Prevalence of Human Papillomavirus in Adolescent Girls Before Reported Sexual Debut

Houlihan, Catherine; Sanjosé, Sílvia de; Baisley, Kathy; Changalucha, John; Ross, David A.; Kapiga, Saidi; Godinez, J.M.; Božičević, Ivana; Hayes, Richard; Watson-Jones, Deborah

doi:10.1093/infdis/jiu202

Cited by 21 publications

(29 citation statements)

References 47 publications

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“… 11 Girls were enrolled between January and August 2012, and followed 3-monthly for 18 months. At each visit, girls had a face-to-face interview in Swahili with a female study nurse using a structured paper questionnaire, 11 and one nurse-assisted, self-administered vaginal Dacron swab was obtained, irrespective of reported sex. Girls who reported previous sex were offered a pregnancy test and asked about symptoms of reproductive tract infections at every visit.…”

Section: Methodsmentioning

confidence: 99%

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Rapid acquisition of HPV around the time of sexual debut in adolescent girls in Tanzania

et al. 2016

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Background: No reports exist on genotype-specific human papillomavirus (HPV) acquisition in girls after first sex in sub-Saharan Africa, despite high HPV prevalence and cervical cancer incidence. Methods: We followed 503 HP-unvaccinated girls aged 15-16 years in Mwanza, Tanzania, 3-monthly for 18 months with interviews and self-administered vaginal swabs. Swabs were tested for 13 higHRisk and 24 low-risk HPV genotypes. Incidence, clearance and duration of overall HPV and genotype-specific infections were calculated and associated factors evaluated. Results : A total of 106 participants reported first sex prior to enrolment ( N = 29) or during follow-up (N = 77). One was HIV-positive at the final visit. The remaining 105 girls contributed 323 adequate specimens. Incidence of any new HPV genotype was 225/100 person-years (pys), and incidence of vaccine types HPV-6, -11, -16 and -18 were 12, 2, 2 and 7/100 pys, respectively. Reporting sex in the past 3 months and knowing the most recent sexual partner for a longer period before sex were associated with HPV acquisition. Median time from reported sexual debut to first HPVinfection was 5 months, and infection duration was 6 months. Conclusion: This is the first description of HPV acquisition after first sex in sub-Saharan Africa where the incidence of cervical cancer is amongst the highest in the world. HPV incidence was very high after first sex, including some vaccine genotypes, and infection duration was short. This very high HPV incidence may help explain high cervical cancer rates, and supports recommendations that the HPV vaccine should be given to girls before first sex.

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Section: Methodsmentioning

confidence: 99%

“… 1 Methods for DNA extraction, amplification and genotype detection were described previously. 11 Specimens negative for β-globin amplification were excluded, since vaginal sampling was assumed to be unsuccessful. …”

Section: Methodsmentioning

confidence: 99%

Rapid acquisition of HPV around the time of sexual debut in adolescent girls in Tanzania

et al. 2016

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“…These routes likely account for a very small proportion of acquisition. In a cohort of schoolgirls resident in Tanzania, who reported not having passed sexual debut, HR-HPV genotypes were detected in 5.3% of self-administered vaginal swabs [81]. An underreporting of sexual activity may account for this finding, as may the practice of intra-vaginal cleansing, an activity common in East Africa.…”

Section: The Role Of Hpv In Ano-genital Cancersmentioning

confidence: 99%

The Burden of HPV-Associated Anogenital Cancers

Wakeham

Kavanagh

2014

Curr Oncol Rep

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The epidemiology of anogenital cancers is under going substantial change. Cervical cancer remains a major public health concern, particular in resource-limited settings. Cancers of the anus, penis, vagina and vulva are relatively uncommon cancers, but may be increasing in incidence. The change in occurrence of anogenital cancers may be due to increasing HPV transmission secondary to changes in sexual behaviour. Screening programmes and the HPV vaccine offer optimism that anogenital cancers can be prevented. This article reviews the epidemiology of anogenital cancers with a focus on Scottish data.

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“…[9,10] The few published studies on HPV infection in adolescent girls in SSA suggest that HPV prevalence may be very high at a young age. A study in Tanzania found HPV prevalences of 73% in sexually active girls aged 14-18 years, and one in Uganda in girls aged [12][13][14][15][16][17][18][19][20][21][22][23][24] found a prevalence of 75%. [11,12] A recent study in Tanzanian girls aged 15-16 years who reported no previous penetrative sex found an HPV prevalence of 8%.…”

Section: Introductionmentioning

confidence: 99%

“…[11,12] A recent study in Tanzanian girls aged 15-16 years who reported no previous penetrative sex found an HPV prevalence of 8%. [13] The prevalence of non-optimal vaginal microbiota, including bacterial vaginosis (BV), is particularly high in SSA. [14] The vaginal microbiome may modulate susceptibility to HPV infection, as well as other sexually transmitted infections (STI) and HIV.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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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.

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Prevalence of Human Papillomavirus in Adolescent Girls Before Reported Sexual Debut

Cited by 21 publications

References 47 publications

Rapid acquisition of HPV around the time of sexual debut in adolescent girls in Tanzania

Rapid acquisition of HPV around the time of sexual debut in adolescent girls in Tanzania

The Burden of HPV-Associated Anogenital Cancers

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

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