HPV prevalence around the time of sexual debut in adolescent girls in Tanzania

Abstract

ObjectivesCervical cancer is the leading cause of cancer-related mortality among women in sub-Saharan Africa (SSA). Data on human papillomavirus (HPV) epidemiology in adolescent girls in SSA are essential to inform HPV vaccine policy recommendations for cervical cancer prevention. We assessed the burden of HPV infection, and risk factors for infection, among adolescent girls around the time of sexual debut.MethodsCross-sectional study of secondary school girls aged 17–18 years in Tanzania. Consenting participants provided samples for HPV and STI testing. Vaginal swabs were tested for 37 HPV genotypes by Roche Linear Array. Logistic regression was used to identify factors associated with HPV infection. Y chromosome was tested as a marker of recent condomless sex.Results163/385 girls (42.3%) reported previous penetrative sex. HPV was detected in 125/385 (32.5%) girls, including 84/163 (51.5%) girls reporting previous sex and 41/222 (18.5%) reporting no previous sex. High-risk (HR) genotypes were detected in 70/125 (56.0%) girls with HPV infection. The most common HR genotype was HPV-16 (15/385; 3.9%). The prevalence of other HR HPV vaccine genotypes was between 0.8% and 3.1%. Among 186 girls who reported no previous sex, were negative for Y chromosome, and had no STI, 32 (17%) had detectable HPV. Lactobacillus sp and bacterial vaginosis-associated bacteria were negatively and positively associated, respectively, with HPV.ConclusionsHPV prevalence among adolescent girls around the time of sexual debut was high. However, prevalence of most vaccine genotypes was low, indicating that extending the age range of HPV vaccination in this region may be cost-effective.

Prevalence and genotype specific concordance of oro-genital and anal human papillomavirus infections among sexually active Nigerian women

“…Previous studies in Nigeria had also reported HPV35 and 42 as the most prevalent for cervical HPV infection [9,11]. Studies in women in South Africa, Zimbabwe and Tanzania found HPV 16 as the most prevalent HR-HPV in the cervix, oral and anal cavities [20,21,[30][31][32]. The prevalence of HPV-16 and -18, which are associated with 70% of HPVassociated cancers was relatively low in this study [33].…”

Prevalence of vaginal HPV infection among adolescent and early adult girls in Jos, North-Central Nigeria

“…Globally, the overall prevalence of HPV infection varies according to geographical regions. Our finding is lower than the 24.5% finding among adolescent girls age 14–19 years in the USA before the introduction of HPV vaccination [ 21 ], 66.7% among girls aged 16–22 years in South Africa and 32.5% among 17–18 year old girls in Tanzania [ 22 , 23 ]. These differences may be due to differences in the type of test used for the HPV detection, the age ranges, prevalence of HIV and sexual history of the participants.…”

Uptake of and factors associated with testing for sexually transmitted infections in community-based settings among youth in Zimbabwe: a mixed-methods study

“…We used a hierarchical conceptual approach with three levels: (1) sociodemographic, (2) behavioural, and (3) other more proximal factors ( appendix p 1 ). 9 , 10 Age and sex were considered a priori confounders for each model. For level 1, all age-adjusted and sex-adjusted sociodemographic factors that met a p value cutoff of less than 0·10 were included in the multivariate model for level 1.…”