Type-specific incidence, persistence and factors associated with human papillomavirus infection among female sex workers in Benin and Mali, West Africa. (May 2021)

• Record Type: Journal Article
• Authors: Tounkara, Fatoumata Korika; Téguété, Ibrahima; Guédou, Fernand A.; Talbot, Denis; Traoré, Cheick B.; Béhanzin, Luc; Traoré, Sidy; Goma-Matsétsé, Ella; Aza-Gnandji, Marlène; Keita, Bintou; Guenoun, Julie; Coutlée, François; Alary, Michel
• Is Part Of: International journal of infectious diseases. Volume 106(2021)
• Page Start: 348
• Page End: 357
• Publication Date: 2021-05
• Subjects: Incidence -- Persistence -- HPV -- Female sex workers -- West Africa; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.04.008
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Studies on the incidence and persistence of high-risk human papillomavirus infection among female sex workers (FSWs) in West Africa are scarce. High incidence and 12-month persistence of HR-HPV infection (38.7%) were found. Better cervical cancer screening is needed in FSWs. There is an urgent need for HPV-specific preventive interventions among new FSWs. Abstract: Objectives: This study in female sex workers (FSWs) aimed to: (1) estimate type-specific incidence and persistence of human papillomavirus (HPV) infection in Cotonou (Benin) and Bamako (Mali); and (2) identify the factors associated with type-specific incidence and persistence of high-risk HPV (HR-HPV) infection. Methods: A 1-year prospective cohort study on cervical cancer screening, and HPV and human immunodeficiency virus (HIV) infections was conducted among FSWs in Cotonou and Bamako from 2017 to 2019. Poisson regression models assessed factors associated with the incidence of HR-HPV infection, while log-binomial regression was performed to identify factors associated with the persistence of HR-HPV infection. Adjusted relative risks (ARR) and 95% confidence intervals (95% CI) were estimated. Results: The incidence of HR-HPV infection was 46.98 per 1000 women-months (predominant types HPV16, HPV35 and HPV59). Factors associated with the incidence of HR-HPV infection were age <20 years (ARR 15.10; 95% CI 3.29–69.19), age at sexual debut <18 years (ARR 6.92; 95% CI 1.97–24.27) and sex work duration ≤1 year (ARR 7.40; 95% CI 1.84–29.69). The persistence of HR-HPV infection at 12 months was 38.7% (most persistent types HPV59, HPV52 and HPV51). Persistence of HR-HPV infection was higher in women with chlamydia ( P = 0.031), HIV infection ( P < 0.001) and multiple-type HPV infections ( P < 0.001). Conclusion: FSWs in West Africa are at high risk of incident and persistent HR-HPV infection, suggesting an urgent need for cervical cancer screening in this population.