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Title:	Cervico-vaginal self-collection in HIV-infected and uninfected women from Tapajós region, Amazon, Brazil: High acceptability, hrHPV diversity and risk factors
Authors:	Rodrigues, Luana L. S. Morgado, Mariza G. Sahasrabuddhe, Vikrant V. Paula, Vanessa S. de Oliveira, Nathália S. Chavez-Juan, Elena Silva, Diane M. da Kast, W. Martin Nicol, Alcina F. Pilotto, José H.
Affilliation:	Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ, Rio de Janeiro, RJ, Brasil / Instituto de Saúde Coletiva. Universidade Federal do Oeste do Pará, Santarém, PA, Brasil Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ. Rio de Janeiro, RJ, Brasil Division of Cancer Prevention, National Cancer Institute. Bethesda, MD, USA Laboratório de Virologia Molecular, IOC-FIOCRUZ. Rio de Janeiro, RJ, Brasil Programa de Pós-Graduação em Patologia. Universidade Federal Fluminense, Niterói, RJ, Brasil Norris Comprehensive Cancer Center. University of Southern California. Los Angeles, CA, USA Norris Comprehensive Cancer Center. University of Southern California, Los Angeles, CA, USA / Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA / Department of Obstetrics and Gynecology. University of Southern California, Los Angeles, CA, USA / Department of Molecular Microbiology and Immunology, University of Southern California, Los Angeles, CA, USA Instituto Nacional de Infectologia Evandro Chagas, INI-FIOCRUZ, Rio de Janeiro, RJ, Brasil / Laboratório Interdisciplinar de Pesquisas Médicas, IOC-FIOCRUZ, Rio de Janeiro, RJ, Brasil Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ. Rio de Janeiro, RJ, Brasil
Abstract:	Objective We evaluated acceptability of cervico-vaginal self-collection (CVSC) and prevalence of human papillomavirus (HPV) in Human immunodeficiency virus (HIV)-infected and HIV-uninfected women living in the Tapajós region, Amazon, Brazil. Methods Cross-sectional study recruited 153 non-indigenous women (HIV-uninfected, n = 112 and HIV-infected, n = 41) who voluntarily sought assistance in health services. Peripheral blood for HIV screening and cervical scraping (CS) for HPV detection were collected. Women who accepted to perform CVSC received instructions and individual collection kits. Risk factors for high-risk HPV genotypes (hrHPV) were identified by uni- and multivariate analyses. Results The overall acceptability of CVSC was 87%. Only HIV-infected women had cytological abnormalities (12.2%). Prevalence of any HPV and hrHPV infection was 42.9% and 47.9% for HIV-uninfected and 97.6% and 77.5% for HIV-infected women, respectively. There was significant agreement in the detection of HPV (88%, 0.76, 95% confidence interval [CI], 0.65–0.87) and hrHPV (79.7%, 0.56, 95% CI, 0.41–0.71) between self-collected and clinician-collected samples. The most prevalent hrHPV types were HPV16 and HPV18 in HIV-uninfected and HPV16, HPV51 and HPV59 in HIV-infected women. HIV-infected women with hrHPV infection had multiple hrHPV infections (p = 0.005) and lower CD4 count (p = 0.018). Risk factors for hrHPV infection included being HIV-infected and having five or more sexual partners. Conclusions CVSC had high acceptability and high prevalence of hrHPV types in women living in the Tapajós region, Amazon, Brazil.
Keywords:	HIV HPV Amazonas Brasil Índios Sul-Americanos Região Norte Saúde de Populações Indígenas Região Amazônica Epidemiologia Síndrome de Imunodeficiência Adquirida Doenças Sexualmente Transmissíveis Saúde da Mulher Papanicolau
DeCS:	Brasil Saúde de Populações Indígenas Índios Sul-Americanos Ecossistema Amazônico Epidemiologia Síndrome de Imunodeficiência Adquirida Doenças Sexualmente Transmissíveis Saúde da Mulher Teste de Papanicolaou
Issue Date:	2018
Publisher:	Elsevier
Citation:	RODRIGUES, Luana L. S.; et al . Cervico-vaginal self-collection in HIV-infected and uninfected women from Tapajós region, Amazon, Brazil: High acceptability, hrHPV diversity and risk factors. Gynecologic Oncology, v. 151, n.1 , p. 102-110, 2018.
metadata.dc.identifier.doi:	10.1016/j.ygyno.2018.08.004
ISSN:	0090-8258
Copyright:	open access
Appears in Collections:	EPI - Artigos de Periódicos

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