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Silhol R, Maheu-Giroux M, Soni N, Fotso AS, Rouveau N, Vautier A, Doumenc-Aïdara C, Geoffroy O, N’Guessan KN, Sidibé Y, Kabemba OK, Gueye PA, Ndeye PD, Mukandavire C, Vickerman P, Keita A, Ndour CT, Ehui E, Larmarange J, Boily MC. The impact of past HIV interventions and diagnosis gaps on new HIV acquisitions, transmissions, and HIV-related deaths in Côte d'Ivoire, Mali, and Senegal. AIDS 2024; 38:1783-1793. [PMID: 38953898 PMCID: PMC11356671 DOI: 10.1097/qad.0000000000003974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/28/2024] [Accepted: 06/06/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES To estimate the epidemiological impact of past HIV interventions and the magnitude and contribution of undiagnosed HIV among different risk groups on new HIV acquisitions in Côte d'Ivoire, Mali and Senegal. DESIGN HIV transmission dynamic models among the overall population and key populations [female sex workers (FSW), their clients, and MSM]. METHODS Models were independently parameterized and calibrated for each set of country-specific demographic, behavioural, and epidemiological data. We estimated the fraction of new HIV infections over 2012-2021 averted by condom use and antiretroviral therapy (ART) uptake among key populations and non-key populations, the direct and indirect contribution of specific groups to new infections [transmission population-attributable fraction (tPAF)] over 2012-2021 due to prevention gaps, and the distribution of undiagnosed people with HIV (PWH) by risk group in January 2022 and their tPAF over 2022-2031. RESULTS Condom use and ART may have averted 81-88% of new HIV infections over 2012-2021 across countries, mostly due to condom use by key population. The tPAF of all key populations combined over 2012-2021 varied between 27% (Côte d'Ivoire) and 79% (Senegal). Male key populations (clients of FSW and MSM) contributed most to new infections (>60% in Mali and Senegal) owing to their higher HIV prevalence and larger prevention gaps. In 2022, men represented 56% of all PWH with an undiagnosed infection in Côte d'Ivoire (male key populations = 15%), 46% in Mali (male key populations = 23%), and 69% in Senegal (male key populations = 55%). If HIV testing and ART initiation rates remain at current levels, 20% of new HIV infections could be due to undiagnosed key populations living with HIV in Côte d'Ivoire over 2022-2031, 53% in Mali, and 65% in Senegal. CONCLUSION Substantial HIV diagnosis gaps remain in Western Africa, especially among male key populations. Addressing these gaps is key to impacting the HIV epidemics in the region and achieving the goal of ending AIDS by 2030.
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Affiliation(s)
- Romain Silhol
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics, School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Nirali Soni
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
| | - Arlette Simo Fotso
- Centre Population & Développement, Université Paris Cité, IRD, Inserm, Paris
- Institut National d’Études Démographiques, INED, Aubervilliers
| | - Nicolas Rouveau
- Centre Population & Développement, Université Paris Cité, IRD, Inserm, Paris
| | - Anthony Vautier
- Solidarité Thérapeutique et Initiatives pour la Santé, Solthis, Paris, France
| | | | - Olivier Geoffroy
- Solidarité Thérapeutique et Initiatives pour la Santé, Solthis, Abidjan, Côte d’Ivoire
| | | | - Younoussa Sidibé
- Solidarité Thérapeutique et Initiatives pour la Santé, Solthis, Bamako, Mali
| | - Odé Kanku Kabemba
- Solidarité Thérapeutique et Initiatives pour la Santé, Solthis, Bamako, Mali
| | - Papa Alioune Gueye
- Solidarité Thérapeutique et Initiatives pour la Santé, Solthis, Dakar, Sénégal
| | - Pauline Dama Ndeye
- Solidarité Thérapeutique et Initiatives pour la Santé, Solthis, Dakar, Sénégal
| | - Christinah Mukandavire
- Department of Epidemiology and Data Science, Coalition for Epidemic Preparedness and Innovations, London, UK
- School of Mathematics and Data Science, Emirates Aviation University, Dubai, United Arab Emirates
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Abdelaye Keita
- Institut National de Santé Publique (INSP), Bamako, Mali
| | - Cheikh Tidiane Ndour
- Division de Lutte contre le Sida et les IST, Ministère de la Santé et de l’Action Sociale Institut d’Hygiène Sociale, Dakar, Sénégal
