Systematic Review and Meta-Analysis of Human Papillomavirus Prevalence and Genotypic Disparities Among Human Immunodeficiency Virus-Positive Women in Africa.

: Human papillomavirus (HPV) is the most prevalent sexually transmitted infection with significant health implications, especially for women living with human immunodeficiency virus (HIV). The variability in reported prevalence and genotype distribution of HPV among HIV-positive women across different regions in Africa necessitates a comprehensive and systemic examination. : A systematic search was conducted across several databases. A random effect model was used to evaluate study heterogeneity through Q statistics and I measures. Publication bias was assessed using funnel plots and Egger's tests. Risk factors for HPV among HIV-positive women were summarized qualitatively. This review was registered with PROSPERO: CRD42024525123. : Twenty-three studies involving 9954 HIV-positive women were combined to estimate HPV prevalence. The overall prevalence of all HPV types was 49.4% (95% CI: 42.43, 56.38), with evidence of heterogeneity (Q = 520.92, df = 16, I = 96.93%, < 0.0001). The prevalence of high-risk HPV was 45.26% (95% CI: 31.02, 59.91), showing heterogeneity across studies (Q = 439.18, df = 10, < 0.0001, I = 97.72%). Low-risk HPV had a prevalence of 24.98% (95% CI: 12.27, 40.41), with variation among studies (Q = 134.39, df = 6, < 0.0001, I = 95.54%). The most frequent genotypes were 16, 18, 52, 33, and 35. A higher cluster of differentiation 4 (CD4) count is associated with a lower prevalence of HPV. : The pooled HPV prevalence among HIV-positive women in Africa is lower compared to previous studies, but the slow decline poses challenges to meet the WHO's goal of eliminating HPV-related cervical cancer by 2030. Therefore, enhanced prevention efforts, including HPV self-sampling, improved vaccination coverage, and early treatment interventions, are essential to meet the goal of eliminating HPV-related cervical cancer.