Trends in HIV Response and Infections: Tanzania


Author: Mark Mascolini

08 October 2013
Tanzanian women with HIV had 4 times higher odds of infection with high-risk (cancer-causing) human papillomavirus (HPV) than women without HIV, according to results of a large cross-sectional study. Having HIV infection also strengthened the association between other risk factors and HPV infection.

High-risk HPV genotypes can cause cervical cancer (an AIDS cancer), anal cancer, and other cancers. Low-risk HPV genotypes can cause genital warts. HPV is the most common sexually transmitted disease in many parts of the world and is more prevalent in people with than without HIV infection. HPV is usually more prevalent in younger women, but in some groups—including Tanzanian women—high HPV prevalence can be found in older women.

To identify high-risk HPV risk factors in Tanzanian women, researchers conducted this cross-sectional study of 3699 HIV-positive and negative women. They interviewed each woman to identify potential risk factors, took a cervical swab to find HPV, used standard genotyping to identify high-risk HPV, and took a blood sample for HIV testing.

HIV infection proved the strongest risk factor for high-risk HPV, quadrupling the odds (odds ratio 4.1, 95% confidence interval 3.3 to 5.3). Other risk factors were young age, shorter duration of current sexual relationship, and increasing number of sex partners. HIV infection strengthened associations between high-risk HPV and lifetime number of sex partners, shorter duration of current relationship, genital warts, and body mass index.

Among women 20 to 29 years old, the strongest risk factors were more sex partners (P = 0.005) and HIV positivity (P < 0.0001). Among underweight women 50 or older, having HIV infection made high-risk HPV infection more likely (P = 0.0009) but having more sex partners did not. Potential indicators of decreased immune function also raised chances of high-risk HPV in older women.

“Human papillomavirus risk factors among HIV-positive and HIV-negative women were similar,” the researchers conclude, “but the strength of association was greater among HIV-positive women.”

Source: Myassa Dartell, Vibeke Rasch, Christian Munk, Crispin Kahesa, Julius Mwaiselage, Thomas Iftner, Susanne Krüger Kjaer. Risk factors for high-risk human papillomavirus detection among HIV-negative and HIV-positive women from Tanzania. Sexually Transmitted Diseases. 2013; 40: 737-743.
For the study abstract

(Downloading the complete article requires a subscription to Sexually Transmitted Diseases or an online payment; the abstract is free.)


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