Background Cervical cancer prevention strategies recommend human papilloma virus (HPV) vaccination for female adolescents prior to their sexual debut. While HIV is a major risk factor for HPV infection in women of childbearing age, its prevalence among HIV-infected adolescent female is mostly unknown. This study aimed to describe the HPV prevalence and correlates among perinatally HIV-infected adolescent females prior to HPV immunisation.
Methods A cross-sectional survey was conducted from January to June 2016, in the four major paediatric HIV clinics of Abidjan, Côte d’Ivoire. All HIV-infected females aged 11–16 years were approached to participate in the study. A questionnaire assessing sexual behaviours and genital hygiene practices was administered to participants completed with a systematic vaginal swab collection. HPV genotyping was performed using the Anyplex II HPV28 Detection (Seegene). A logistic regression analysis was performed to identify factors associated with the presence of HPV infection. HPV immunisation was proposed free of charge to all participants.
Results A total of 250 participants were included, with a median age of 13 years (IQR 11–14). Among them, 237 (94.8%) were on antiretroviral treatment with a median CD4 count of 660 (IQR 439–914) cells/mm3. The overall prevalence of at least one HPV was 3.6% (95% CI 1.6 to 6.7) and the prevalence of at least one carcinogenic HPV was 2.8% (95% CI 0.7 to 4.8). Vaginal cleansing was reported by 75 (30%) of participants, with a median age at initiation of 12 years (IQR 10–13). Sexual activity was self-reported by 12 (4.8%) participants with a median age at sexual debut of 11 years (IQR 10–14). HPV infection was associated with vaginal cleansing (adjusted OR=7.0 (95% CI 1.4 to 31.6)).
Conclusion The reported low prevalence of carcinogenic HPV infections supports the appropriateness of HPV immunisation in this population. The reported association between cleansing practices and HPV infection deserves further prospective longitudinal studies.
- modes of transmission
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Handling editor Bea Vuylsteke
Contributors AJ, BT and AH designed the study. BT, SB, AH, DE, AT, MAF, VL, IG, FD and AJ supervised the study implementation and data collection. Statistical analysis was performed by BT, SB and AJ. Data interpretation and first draft of manuscript was done by BT, SB, IG, AH and AJ. Critical revision of the manuscript for important intellectual content was provided by all the coauthors who read and commented on the original manuscript and all agreed on the version finalised by BT, SB and AJ for submission.
Funding The study was conducted under the IeDEA West Africa collaboration grants funded by the National Cancer Institute (NCI); Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD); National Institute of Allergy and Infectious Diseases (NIAID); Grant number: 5U01AI069919.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The protocol of this study was approved by the ministry of health in Cote d’Ivoire, through the Comité Nationald’Ethique des Sciences de la Vie et de la Santé (CNESVS) n°067/MSLS/CNER-dkn.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in a public, open access repository. All files used in the present analysis will be made available after acceptance of the manuscript at the following URL: https://figshare.com/s/aa30384566ff726358ba. The authors may be contacted at firstname.lastname@example.org and email@example.com.
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