Nekemte public health research and referral laboratory, Oromia regional health bureau, Nekemte, Ethiopia.
Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
BMC Womens Health. 2024 Jul 25;24(1):423. doi: 10.1186/s12905-024-03249-y.
Human Papillomavirus infection (HPV) is among the most common sexually transmitted infections with the highest incidence and prevalence worldwide. HPV has been established as the main cause of cervical cancer and remains a public health problem globally. In Western Oromia, Ethiopia cervical screening remains a major issue because of limited resources, and shortage of HPV testing technology. As a result, the prevalence of HPV and associated factors remain unknown among HIV-positive women. This study aimed to assess the prevalence of HPV and associated factors among women living with HIV attending Antiretroviral Therapy (ART) services in public health facilities of East Wollega and West Showa Zones, Ethiopia, 2022.
Using a cross-sectional study design, a total of 415 women ≥ 18 years old were enrolled using systematic random sampling from five public health facilities. Cervical specimens were collected by a trained nurse from April 01 2022, to May 30 2022, and tested at Nekemte Public Health Research and Referral Molecular Biology, a certified/accredited laboratory for HPV-DNA Polymerase Chain Reaction by expertise using Abbott m2000rt-PCR assays. Finally, Epi data version 4.6 was used for data entry and SPSS version 24.0 were used for data cleaning and analysis, and frequencies and prevalence of HPV were computed. Variables were identified using the multivariable model and statistically significant associations of variables were determined based on the adjusted odds ratio (AOR) with its 95% CI and P-value < 0.05 to determine the strength of association.
The prevalence of HPV was 30.4% [95% CI: 26.0, 34.9]. Of HPV-infected women, 11.9% were positive for HPV-16, 9.5% for HPV-18, and 65.9% were positive for other hr-HPV . The odds of HPV infection among women aged beyond 48 years are 2.85 times the odds of HPV among people who were aged 18-27(AOR = 2.85, 95% CI: 1.16, 5.58). The odds of HPV infection among women who had three or more sexual partners is 4.12 times the odds of HPV infection among women with a single sexual partner(AOR = 4.12, 95% CI: 2.34-8.62). The odds of HPV infection among women who didn't use condom during sexual intercourse are 4.73 times the odds of HPV among women who used condom during sexual intercourse. (AOR = 4.73, 95% CI: 1.98-9.33). The odds of HPV infection among women who had history of is 4.52 times the odds of HPV infection among women with no history of abortion. [AOR = 4.52, 95% CI: 2.04, 6.89] The odds of HPV infection among women with history of Sexually Transmitted Infection (STI) 3.62 times the odds of HPV among women with no history of STI (AOR = 3.62, 95%CI: 1.75, 5.83). The odd of HPV among women with abnormal vaginal discharge is 3.31 times the odds of the disease among women with normal vaginal discharge [AOR = 3.31, 95% CI: 2.87,7.35).
The prevalence of HPV infection among HIV-infected women was high in the study area. Given the above-associated factors, we recommend that the stakeholders integrate HPV prevention strategies into HIV /AIDS services. Furthermore, the study has provided essential information about the HIV link with hr-HPV infections, which may explain the high prevalence among HIV-infected women. This can contribute to policy development and planning of prevention strategies incorporating HPV infection prevention especially among youth and HIV-infected people.
人乳头瘤病毒（HPV）感染是全球最常见的性传播感染之一，发病率和流行率最高。HPV 已被确定为宫颈癌的主要病因，仍然是全球公共卫生问题。在埃塞俄比亚的西奥罗米亚，由于资源有限和 HPV 检测技术短缺，宫颈筛查仍然是一个主要问题。因此，HIV 阳性妇女中 HPV 的流行情况及其相关因素仍不清楚。本研究旨在评估东沃莱加和西绍瓦地区公立卫生设施中接受抗逆转录病毒治疗（ART）服务的 HIV 阳性妇女中 HPV 的流行情况及其相关因素，时间为 2022 年 4 月 1 日至 5 月 30 日。
采用横断面研究设计，从五家公立卫生设施中采用系统随机抽样的方法，共纳入 415 名年龄≥18 岁的妇女。由经过培训的护士采集宫颈标本，使用雅培 m2000rt-PCR 检测试剂盒在 Nekemte 公共卫生研究和转诊分子生物学实验室进行检测。最后，使用 Epi data 版本 4.6 进行数据录入，使用 SPSS 版本 24.0 进行数据清理和分析，计算 HPV 的频率和流行率。使用多变量模型识别变量，并根据调整后的优势比（AOR）及其 95%置信区间和 P 值<0.05 确定变量的统计学显著关联，以确定关联的强度。
HPV 的流行率为 30.4%[95%CI：26.0，34.9]。在 HPV 感染的妇女中，11.9%的人 HPV-16 阳性，9.5%的人 HPV-18 阳性，65.9%的人其他高危型 HPV 阳性。年龄超过 48 岁的妇女感染 HPV 的几率是年龄在 18-27 岁的妇女的 2.85 倍（AOR=2.85，95%CI：1.16，5.58）。有三个或更多性伴侣的妇女感染 HPV 的几率是单一性伴侣妇女的 4.12 倍（AOR=4.12，95%CI：2.34-8.62）。在性行为中不使用安全套的妇女感染 HPV 的几率是使用安全套的妇女的 4.73 倍（AOR=4.73，95%CI：1.98-9.33）。有流产史的妇女感染 HPV 的几率是没有流产史的妇女的 4.52 倍（AOR=4.52，95%CI：2.04，6.89）。有性传播感染（STI）史的妇女感染 HPV 的几率是没有 STI 史的妇女的 3.62 倍（AOR=3.62，95%CI：1.75，5.83）。有异常阴道分泌物的妇女感染 HPV 的几率是阴道分泌物正常的妇女的 3.31 倍（AOR=3.31，95%CI：2.87，7.35）。
在研究地区，HIV 阳性妇女中 HPV 感染的流行率很高。鉴于上述相关因素，我们建议利益相关者将 HPV 预防策略纳入 HIV/AIDS 服务中。此外，本研究提供了有关 HIV 与高危型 HPV 感染之间联系的重要信息，这可能解释了 HIV 阳性妇女中 HPV 感染的高流行率。这有助于制定政策和规划预防策略，特别是针对年轻人和 HIV 感染者的 HPV 感染预防。
