Universidade Federal de Pelotas, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brasil.
Universidade Federal de Pelotas, Departamento de Medicina Social, Programa de Pós-Graduação em Epidemiologia, Pelotas, RS, Brasil.
Rev Soc Bras Med Trop. 2023 Oct 9;56:e02772023. doi: 10.1590/0037-8682-0277-2023. eCollection 2023.
Women living with human immunodeficiency virus (HIV) (WLWH) are more likely to be infected with the oncogenic human papillomavirus (HPV). We assessed the prevalence of high-risk (HR) (16/18/31/33/35/39/45/51/52/56/58/59/68/73/82), probable high-risk (pHR) (26/53/66), and low-risk (LR) (6/11/40/42/43/44/54/61/70) HPV types and their associated risk factors.
This cross-sectional study of WLWH aged 18-64 years included one laboratory and eight HIV-specialty healthcare facilities in the pilot network. Descriptive statistics were used to assess sociodemographic and behavioral characteristics. Adjusted analyses were conducted to evaluate risk factors associated with HR and/or pHR HPV infection in WLWH.
From May/2021 to May/2022, 1,914 (92.5%) WLWH participated in the pilot study and had valid HPV-DNA results of self-collected vaginal samples. The median age of the participants was 45 years, 60.1% had ≥ 9 years of schooling, 80.5% were ≤ 18 years at first sexual intercourse, and 51.7% had > 4 sexual partners throughout life. The prevalence of any HPV type, HR HPV, pHR HPV, and LR HPV was 65.8%, 49.6%, 16.7%, and 40.0%, respectively. Age was inversely associated with pHR and/or HR-HPV (p < 0.001), and education level was inversely associated with HR-HPV (p = 0.003) types. Any HR or pHR was associated with being single (p = 0.029) and exchanging sex for drugs (p = 0.037).
The prevalence of HPV, especially HR HPV, among WLWH is high in Brazil, highlighting the need for HPV screening in this population. Self-collection of vaginal samples is an important strategy for increasing testing access.
感染人类免疫缺陷病毒（HIV）的女性（WLWH）更有可能感染致癌性人乳头瘤病毒（HPV）。我们评估了高危型（HR）（16/18/31/33/35/39/45/51/52/56/58/59/68/73/82）、可能高危型（pHR）（26/53/66）和低危型（LR）（6/11/40/42/43/44/54/61/70）HPV 类型的流行率及其相关危险因素。
本项横断面研究纳入了年龄在 18-64 岁之间的 WLWH，共包括试点网络中的一个实验室和八个 HIV 专科医疗设施。采用描述性统计评估社会人口统计学和行为特征。对调整后的分析进行了评估，以评估与 HR 和/或 pHR HPV 感染相关的危险因素。
2021 年 5 月至 2022 年 5 月，共有 1914 名（92.5%）WLWH 参与了试点研究，并对其自行采集的阴道样本进行了有效的 HPV-DNA 检测。参与者的中位年龄为 45 岁，60.1%完成了至少 9 年的学业，80.5%初次性行为发生在 18 岁以下，51.7%的人一生中发生过超过 4 个性伴侣。任何 HPV 类型、HR HPV、pHR HPV 和 LR HPV 的流行率分别为 65.8%、49.6%、16.7%和 40.0%。年龄与 pHR 和/或 HR-HPV 呈负相关（p<0.001），教育水平与 HR-HPV 呈负相关（p=0.003）。任何 HR 或 pHR 均与单身（p=0.029）和性换毒品（p=0.037）有关。
巴西 WLWH 中 HPV，尤其是 HR HPV 的流行率较高，突出了对该人群进行 HPV 筛查的必要性。阴道样本的自我采集是增加检测机会的重要策略。
