上具有一致性。醋酸视觉检查的结果存在矛盾。筛查服务的利用与提供者的推荐、性传播感染史、就诊频率和阴道检查史有关。对角线方案导致筛查增加，这归因于有针对性的服务。
规划宫颈癌服务时，背景很重要。在宫颈癌预防中，需要加强性传播感染和病毒管理。应增强性工作者自我采集储存干燥样本的能力，特别是在资源有限的地区。应根据性工作者的需求调整宫颈癌筛查服务。
