Prevalence and Risk Factors for HPV in HIV-Positive Young Women Receiving Their First HPV Vaccination.

Publication Type:

Journal Article

Source:

Journal of acquired immune deficiency syndromes (1999) (2012)

Abstract:

BACKGROUND:: The objectives of this study were to describe the prevalence and risk factors for HPV infection among HIV-infected young women receiving their first quadrivalent HPV (HPV-6, -11, -16, -18) vaccine dose. METHODS:: We recruited 16-23 year-old women from 14 sites for an HPV vaccine trial. At the first visit they completed a questionnaire and were tested for cervicovaginal HPV DNA (41 types) and HPV serology (4 vaccine types). Factors associated with any HPV, type-specific HPV, and high-risk (cancer-associated) HPV infection were identified using univariate and multivariable logistic regression. RESULTS:: The mean age of participants (N=99) was 21.4 years, 30.3% were on antiretroviral therapy, 74.7% were positive for ≥ 1 HPV DNA type, 53.5% for ≥ 1 high-risk type, 12.1% for HPV-16, and 5.1% for HPV-18. Most were HPV DNA negative and seronegative for HPV-16 (55.6%) and HPV-18 (73.7%); 45.5% were HPV DNA and seronegative for both HPV-16 and -18. Three variables were associated with high-risk HPV DNA in multivariable analysis: non-Hispanic Black vs. Hispanic ethnicity (AOR 7.06, 95% CI 1.63-30.5), HIV viral load ≥ 400 vs. < 400 copies/mL (AOR 3.47, 95% CI 1.28-9.43), and frequency of vaginal sex in the past 90 days (AOR 5.82, 95% CI 1.30-26.11 for ≥ 6 vs. 0 times). CONCLUSIONS:: The prevalence of ≥ 1 HPV type was high in these young women, demonstrating the importance of vaccinating prior to sexual initiation. However, most were HPV DNA negative and seronegative for high-risk, vaccine-type HPV infection, supporting vaccination of sexually experienced HIV-positive young women.