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Table 1 Correlates of HR-HPV in HIV-negative and HIV-positive high-risk women with normal cytology, Kigali, Rwanda

From: The epidemiology of human papillomavirus infection in HIV-positive and HIV-negative high-risk women in Kigali, Rwanda

 

HIV negative women1

HIV positive women2

 

HR HPV positive

Unadjusted OR (95% CI)

Adjusted OR (95% CI)

HR HPV positive

Unadjusted OR

(95% CI)

Adjusted OR (95% CI)

 

n/N

N = 349

N = 318

n/N

N = 126

N = 126

Demographical characteristics at baseline

Age

      

   < 30 yrs

99/281

1

1

42/75

1

1

   ≥ 30 yrs

12/68

0.39 (0.20-0.78)

0.62 (0.29-1.33)

22/51

0.60 (0.29-1.23)

0.71 (0.34-1.50)

Marital status3

   

4

  

   Never married

98/264

1

1

44/82

1

 

   Widowed/Divorced

13/80

0.33 (0.17-0.63)

0.42 (0.20-0.85)

20/44

0.72 (0.34-1.51)

 

Education level

      

   No formal schooling

29/72

1

 

12/30

1

 

   Primary school (partial/completed)

76/246

0.66 (0.38-1.14)

 

46/81

1.97 (0.83-4.69)

 

   Secondary school (partial/completed)

6/31

0.36 (0.13-1.00)

 

6/15

1.00 (0.28-3.59)

 

Sexual and reproductive characteristics at baseline

Age at sexual debut

      

   < 15 yrs

18/43

1

 

9/16

1

 

   15-19 yrs

79/249

0.65 (0.33-1.26)

 

49/92

0.89 (0.30-2.60)

 

   ≥ 20 yrs

13/53

0.45 (0.19-1.10)

 

6/18

0.39 (0.09-1.66)

 

Parity

      

   < 3 pregnancies

80/224

1

 

40/70

1

 

   ≥ 3 pregnancies

31/125

0.59 (0.36-0.97)

 

24/55

0.58 (0.28-1.20)

 

Genital infections at baseline

Neisseria gonorrhoeae by PCR

      

   negative

90/314

1

1

 

not done

 

   Positive

21/35

3.73 (1.79-7.79)

3.19 (1.38-7.38)

 

not done

 

Chlamydia trachomatis by PCR

      

   negative

100/332

1

1

 

not done

 

   Positive

11/17

4.25 (.51-12.0)

4.38 (1.30-14.77)

 

not done

 

Trichomonas vaginalis by InPouch culture

      

   negative

92/289

1

  

not done

 

   Positive

19/60

0.99 (0.55-1.81)

  

not done

 

HSV-2 serology4

      

   negative

40/142

1

 

7/12

1

 

   Positive

59/181

1.23 (0.76-2.00)

 

53/108

0.69 (0.20-2.32)

 

Positive syphilis serology5

      

   negative

98/322

1

  

not done

 

   Positive

12/26

1.96 (0.87-4.41)

  

not done

 

BV by Nugent score

      

   Normal (score 0-3)

39/140

1

  

not done

 

   Intermediate flora (score 4-6)

10/48

0.68 (0.31-1.50)

  

not done

 

   BV (score 7-10)

54/146

1.52 (0.92-2.51)

  

not done

 

Current sexual and reproductive characteristics

No of clients in the past week

      

   0

1/15

0.14 (0.02-1.16)

 

18/44

1

 

   1-4

35/103

1

 

29/54

1.68 (0.74-3.79)

 

   5-9

33/107

0.70 (0.36-1.37)

 

7/14

1.44 (0.43-4.90)

 

   ≥ 10

41/121

1.13 (0.64-2.00)

 

10/14

3.61 (0.92-14.14)

 

No of vaginal sex acts in past month

      

   0

6/8

7.96 (1.49-42.55)

 

6/20

1

 

   1-24

49/179

1

 

47/83

3.05 (1.03-8.97)

 

   ≥ 25

56/161

1.41 (0.89-2.25)

 

11/23

2.14 (0.59-7.81)