| | - Eboi Ehui
- Programme National de Lutte contre le Sida, Abidjan, Côte d’Ivoire
| | - Joseph Larmarange
- Centre Population & Développement, Université Paris Cité, IRD, Inserm, Paris
- Institut National d’Études Démographiques, INED, Aubervilliers
| | - Marie-Claude Boily
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, UK
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Xu W, Liang P, Wang C. Facilitators and Barriers for Chlamydia and Gonorrhea Testing in Female Sex Workers: A Scoping Review. Open Forum Infect Dis 2023; 10:ofad397. [PMID: 37559756 PMCID: PMC10407459 DOI: 10.1093/ofid/ofad397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
We conducted a scoping review to examine the barriers and facilitators accessing Chlamydia trachomatis and Neisseria gonorrhoeae testing among female sex workers. A literature search was conducted in Embase, Medline, and Web of Science for studies published from the date of creation of database to 17 March 2023, without restrictions for publication date. We used thematic synthesis to identify common affecting factors across included studies and then linked them into categories of the socioecological framework. Among the 14 articles included, 3 utilized qualitative methods, 7 utilized quantitative surveys, 2 were mixed methods, and 2 were randomized controlled trials. Several important affecting factors stood out during this review, including stigma and discrimination, as well as social support at the societal level, and financial costs at the service level. This review suggested that interventions on addressing societal- and service-level determinants are needed, which includes reducing stigma and discrimination toward sex work and cost for facility testing, as well as increasing social support and community engagement.
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Affiliation(s)
- Wenqian Xu
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
- Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Peng Liang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
- Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Cheng Wang
- Dermatology Hospital of Southern Medical University, Guangzhou, China
- Southern Medical University Institute for Global Health, Guangzhou, China
- Guangdong Provincial Center for Skin Diseases and STIs Control, Guangzhou, China
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Appiah CK, Dowou RK, Balame SK, Adzigbli LA, Yeboah PA, Aboagye RG, Cadri A. Self-reported sexually transmitted infections among adolescent girls and young women in Mali: analysis of prevalence and predictors. BMJ Open 2023; 13:e069226. [PMID: 37094889 PMCID: PMC10151941 DOI: 10.1136/bmjopen-2022-069226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
OBJECTIVE To examine the prevalence and predictors of self-reported sexually transmitted infections (SR-STIs) among adolescent girls and young women in Mali. DESIGN We performed a cross-sectional analysis of data from the Demographic and Health Survey of Mali, which was conducted in 2018. A weighted sample of 2105 adolescent girls and young women aged 15-24 was included. Percentages were used to summarise the results of the prevalence of SR-STIs. We used a multilevel binary logistic regression analysis to examine the predictors of SR-STIs. The results were presented using an adjusted odds ratio (aOR) with 95% confidence interval (CI). Statistical significance was set at p<0.05. SETTING Mali. PARTICIPANTS Adolescent girls (15-19 years) and young women (20-24 years). OUTCOME MEASURE SR-STIs. RESULTS The prevalence of SR-STIs among the adolescent girls and young women was 14.1% (95% CI=12.3 to 16.2). Adolescent girls and young women who had ever tested for HIV, those with one parity, those with multiparity, those with two or more sexual partners, those residing in urban areas, and those exposed to mass media were more likely to self-report STIs. However, those residing in Sikasso and Kidal regions were less likely to report STIs. CONCLUSION Our study has shown that SR-STIs are prevalent among adolescent girls and young women in Mali. Health authorities in Mali and other stakeholders should formulate and implement policies and programmes that increase health education among adolescent girls and young women and encourage free and easy access to STI prevention and treatment services.
