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Meta-Analysis
. 2020 Sep 25;20(1):1455.
doi: 10.1186/s12889-020-09570-z.

Prevalence and genotype distribution of genital human papillomavirus infection in female sex workers in the world: a systematic review and meta-analysis

Mohammad Farahmand  1 , Mohsen Moghoofei  2 , Abolfazl Dorost  3 , Saeedeh Abbasi  4 , Seyed Hamidreza Monavari  4 , Seyed Jalal Kiani  4 , Ahmad Tavakoli  5   6
Affiliations
Meta-Analysis

Prevalence and genotype distribution of genital human papillomavirus infection in female sex workers in the world: a systematic review and meta-analysis

Mohammad Farahmand et al. BMC Public Health. .

Abstract

Background: Female sex workers (FSWs) are amongst the most susceptible groups to acquire human papillomavirus (HPV) infection and consequently, to develop cervical intraepithelial neoplasia and cervical cancer. This is the first systematic review and meta-analysis to provide estimates of the pooled prevalence of HPV infection and the distribution of HPV types among FSWs across the world.

Methods: Five computerized databases were searched for relevant studies published since the inception date of databases to September 2019. The pooled HPV prevalence was calculated by the random effect model described by DerSimonian-Laird. Subgroup analysis was performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the "Metaprop" function in the R package Meta.

Results: Sixty-two studies involving 21,402 FSWs from 33 countries were included in this meta-analysis, and the pooled HPV prevalence was 42.6% (95% confidence interval (CI): 38.5-46.7%). HPV-16 (10.1, 95% CI: 8.2-12.5%), HPV-52 (7.9, 95% CI: 5.9-10.7%), and HPV-53 (6.0, 95% CI: 4.4-8.1%) were the most common high-risk HPV types identified among FSWs. The pooled estimated prevalence of HPV infection among FSWs before and after 2010 were slightly different, 43.6% (95% CI: 36.1-51.4%) and 41.9% (95% CI: 37.2-46.8%), respectively.

Conclusion: Due to the high prevalence of HPV infection, particularly with high-risk types, FSWs have a great susceptibility to the development of cervical and vaginal cancers. Furthermore, they can transmit their infection to their clients, which may result in a high prevalence of HPV and the incidence of HPV-associated malignancies among the general population.

Keywords: Epidemiology; Female sex workers; HPV; Human papillomavirus; Meta-analysis; Prostitution.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart presenting the steps of literature search and selection
Fig. 2
Fig. 2
Forest plot of the prevalence of HPV infection in FSWs, stratified by study year (before and after 2010)
Fig. 3
Fig. 3
The global maps are presenting the geographical variations in the prevalence of HPV infection in FSWs. Colors indicate the level of prevalence of HPV infection per country
Fig. 4
Fig. 4
Prevalence and genotype distribution of genital HPV (high-risk and low-risk) among FSWs
See this image and copyright information in PMC

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