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Table 3 Predictors of HR-HPV incidence and persistence in HIV-negative 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

  Incidence1 Persistence2
  Incident cases Unadjusted OR (95% CI) Adjusted OR (95% CI) Persistent cases Unadjusted OR (95% CI)
  n/N N = 296 N = 295 n/N N = 90
Demographical and reproductive characteristics at baseline
Age      
   < 30 75/243 1 1 27/81 1
   ≥ 30 yrs 7/53 0.34 (0.15-0.80) 0.44 (0.18-1.06) 2/9 0.57 (0.11-2.98)
Age at sexual debut      
   < 15 10/39 1   2/16 1
   15-19 63/213 1.22 (0.56-2.65)   24/65 4.10 (0.82-20.50)
   ≥ 20 8/41 0.70 (0.24-2.04)   2/8 2.33 (0.24-22.27)
Parity      
   < 3 pregnancies 58/188 1   18/62 1
   ≥ 3 pregnancies 24/108 0.64 (0.37-1.11)   11/28 1.58 (0.61-4.07)
HPV infection at Month 6 (first HPV measurement)
LR-HPV      
   Negative 44/199 1   11/39 1
   Positive 38/97 2.27 (1.33-3.88)   18/51 1.39 (0.58-3.45)
HR-HPV co-infections3      
   Negative 51/206 1   16/57 1
   Positive 31/90 1.59 (0.93-2.74)   13/33 1.67 (0.67-4.17)
HR HPV 33 and/or 52 and/or 584      
   Negative 66/269 1 1   
   Positive 16/27 4.47 (1.93-10.35) 4.10 (1.73-9.75)   
Neisseria gonorrhoeae by PCR      
   Negative 76/266 1   25/75 1
   Positive 5/23 0.69 (0.25-1.94)   4/9 1.73 (0.42-7.08)
Chlamydia trachomatis by PCR      
   Negative 79/280 1   28/88 1
   Positive 2/12 0.51 (0.11-2.39)   1/2 2.14 (0.13-36.25)
Trichomonas vaginalis by InPouch culture      
   Negative 74/245 1   24/72 1
   Positive 8/48 0.46 (0.20-1.04)   5/7 0.83 (0.26-2.66)
Syphilis serology      
   Negative 75/272 1   27/81 1
   Positive 5/20 0.88 (0.31-2.50)   2/7 0.80 (0.14-4.44)
BV by Nugent score      
   Normal (score 0-3) 35/127 1   11/31 1
   Intermediate flora (score 4-6) 5/39 0.39 (0.14-1.08)   4/11 1.04 (0.24-4.43)
   BV (score 7-10) 35/108 1.26 (0.72-2.21)   12/42 0.73 (0.27-1.99)
Genital co-infection at M12
Neisseria gonorrhoeae by PCR      
   Negative 73/270 1   23/77 1
   Positive 9/25 1.52 (0.64-3.60)   6/13 2.1 (0.60-6.75)
Chlamydia trachomatis by PCR      
   Negative 73/277 1 1 28/84 1
   Positive 9/18 2.79 (1.06-7.38) 2.90 (1.03-8.14) 1/6 0.40 (0.04-3.66)
Trichomonas vaginalis by InPouch culture      
   Negative 76/273 1   26/80 1
   Positive 4/19 0.69 (0.22-2.15)   3/9 1.03 (0.24-4.52)
Syphilis serology      
   Negative 79/275 1   27/82 1
   Positive 1/17 0.16 (0.02-1.21)   2/6 1.02 (0.17-5.97)
BV by Nugent score      
   Normal (score 0-3) 30/123 1   17/32 1
   Intermediate flora (score 4-6) 11/33 1.55 (0.67-3.58)   2/8 0.29 (0.05-1.80)
   BV (score 7-10) 34/105 1.48 (0.83-2.66)   9/43 0.23 (0.08-0.69)
Current (Year 2) sexual and reproductive characteristics
Female sex worker (self-identified)6      
   No 8/63 1 1 6/21 1
   Yes 74/233 3.20 (1.43-7.16) 3.01 (1.32-6.83) 23/69 1.25 (0.43-3.67)
Sexually active7      
   No 4/24 1   1/8 1
   Yes 78/272 2.01 (0.66-6.10)   28/82 3.63 (0.41-21.96)