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Affiliation(s)
- Collins Kwame Appiah
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Robert Kokou Dowou
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | | | - Leticia Akua Adzigbli
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Paa Akonor Yeboah
- Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Abdul Cadri
- Department of Family Medicine, McGill University Montreal, Montreal, Quebec, Canada
- Department of Social and Behavioural Science, University of Ghana, Legon, Ghana
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Willis B, Perttu E, Fitzgerald M, Thompson H, Weerasinghe S, Macias-Konstantopoulos W. Causes of mortality among female sex workers: Results of a multi-country study. EClinicalMedicine 2022; 52:101658. [PMID: 36313149 PMCID: PMC9596307 DOI: 10.1016/j.eclinm.2022.101658] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The vast majority of studies on female sex workers (FSW) focus on causes of morbidity while data on causes of mortality are scarce. In low- and middle-income countries, where civil registry and vital statistics data are often incomplete and FSW may not be identified as such in official registries, identifying causes of mortality among FSW has proven challenging. METHODS As part of a larger investigation on the maternal health of FSW, the current study used the Community Knowledge Approach (CKA) to identify causes of mortality among FSW in LMIC across three global regions in 2019. The CKA, validated to identify maternal, neonatal, and jaundice-associated deaths among women living in a community, was employed to identify deaths of any cause among communities of FSW. Study participants, recruited by in-country partner non-governmental organizations (NGOs) working with local FSW, provided detailed information about FSW deaths in their communities. FINDINGS 1280 FSW participated in 165 group meetings through which 2112 FSW deaths were identified. Of these reported deaths, 57·9% occurred in 2019 and 57·2% were among women aged 20-29. Causes of death included abortion (35·5%), other maternal causes (16·6%), suicide (13·6%), murder (12·5%), unclassified causes (11·6%), HIV/AIDS (7·9%), and accidents (3·2%). A total of 3659 children lost their mothers. INTERPRETATION Maternal death comprised the leading cause of FSW mortality in our sample. This methodology can be used by local governments and NGOs to identify unrecognized patterns and clusters of FSW deaths in near-real time and urgently steer targeted preventative strategies. FUNDING New Venture Fund.
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Affiliation(s)
- Brian Willis
- Global Health Promise, Portland, OR, United States
- Corresponding author.
| | - Emily Perttu
- Global Health Promise, Portland, OR, United States
| | - Meghan Fitzgerald
- Global Health Promise, Portland, OR, United States
- U.S. Overseas Cooperative Development Council, Washington DC, United States
| | - Heather Thompson
- Global Health Promise, Portland, OR, United States
- Schulich School of Medicine, McMaster Faculty of Medicine, Grey Bruce Health Services, Hamilton, Ontario, Canada
| | - Swarna Weerasinghe
- Global Health Promise, Portland, OR, United States
- Department of Community Health and Epidemiology, Dalhousie University, Faculty of Medicine, Halifax, Nova Scotia, Canada
| | - Wendy Macias-Konstantopoulos
- Global Health Promise, Portland, OR, United States
- Center for Social Justice and Health Equity, Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
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Abdella S, Demissie M, Worku A, Dheresa M, Berhane Y. HIV prevalence and associated factors among female sex workers in Ethiopia, east Africa: A cross-sectional study using a respondent-driven sampling technique. EClinicalMedicine 2022; 51:101540. [PMID: 35813094 PMCID: PMC9256839 DOI: 10.1016/j.eclinm.2022.101540] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND HIV acquisition among Female Sex Workers (FSWs) is 30 times higher than the acquisition rate among females in the respective general population. A higher HIV burden in FSWs challenges the prevention and control of the virus in other population groups. However, there is inadequate evidence on the burden of HIV among FSWs in Ethiopia. This study was conducted to assess the extent of HIV and associated factors among FSWs in the country. METHODS This was a cross-sectional study that involved a total of 6,085 FSWs. The participants were selected using a respondent-driven sampling technique (RDS). FSWs who lived at the study sites for at least a month before the study time were considered eligible for recruitment. The study was conducted from January 01 to June 30, 2020 in 16 cities across Ethiopia. A mixed-effect logistic regression model was applied to determine factors associated with HIV positivity. FINDINGS The pooled HIV prevalence among FSWs in this study was 18·7% (95% CI: 17·8, 19·7) with considerable variation across cities. The highest HIV prevalence was observed in Bahir Dar city, 28·2% (95% CI: 23·9, 33.0) and the lowest was seen in Shashemene city, 14.0% (95% CI: 10·2, 18·9). The odds of HIV positivity in FSWs was associated with being older than 35 years of age (AOR = 8·1; 95% CI: 6·1, 10·3), reactive for Treponema Pallidum (AOR = 2·6; 95% CI: 1·0, 3·4), being widowed (OR = 2·2; 95% CI: 1·6, 2·9), not able to read and write (OR = 2·0; 95% CI: 1·5, 2·4), incidence of condom breakage (OR = 1·5; 95% CI: 1·2, 1·7) and having a history of STIs (OR = 1·3; 95% CI: 1·1, 1·6). INTERPRETATION One in five FSWs was HIV positive. HIV prevalence was higher in the older age groups and in those who were positive for Treponema Pallidum (Syphilis). The findings indicated the importance of strengthening HIV prevention and control in FSWs to achieve the national goal to eliminate HIV by 2030. FUNDING The study was supported by The Ethiopian Ministry of Health through the Federal HIV/AIDS Prevention and Control Office.
