Prevalence and determinants of high-risk human papillomavirus (HPV) infection and cervical cytological abnormalities in imprisoned women

Abstract

The aim of the study was to estimate the prevalence and risk factors associated with infection by high-risk human papillomavirus (HR-HPV) in cervix and squamous intra-epithelial lesions (SIL) in imprisoned women. This was done by a cross-sectional study of imprisoned women attending the gynaecological clinic in Foncalent prison in Alicante, Spain. The study period was from May 2003 to December 2005. HR-HPV infection was determined through Digene HPV Test, Hybrid Capture II (HC-II). HPV typing was determined by multiplex nested PCR assay combining degenerate E6/E7 consensus primers. Multiple logistic regression modelling was used for the analysis of associations between variables where some were considered possible confounders after checking for interactions. A total of 219 women were studied. HR-HPV prevalence was 27.4% and prevalence of SIL was 13.3%. HIV prevalence was 18%, higher in Spaniards than in migrant women (24.6% vs. 14.3%, P<0.05). In multivariate analyses, risk factors for HPV infection were younger age (P for trend=0.001) and tobacco use (OR 2.62, 95% CI 1.01-6.73). HPV infection (OR 4.8, 95% CI 1.7-13.8) and HIV infection were associated with SIL (OR 4.8, 95% CI 1.6-14.1). The commonest HPV types were HPV16 (29.4%), HPV18 (17.6%), HPV39 (17.6%) and HPV68 (17.6%). The prevalence of both HR-HPV infection and SIL in imprisoned women found in this study is high. Determinants for each of the outcomes studied were different. HPV infection is the most important determinant for SIL. A strong effect of HIV co-infection on the prevalence of SIL has been detected. Our findings reinforce the need to support gynaecological clinics in the prison setting.

Infección por el Virus del Papiloma Humano en mujeres recluidas en Centros de Readaptación Social en el sureste de México

“…In our report, a prevalence of 20.7% has been observed, similar to the one reported in Brazil (21.1%) but lower than in other studies [10][11][12][13] . It is certain that women infected by the human immunodeficiency virus are more vulnerable to HPV infection and a high prevalence for the later has been reported in this population group 19,20 .…”

“…Few studies have approached the problem of HPV infection among imprisoned women, with a reported prevalence ranging between 20.1% and 46% depending on the population under study [10][11][12][13] . In Mexico, there is no epidemiologic data on HPV among imprisoned women hence; this study intends to describe the epidemiology of the HPV infection in women deprived of freedom in the state of Yucatan, Mexico.…”

Risk factors for cervical cancer among young women

“…Wright showed the presence of HPV in 73.8% of women aged 25 years with cytological results: ASCUS (p=0.002) [25], while Allen in his study found HPV infection in 94.9% of patients with ASCUS [26]. González has shown that HPV infection five-fold increases the risk of intraepithelial neoplasia [27]. A similar association is shown in other studies [28,29].…”

Tabakprävention in Gefängnissen

“…In einer Studie, in der 866 weibliche Insassen über Tabakkonsum befragt wurden, berichteten 12,5% (von den 619 Raucherinnen) über Tabakinduzierte medizinische Probleme (keine genaue Angabe über die Art des Problems) (Cropsey, Eldridge et al 2004). Eine Prävalenz-Studie über chronische Erkrankungen aus den USA zeigt, dass Häftlinge und Gefangene signifikant öfter an Bluthochdruck, Diabetes, Herzinfarkt, Asthma, Arthritis, Gebärmutterhalskrebs und Hepatitis leiden als nicht-institutionalisierte Er-wachsene (Binswanger, Krueger et al 2009 (Gonzalez, Canals et al 2008).…”