No. of clients in the past week      
   0 8/62 1   6/21 1
   1-4 35/102 3.53 (1.47-8.46)   7/26 0.92 (0.25-3.37)
   5-9 17/61 2.61 (1.01-6.74)   5/19 0.89 (0.22-3.66)
   ≥ 10 22/70 3.09 (1.23-7.79)   11/24 2.12 (0.59-7.58)
No of vaginal sex acts in past month      
   0 4/24 1   1/8 1
   1-24 50/176 1.98 (0.647-6.14)   13/48 2.60 (0.28-24.06)
   ≥ 25 28/90 2.26 (0.70-7.33)   15/32 6.18 (0.60-63.4)
Condom use during vaginal sex in the past month      
   Always 21/66 1   4/14 1
   Never/inconsistent 56/199 0.84 (0.46-1.54)   23/65 1.37 (0.38-4.90)
   No sex 5/31 0.41 (0.14-1.25)   2/11 0.56 (0.08-4.01)
Hormonal contraceptive use8      
   No 57/195 1   17/57 1
   Yes 23/98 0.74 (0.42-1.30)   12/32 1.41 (0.56-3.55)
BV by Nugent score      
   Normal (score 0-3) 35/144 1   14/37 1
   Intermediate flora (4-6) 6/21 1.25 (0.45-3.47)   2/6 0.82 (0.13-5.20)
   BV (score 7-10) 38/124 1.38 (0.80-2.37)   13/46 0.65 (0.25-1.65)
Concurent LR HPV infection      
   No 36/87 1 1 18/55 1
   Yes 46/209 2.50 (1.44-4.33) 2.41 (1.34-4.34) 11/35 0.94 (0.38-2.35)
HSV-2 serology      
   Negative Enr-Year 2 26/96 1   6/19 1
   Positive at Enr 41/158 0.94 (0.53-1.68)   17/50 1.12 (01.36-3.49)
   Incident at Year 2 7/14 2.69 (0.84-8.60)   3/8 1.30 (0.22-7.58)
  1. 1 Incidence is composite grouped-type specific incident variable including HIV-negative women with normal cytology who develop at least one incident infection. Population at risk includes women with/without HR-HPV co-infection with other types than the type at interest; mean interval incidence 16.6 months (SD 1.8); 2 Persistence is a composite grouped-type-specific persistence variable, including HIV-negative women with normal cytology who are at risk of at least one persistent infection. The population at risk includes women with/without HR-HPV co-infection with other types than the type at interest; mean interval ersistence 16.9 months (SD 1.7); 3 No HR-HPV infection at Month 6 compared to ≥ 1 types detected for HPV incidence model - and a single HR-HPV infection at Month 6 compared to ≥ 2 types for HPV persistence model; 4 Reference group: no HR-HPV at Month 6. Other prevalent HR-HPV types were not associated with acquisition of new HR HPV types; 5 Reference group: all others; 6 31/296 women in incidence model stopped sex work since last study visit - and 23/99 women in persistence analysis; 7 24/296 women reported no sexually activity at Year 2 visit in incidence analysis; 8/99 reported no sexual activity at Year 2 visit in persistence analysis; 8 Oral contraceptives, injectables or implants
  2. Abbreviations: HR-HPV = high-risk human papillomavirus infection; LR-HPV = low-risk HPV; HIV = human immunodeficiency virus; OR = odds ratio; CI = confidence interval; HSV-2 = herpes simplex virus type 2; ASCUS = atypical squamous cells of undetermined significance; Sample sizes for different questions may vary slightly from the total N based on missing responses.