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Affiliation(s)
- Saro Abdella
- HIV and TB Research directorate, Ethiopian Public Health Institute, Addis Ababa, Swaziland Street, Ethiopia
- School of Nursing and Midwifery, College of Health Sciences, Haramaya University, Harar, Ethiopia
- Corresponding author.
| | - Meaza Demissie
- Department of Global Health and Health Policy, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Sefere Selam Campus, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health Sciences, Haramaya University, Harar, Ethiopia
| | - Yemane Berhane
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Grabert BK, Islam JY, Kabare E, Vielot NA, Waweru W, Mandaliya K, Shafi J, Adala L, McClelland RS, Smith JS. Testing for Sexually Transmitted Infection Using Wet and Dry Self-Collected Brush Samples Among Women in Mombasa, Kenya. Sex Transm Dis 2022; 49:e100-e103. [PMID: 34694274 PMCID: PMC9023596 DOI: 10.1097/olq.0000000000001575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT We compared detection of Chlamydia trachomatis , Neisseria gonorrhoeae , and Trichomonas vaginalis using dry and wet self-collected samples using brushes among females who engage in sex work in Mombasa, Kenya. Detection of T. vaginalis and N. gonorrhoeae in dry and wet samples was similar, but C. trachomatis detection in dry samples appeared lower.
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Affiliation(s)
- Brigid K. Grabert
- Lineberger Cancer Center, University of North Carolina at Chapel Hill, NC, USA
| | - Jessica Y. Islam
- Lineberger Cancer Center, University of North Carolina at Chapel Hill, NC, USA
| | - Emmanuel Kabare
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Nadja A. Vielot
- Department of Family Medicine, University of North Carolina at Chapel Hill, NC, USA
| | - Wairimu Waweru
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Juma Shafi
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Lucy Adala
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - R. Scott McClelland
- Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Jennifer S. Smith
- Lineberger Cancer Center, University of North Carolina at Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
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Bitty-Anderson AM, Gbeasor-Komlanvi FA, Bakoubayi AW, Tchankoni MK, Sadio AJ, Salou M, Dagnra CA, Ekouevi DK, Coffie PA. High burden of self-reported sexually transmitted infections among female sex workers in Togo in 2021. Front Public Health 2022; 10:915029. [PMID: 35991055 PMCID: PMC9381961 DOI: 10.3389/fpubh.2022.915029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/04/2022] [Indexed: 12/02/2022] Open
Abstract
Background Sexually Transmitted Infections (STI) remain a public health challenge, especially for Female Sex Workers (FSW) who are particularly vulnerable. In sub-Saharan Africa where the overlapping epidemics of STI and HIV are concentrated among key populations, epidemiological data are needed in order to better understand STI trends in this population. The aim of this study was to assess the prevalence of self-reported STI symptoms and their risk factors among FSW in Togo in 2021. Methods A cross-sectional study was completed in June and July 2021 among FSW in two cities of Togo: in Lomé (capital city, south of Togo) and in Kara (north of Togo). A snowball sampling method was used and after consent, a standardized questionnaire was administered by trained research staff to collect information on STI. A multivariate logistic regression model was used to identify factors associated with self-reported STI. Results A total of 447 FSW, 300 in Lomé and 147 in Kara participated in this study. Median age was 30 [IQR: 24-38] and STI symptoms in the previous 12 months were reported by 191 FSW [42.7%, 95% CI: (38.1-47.5)], among whom 116 (60.7%) sought medical care. The most common reported symptoms were abnormal vaginal discharge (n = 78; 67.2%) and vaginal itching (n = 68; 58.6%). Current STI symptoms (at the time of the survey) were reported by 88 FSW (19.7%). In multivariable logistic regression, self-reported STI symptoms in the previous 12 months was negatively associated with living in the Lomé and older age and positively associated with having more than 15 clients in the previous week and being victim of violence. Conclusions Findings from this study reveal that the self-reported STI burden is relatively high among FSW Togo. Additional strategies are needed at the structural, medical, political and social levels to curb this trend and effectively aim at the elimination of STI epidemics by the year 2030.
