Objectives

This study aimed to: (1) Estimate HPV prevalence and genotype distribution among female sex workers (FSWs) in Mali and Benin as well as the prevalence of multiple HPV type infections in this group, and (2) Identify potential risk factors associated with high-risk (HR) HPV infections.

Methods

We analyzed baseline data of 665 FSWs aged ≥ 18 years recruited during a prospective cohort of cervical cancer screening in Cotonou (Benin) and Bamako (Mali) from 2017 to 2018. The Linear Array HPV genotyping test was used to identify HPV genotypes. Descriptive statistics and multivariate log-binomial regression were used. Adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) were estimated to identify risk factors associated with HR-HPV infections.

Results

HPV data were available for 659 FSWs (Benin: 309; Mali: 350). The mean age was 35.0 years (± 10.7) in Benin and 26.8 years (± 7.6) in Mali. The overall HPV prevalence rates were 95.5% in Benin and 81.4% in Mali. About 87.7% and 63.4% of FSWs harbored ≥ 2 HPV types in Benin and Mali, respectively. The top three prevalent HR-HPV among FSWs in Benin were: HPV58 (37.5%), HPV16 (36.6%) and HPV52 (28.8%). Corresponding patterns in Mali were HPV16 (15.7%), HPV51 (14.3%) and HPV52 (12.9%). In Benin, the main factors associated with HR-HPV were vaginal douching (APR = 1.17; 95%CI:1.02–1.34) and gonococcal infection (APR = 1.16; 95%CI:1.04–1.28), while in Mali they were sex work duration ≤ 1 year (APR = 1.35; 95%CI:1.10–1.65) and HIV infection (APR = 1.26; 95%CI: 1.06–1.51).

Conclusion

Our study found a very high prevalence of HPV infection as well as high frequency of multiple HPV type infections in FSWs in two countries in West Africa. These findings suggest the necessity to emphasize cervical cancer prevention in this high-risk group.

中文翻译：

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西非女性性工作者中人乳头瘤病毒基因型分布及相关因素

目标

这项研究旨在：（1）估计马里和贝宁的女性性工作者（FSW）中的HPV患病率和基因型分布，以及该组中多种HPV型感染的患病率，以及（2）识别与高感染率相关的潜在危险因素-高危（HR）HPV感染。

方法

我们分析了2017年至2018年在科托努（贝宁）和巴马科（马里）进行的宫颈癌筛查前瞻性队列研究中招募的665名年龄≥18岁的FSW的基线数据。使用线性阵列HPV基因分型测试来鉴定HPV基因型。使用描述性统计和多元对数二项式回归。估计具有95％置信区间（95％CI）的调整后患病率（APR），以确定与HR-HPV感染相关的危险因素。

结果

HPV数据可用于659个FSW（贝宁：309；马里：350）。贝宁的平均年龄为35.0岁（±10.7），马里的平均年龄为26.8岁（±7.6）。贝宁和马里的总HPV患病率分别为95.5％和81.4％。贝宁和马里分别约有87.7％和63.4％的FSW携带≥2种HPV类型。贝宁FSW中流行的HR-HPV前三名是：HPV58（37.5％），HPV16（36.6％）和HPV52（28.8％）。马里的对应模式为HPV16（15.7％），HPV51（14.3％）和HPV52（12.9％）。在贝宁，与HR-HPV相关的主要因素是阴道冲洗（APR = 1.17； 95％CI：1.02-1.34）和淋球菌感染（APR = 1.16； 95％CI：1.04-1.28），而在马里，他们是性工作时间≤1年（APR = 1.35； 95％CI：1.10-1.65）和HIV感染（APR = 1.26； 95％CI：1.06-1.51）。

结论

我们的研究发现，在西非两个国家的FSW中，HPV感染的患病率很高，多种HPV类型感染的发生率也很高。这些发现表明，在这一高风险人群中必须强调预防子宫颈癌。