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. 2019 Oct;30(12):1169-1176.
doi: 10.1177/0956462419868618. Epub 2019 Sep 27.

Performance of vaginal self-sampling for human papillomavirus testing among women living with HIV in Botswana

Tamara Elliott  1 , Racquel E Kohler  2   3   4 , Barati Monare  1 , Neo Moshashane  1 , Kehumile Ramontshonyana  1 , Charles Muthoga  1 , Adriane Wynn  1   5 , Rebecca Howett  1 , Rebecca Luckett  4   6 , Chelsea Morroni  1   4   7 , Doreen Ramogola-Masire  8
Affiliations

Performance of vaginal self-sampling for human papillomavirus testing among women living with HIV in Botswana

Tamara Elliott et al. Int J STD AIDS. 2019 Oct.

Abstract

Background:: In Botswana, where HIV prevalence remains high, cervical cancer is the leading cause of cancer deaths in women. Multiple organizations recommend high-risk human papillomavirus (hr-HPV) testing as a screening tool, however, high coverage may not be feasible with provider-collected samples. We conducted the first assessment of self- versus provider-collected samples for hr-HPV testing in HIV-positive women in Botswana and report prevalence of hr-HPV and histological outcomes.

Methods:: We recruited HIV-positive women ≥25 years attending an HIV clinic in Gaborone. Self- and provider-collected samples from participants were tested for hr-HPV using Cepheid GeneXpert. Women testing positive for any hr-HPV returned for colposcopy. We used unweighted κ statistics to determine hr-HPV agreement.

Results:: Thirty-one (30%) of 103 women tested positive for any hr-HPV. The most common genotypes were HPV 31/33/35/52/58. Overall agreement between self- and provider-collected samples for any hr-HPV was 92% with a κ of 0.80. Ten of the 30 hr-HPV positive women attending colposcopy had CIN 2+ (33%).

Conclusions:: In this HIV-positive population, hr-HPV prevalence was 30%, with excellent agreement between self and provider samples. Self-sampling may play an important role in screening programs in high HIV burden settings with limited resources like Botswana.

Keywords: Africa; human immunodeficiency virus; human papillomavirus; screening; self-sampling.

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Figures

Figure 1.
Figure 1.
Study management algorithm
Figure 2.
Figure 2.. High-risk HPV genotype prevalence and agreement for paired samples
Notes: excludes three women with invalid results. Agreement for each high-risk HPV subtype calculated using kappa statistic.
See this image and copyright information in PMC

References

    1. Parkin DM, Bray F, Ferlay J, Jemal A. Cancer in Africa 2012. Cancer Epidemiol Biomarkers Prev. 2014. June 1;23(6):953–66. - PubMed
    1. Human Papillomavirus and Related Diseases Report WORLD. 2016;
    1. de Sanjose S, Quint WG, Alemany L, Geraets DT, Klaustermeier JE, Lloveras B, et al. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol. 2010. November;11(11):1048–56. - PubMed
    1. Massad LS, Xie X, Burk R, Keller MJ, Minkoff H, D’Souza G, et al. Long-term cumulative detection of human papillomavirus among HIV seropositive women. AIDS. 2014. November 13;28(17):2601–8. - PMC - PubMed
    1. Massad LS, Seaberg EC, Wright RL, Darragh T, Lee Y-C, Colie C, et al. Squamous Cervical Lesions in Women With Human Immunodeficiency Virus. Obstet Gynecol. 2008. June;111(6):1388–93. - PubMed

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