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Affiliation(s)
- Alexandra M. Bitty-Anderson
- African Research Center in Epidemiology and Public Health (CARESP), Lomé, Togo
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
- PAC-CI Research Center – ANRS Site Côte d'Ivoire, CHU de Treichville, Abidjan, Côte d'Ivoire
| | - Fifonsi A. Gbeasor-Komlanvi
- African Research Center in Epidemiology and Public Health (CARESP), Lomé, Togo
- Public Health Department, Faculty of Health Sciences, University of Lomé, Lomé, Togo
| | - Akila W. Bakoubayi
- African Research Center in Epidemiology and Public Health (CARESP), Lomé, Togo
- Public Health Department, Faculty of Health Sciences, University of Lomé, Lomé, Togo
| | - Martin K. Tchankoni
- African Research Center in Epidemiology and Public Health (CARESP), Lomé, Togo
| | - Arnold J. Sadio
- African Research Center in Epidemiology and Public Health (CARESP), Lomé, Togo
- Public Health Department, Faculty of Health Sciences, University of Lomé, Lomé, Togo
| | - Mounerou Salou
- Molecular Biology Laboratory, Fundamental Sciences Department, University of Lomé, Lomé, Togo
- National HIV/AIDS, Viral Hepatitis and Sexually Transmitted Infections Program (PNLS/HV/IST), Lomé, Togo
- Laboratory Services, University Hospital Campus (CHU Campus), Lomé, Togo
| | - Claver A. Dagnra
- Molecular Biology Laboratory, Fundamental Sciences Department, University of Lomé, Lomé, Togo
- National HIV/AIDS, Viral Hepatitis and Sexually Transmitted Infections Program (PNLS/HV/IST), Lomé, Togo
| | - Didier K. Ekouevi
- African Research Center in Epidemiology and Public Health (CARESP), Lomé, Togo
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
- Public Health Department, Faculty of Health Sciences, University of Lomé, Lomé, Togo
| | - Patrick A. Coffie
- PAC-CI Research Center – ANRS Site Côte d'Ivoire, CHU de Treichville, Abidjan, Côte d'Ivoire
- Medical Sciences Research and Formation Unit, Dermatology and Infectiology Department, University Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
- University Hospital of Treichville, Infectious and Tropical Diseases Service, Abidjan, Côte d'Ivoire
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Tounkara FK, Téguété I, Guédou FA, Talbot D, Traoré CB, Béhanzin L, Traoré S, Goma-Matsétsé E, Aza-Gnandji M, Keita B, Guenoun J, Coutlée F, Alary M. Type-specific incidence, persistence and factors associated with human papillomavirus infection among female sex workers in Benin and Mali, West Africa. Int J Infect Dis 2021; 106:348-357. [PMID: 33848674 DOI: 10.1016/j.ijid.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/31/2021] [Accepted: 04/04/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study in female sex workers (FSWs) aimed to: (1) estimate type-specific incidence and persistence of human papillomavirus (HPV) infection in Cotonou (Benin) and Bamako (Mali); and (2) identify the factors associated with type-specific incidence and persistence of high-risk HPV (HR-HPV) infection. METHODS A 1-year prospective cohort study on cervical cancer screening, and HPV and human immunodeficiency virus (HIV) infections was conducted among FSWs in Cotonou and Bamako from 2017 to 2019. Poisson regression models assessed factors associated with the incidence of HR-HPV infection, while log-binomial regression was performed to identify factors associated with the persistence of HR-HPV infection. Adjusted relative risks (ARR) and 95% confidence intervals (95% CI) were estimated. RESULTS The incidence of HR-HPV infection was 46.98 per 1000 women-months (predominant types HPV16, HPV35 and HPV59). Factors associated with the incidence of HR-HPV infection were age <20 years (ARR 15.10; 95% CI 3.29-69.19), age at sexual debut <18 years (ARR 6.92; 95% CI 1.97-24.27) and sex work duration ≤1 year (ARR 7.40; 95% CI 1.84-29.69). The persistence of HR-HPV infection at 12 months was 38.7% (most persistent types HPV59, HPV52 and HPV51). Persistence of HR-HPV infection was higher in women with chlamydia (P = 0.031), HIV infection (P < 0.001) and multiple-type HPV infections (P < 0.001). CONCLUSION FSWs in West Africa are at high risk of incident and persistent HR-HPV infection, suggesting an urgent need for cervical cancer screening in this population.
