Human papillomavirus prevalence in South African women and men according to age and human immunodeficiency virus status

Abstract

Background: Both cervical cancer and human immunodeficiency virus (HIV) are major public health problems in Sub-Saharan Africa. The objectives of the study were to investigate human papillomavirus (HPV) prevalence according to age, HIV status and gender. Methods: Participants were 208 HIV-negative women, 278 HIV-positive women, 325 HIV-negative men and 161 HIV-positive men between the ages of 18-66 years. HPV types were determined in cervical and penile cells by Roche Linear Array HPV genotyping assay. Results: HPV prevalence was 36.7% (76/207; 95% confidence intervals (CI): 30.4-43.4%) in HIV-negative women, with the highest prevalence of 61.0% (25/41; 95% CI: 45.7-74.4 %) in women aged 18-25 years. HPV prevalence was 74.0% (205/277; 95% CI: 68.5-78.8%) in HIV-positive women, with the highest prevalence of 86.4% (38/44; 95% CI: 72.9-94.0%) in women aged 18-25 years. HPV prevalence was found to decrease with increasing age in HIV-negative women (P = 0.0007), but not in HIV-positive women (P = 0.898). HPV prevalence was 50.8% (159/313; 95% CI: 45.3-56.3%) in HIV-negative men, with the highest prevalence of 77.0% (27/35; 95% CI: 60.7-88.2%) in men aged 18-25 years. HPV prevalence was 76.6% (121/158; 95% CI: 69.2-82.9%) in HIV-positive men, with the highest prevalence of 87.5% (7/8; 95% CI: 50.8-99.9%) in men 18-25 years of age. HPV prevalence was found to decrease with increasing age in HIV-negative men (P = 0.004), but not in HIV-positive men (P = 0.385). HIV-positive women had a significantly higher prevalence of one or more HPV type(s) in the bivalent (HPV-16/18: 20% 55/277, 9% 12/207; P <0.001), quadrivalent (HPV-6/11/16/18: 26% 71/277, 12% 24/207; P = 0.001) and nonavalent vaccine (HPV-6/11/16/18/31/33/52/56/58: 65% 181/277, 24% 50/207; P <0.001) compared to HIV-negative women. Similar observation were observed in men for bivalent (20% 32/158, 10% 30/313; P = 0.001), quadrivalent (35% 56/158, 13% 41/313; P <0.001) and nonavalent vaccine (75% 119/158, 28% 87/313; P <0.001). Conclusions: This study demonstrated high HPV prevalence among HIV-positive women and men in all age groups. The high prevalence of HPV types found in bivalent, quadrivalent and nonavalent vaccines in South African HIV-positive and HIV-negative women and men demonstrate that this population will greatly benefit from current HPV vaccines.