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. 2023 Oct 9:56:e02772023.
doi: 10.1590/0037-8682-0277-2023. eCollection 2023.

Detection of HPV DNA in vaginal samples self-collected by women living with HIV treated through the Brazilian public health system: Prevalence and analysis of risk factors

Mariângela Freitas da Silveira  1 , Romina Buffarini  2 , Pâmela Cristina Gaspar  3   4 , Hanalydia de Melo Machado  5 , Maria Luiza Bazzo  5 , Aline Scherer  6 , Álvaro Luis Colusso  7 , Ana Gabriela Álvares Travassos  8 , Denise Arakaki-Sanchez  7 , Djane Clarys Baia-da-Silva  9 , Eduardo Campos de Oliveira  10 , Isabella Ribeiro Zago  11 , Marcos de Assis Moura  12 , Marcus Vinicius Guimarães de Lacerda  9 , Simone Murta Martins  8 , Tânia Reuter  13 , Valdir Monteiro Pinto  14 , Waltesia Perini  13 , Gerson Fernando Mendes Pereira  3 , Angélica Espinosa Miranda  3   15
Affiliations

Detection of HPV DNA in vaginal samples self-collected by women living with HIV treated through the Brazilian public health system: Prevalence and analysis of risk factors

Mariângela Freitas da Silveira et al. Rev Soc Bras Med Trop. .

Abstract

Background: Women living with human immunodeficiency virus (HIV) (WLWH) are more likely to be infected with the oncogenic human papillomavirus (HPV). We assessed the prevalence of high-risk (HR) (16/18/31/33/35/39/45/51/52/56/58/59/68/73/82), probable high-risk (pHR) (26/53/66), and low-risk (LR) (6/11/40/42/43/44/54/61/70) HPV types and their associated risk factors.

Methods: This cross-sectional study of WLWH aged 18-64 years included one laboratory and eight HIV-specialty healthcare facilities in the pilot network. Descriptive statistics were used to assess sociodemographic and behavioral characteristics. Adjusted analyses were conducted to evaluate risk factors associated with HR and/or pHR HPV infection in WLWH.

Results: From May/2021 to May/2022, 1,914 (92.5%) WLWH participated in the pilot study and had valid HPV-DNA results of self-collected vaginal samples. The median age of the participants was 45 years, 60.1% had ≥ 9 years of schooling, 80.5% were ≤ 18 years at first sexual intercourse, and 51.7% had > 4 sexual partners throughout life. The prevalence of any HPV type, HR HPV, pHR HPV, and LR HPV was 65.8%, 49.6%, 16.7%, and 40.0%, respectively. Age was inversely associated with pHR and/or HR-HPV (p < 0.001), and education level was inversely associated with HR-HPV (p = 0.003) types. Any HR or pHR was associated with being single (p = 0.029) and exchanging sex for drugs (p = 0.037).

Conclusions: The prevalence of HPV, especially HR HPV, among WLWH is high in Brazil, highlighting the need for HPV screening in this population. Self-collection of vaginal samples is an important strategy for increasing testing access.

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Conflict of interest statement

Conflict of Interest: The authors declare no conflict of interest.

Figures

FIGURE 1:
FIGURE 1:. Probable high-risk and high-risk HPV types found in women with valid HPV DNA testing (n = 1,914).
See this image and copyright information in PMC

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