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Sex Transm Infect. 2019 Jun 20. pii: sextrans-2019-054012. doi: 10.1136/sextrans-2019-054012. [Epub ahead of print]

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

Author information

1
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK kathy.baisley@lshtm.ac.uk.
2
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
3
Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, Tanzania.
4
Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium.
5
National Institute for Medical Research, Mwanza, Tanzania.
6
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.

Abstract

OBJECTIVES:

Cervical 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.

METHODS:

Cross-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.

RESULTS:

163/385 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.

CONCLUSIONS:

HPV 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.

KEYWORDS:

Africa; HPV; adolescent; vaccination

PMID:
31221744
DOI:
10.1136/sextrans-2019-054012
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Conflict of interest statement

Competing interests: DWJ has received research grants from GSK Biologicals for HPV vaccine-related research.

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