Spousal migration and human papillomavirus infection among women in rural western Nepal

Abstract

Background: In April 2014 we investigated the association of migration of a woman's husband with her high-risk human papillomavirus (HR-HPV) infection status and her abnormal cervical cytology status in the Achham district of rural Far-Western Nepal.

Methods: Women were surveyed and screened for HR-HPV during a health camp conducted by the Nepal Fertility Care Center. Univariate and multivariable statistical tests were performed to determine the association of a husband's migration status with HR-HPV infection and cervical cytology status.

Results: In 265 women, the prevalence of HR-HPV was 7.5% (20/265), while the prevalence of abnormal cervical cytology, defined using the Bethesda system as atypical glandular cells of undetermined significance or worse, was 7.6% (19/251). Half of the study participants (50.8%, 130/256) had husbands who had reported migrating for work at least once. Women aged ≤34 years were significantly less likely to test positive for HR-HPV than women aged >34 years (OR 0.22, 95% CI 0.07 to 0.71). HR-HPV infection and abnormal cervical cytology status were not directly associated with a husband's migration.

Conclusion: Older women were found to have a higher prevalence of HPV than younger women. It is possible that a husband's migration for work could be delaying HR-HPV infections in married women until an older age.

Keywords: Cervical cancer; HPV; Migration; Nepal.

Figure 1.

Study design flow chart illustrating the selection procedure and sample size of women attending a one-day reproductive health camp in Achham, Nepal. HR-HPV: high-risk human papillomavirus. ^a Women were eligible for the study if they were married, between the ages of 16 and 60, had a cervix, were not menstruating, and were not pregnant.