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

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Mariângela Freitas da Silveira, Romina Buffarini, Pâmela Cristina Gaspar, Hanalydia de Melo Machado, Maria Luiza Bazzo, Aline Scherer, Álvaro Luis Colusso, Ana Gabriela Álvares Travassos, Denise Arakaki-Sanchez, Djane Clarys Baia-da-Silva, Eduardo Campos de Oliveira, Isabella Ribeiro Zago, Marcos de Assis Moura, Marcus Vinicius Guimarães de Lacerda, Simone Murta Martins, Tânia Reuter, Valdir Monteiro Pinto, Waltesia Perini, Gerson Fernando Mendes Pereira, Angélica Espinosa Miranda
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2023
• Subjects: HPV; Screening; HIV; Uterine cervical neoplasms; Cervical intraepithelial neoplasia; HPV-DNA; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/0037-8682-0277-2023; https://doaj.org/article/c92ab33d601e494f87de0605cbc63259

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.