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Human papillomavirus seropositivity and subsequent risk of HIV acquisition in rural South African women.

Abstract：

OBJECTIVE:This study aimed to provide a population-based estimate of human papillomavirus (HPV) seropositivity for women in a rural African context and to evaluate the impact of HPV serostatus on subsequent acquisition of HIV outside a clinical setting. DESIGN:A random sample of women participating in a longitudinal, population-based HIV survey combined with a case-control study. METHODS:Blood samples of women participating in a single round of population-based HIV surveillance (N = 1049) in a rural South African population were used to measure vaccine-preventable HPV seropositivity (types 6, 11, 16, and 18) in the general population in 2010. Using results from the repeat HIV surveys, a case-control analysis was then performed comparing HPV sero-status in samples taken from HIV sero-converting women (prior to infection with HIV) against samples from HIV-uninfected, sexually-active controls matched 1:1 according to 5-year age band (377:377). Unconditional multivariable logistic regression with multiple imputations was used to control for sociodemographic and behavioral variables associated with HIV acquisition. RESULTS:Human papillomavirus seropositivity in the population-based sample of women was 20.8% (95% confidence interval [CI], 18.3-23.4), and HIV prevalence was 27.6% (95% CI, 24.9-30.4). In the case-control analysis, allowing for variables known to be associated with HIV incidence, HPV seropositivity was associated with nearly 2.5 times the odds of subsequent acquisition of HIV (adjusted odds ratio, 2.33 [95% CI, 1.61-3.39]; P < 0.001). CONCLUSIONS:These results suggest that HPV vaccination before or soon after sexual debut could lower HIV infection risk. Randomized trials that quantify the impact of HPV vaccination in girls on the risk of acquiring HIV are urgently required.

journal_name

Sex Transm Dis

journal_title

Sexually transmitted diseases

authors

Tanser F,Jones KG,Viljoen J,Imrie J,Grapsa E,Newell ML

doi

10.1097/OLQ.0b013e3182918578

subject

Has Abstract

pub_date

2013-07-01 00:00:00

pages

601-6

issue

eissn

0148-5717

issn

1537-4521

pii

00007435-201307000-00018

journal_volume

pub_type

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Human papillomavirus seropositivity and subsequent risk of HIV acquisition in rural South African women.