 

Condom use during vaginal sex in the past month

      

   Always

44/153

1

 

18/40

1

 

   Never/sometimes

61/186

1.22 (0.76-1.93)

 

40/66

1.88 (0.84-4.22)

 

   No sex

6/8

7.43 (1.38-40.0)

 

6/20

0.52 (0.16-1.68)

 

Hormonal contraceptive use6

      

   No or < 6 months

80/283

1

  

NA

 

   > 6 months

29/63

2.16 (1.23-3.81)

  

NA

 

Current genital co-infections

Neisseria gonorrhoeae by PCR

      

   negative

97/315

1

  

not done

 

   Positive

11/25

1.77 (0.77-4.04)

  

not done

 

Chlamydia trachomatis by PCR

      

   negative

105/327

1

  

not done

 

   Positive

6/17

1.15 (0.41-3.21)

  

not done

 

Trichomonas vaginalis by InPouch culture

      

   negative

91/292

1

  

not done

 

   Positive

19/54

1.20 (0.65-2.11)

  

not done

 

HSV-2 serology7

      

   negative

36/139

1

 

5/9

1

 

   Positive

70/197

1.58 (0.97-2.55)

 

59/117

0.81 (0.21-3.20)

 

HSV-2 serology4

      

   Negative (Enr-M6)

33/132

1

1

 

NA

 

   Positive at enrollment

59/181

1.45 (0.88-2.40)

1.78 (1.01-3.12)

 

NA

 

   Incident at M6

7/10

7.00 (1.62-30.21)

6.69 (1.41-31.38)

 

NA

 

Positive syphilis serology

      

   negative

100/321

1

  

not done

 

   Positive

9/24

1.33 (0.56-3.14)

  

not done

 

Concurrent LR HPV infection

      

   negative

51/236

1

1

22/57

1

1

   Positive

60/113

4.11 (2.47-6.83)

3.77 (02.17-6.54)

42/69

2.48 (1.18-5.19)

2.31 (1.11-4-81)

BV by Nugent score

      

   Normal (score 0-3)

57/149

1

 

16/35

  

   Intermediate flora (score 4-6)

17/51

1.51 (0.76-3.03)

 

7/18

  

   BV (score 7-10)

50/126

1.99 (1.18-3.36)

 

39/68

  

Current (Year 2) HIV-related indicators

CD4 count (copies/mL)- use of cART

      

   > 350 - no cART

 

NA

 

33/60

1

 

   > 350 - cART

 

NA

 

13/34

0.51 (0.21-1.21)

 

   ≤ 350 - no cART

 

NA

 

7/15

0.72 (0.23-2.25)

 

   ≤ 350 - cART

 

NA

 

10/15

1.64 (0.49-5.44)

 
  1. 1 HR-HPV in HIV-negative women at Month 6 with normal cytology. 16 women excluded because of abnormal cytology results; 2 HR-HPV in HIV = positive women at Year 2. 14 women excluded because of abnormal cytology results; 3 only 4 women were married; 4 intermediate HSV-2 results are excluded (HIV negative n = 27; HIV-positive n = 10); 5 RPR and TPHA positive; 6 oral contraceptives, injectables or implants. Reference group includes women using condoms for family planning; 7 intermediate HSV-2 results are excluded (HIV negative n = 13; HIV positive n = 3)
  2. Notes: Abbreviations: HR-HPV = high-risk human papillomavirus infection; LR-HPV = low-risk HPV; HIV = human immunodeficiency virus; OR = odds ratio; CI = confidence interval; FSW = female sex worker; HSV-2 = herpes simplex virus type 2; BV = bacterial vaginosis; N.A = not applicable. Sample sizes for different questions may vary slightly from the total N based on missing responses.
  3. Classification of HR-HPV is independent of LR-HPV status. In HIV-negative HR-HPV positive women 54% had LR-HPV coinfection. In HIV-negative HR-HPV negative women 23% had LR-HPV coinfection. In HIV-positive HR-HPV positive women 65% had LR-HPV coinfection. In HIV-positive HR-HPV negative women 44% had LR-HPV coinfection.