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Affiliation(s)
- Fatoumata Korika Tounkara
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Ibrahima Téguété
- Département de Gynécologie-Obstétrique, CHU Gabriel Toure, BP 267, Bamako, Mali
| | - Fernand A Guédou
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Dispensaire des Infections Sexuellement Transmissibles (DIST), Centre de santé de Cotonou-1, Cotonou, Benin
| | - Denis Talbot
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Cheick B Traoré
- Département d'Anatomie-Pathologie, CHU Point G, Bamako, Mali
| | - Luc Béhanzin
- École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou, Benin
| | - Sidy Traoré
- Département de Gynécologie-Obstétrique, CHU Gabriel Toure, BP 267, Bamako, Mali
| | - Ella Goma-Matsétsé
- Dispensaire des Infections Sexuellement Transmissibles (DIST), Centre de santé de Cotonou-1, Cotonou, Benin
| | - Marlène Aza-Gnandji
- Dispensaire des Infections Sexuellement Transmissibles (DIST), Centre de santé de Cotonou-1, Cotonou, Benin
| | - Bintou Keita
- Association de Recherche de Communication et d'Accompagnement à Domicile de personnes Vivant avec le VIH (ARCAD-SIDA), Bamako, Mali
| | - Julie Guenoun
- Département de Microbiologie et Infectiologie, Centre de recherche du CHU de Montréal, Montréal, Canada
| | - François Coutlée
- Département de Microbiologie et Infectiologie, Centre de recherche du CHU de Montréal, Montréal, Canada
| | - Michel Alary
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Institut national de santé publique du Québec, Québec, Canada.
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Tounkara FK, Téguété I, Guédou FA, Goma-Matsétsé E, Koné A, Béhanzin L, Traoré S, Aza-Gnandji M, Keita B, Guenoun J, Coutlée F, Alary M. Human papillomavirus genotype distribution and factors associated among female sex workers in West Africa. PLoS One 2020; 15:e0242711. [PMID: 33237976 PMCID: PMC7688172 DOI: 10.1371/journal.pone.0242711] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 11/09/2020] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES This study aimed to: (1) Estimate HPV prevalence and genotype distribution among female sex workers (FSWs) in Mali and Benin as well as the prevalence of multiple HPV type infections in this group, and (2) Identify potential risk factors associated with high-risk (HR) HPV infections. METHODS We analyzed baseline data of 665 FSWs aged ≥ 18 years recruited during a prospective cohort of cervical cancer screening in Cotonou (Benin) and Bamako (Mali) from 2017 to 2018. The Linear Array HPV genotyping test was used to identify HPV genotypes. Descriptive statistics and multivariate log-binomial regression were used. Adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) were estimated to identify risk factors associated with HR-HPV infections. RESULTS HPV data were available for 659 FSWs (Benin: 309; Mali: 350). The mean age was 35.0 years (± 10.7) in Benin and 26.8 years (± 7.6) in Mali. The overall HPV prevalence rates were 95.5% in Benin and 81.4% in Mali. About 87.7% and 63.4% of FSWs harbored ≥ 2 HPV types in Benin and Mali, respectively. The top three prevalent HR-HPV among FSWs in Benin were: HPV58 (37.5%), HPV16 (36.6%) and HPV52 (28.8%). Corresponding patterns in Mali were HPV16 (15.7%), HPV51 (14.3%) and HPV52 (12.9%). In Benin, the main factors associated with HR-HPV were vaginal douching (APR = 1.17; 95%CI:1.02-1.34) and gonococcal infection (APR = 1.16; 95%CI:1.04-1.28), while in Mali they were sex work duration ≤ 1 year (APR = 1.35; 95%CI:1.10-1.65) and HIV infection (APR = 1.26; 95%CI: 1.06-1.51). CONCLUSION Our study found a very high prevalence of HPV infection as well as high frequency of multiple HPV type infections in FSWs in two countries in West Africa. These findings suggest the necessity to emphasize cervical cancer prevention in this high-risk group.
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Affiliation(s)
- Fatoumata Korika Tounkara
- Département de Médecine Sociale et Préventive, Université Laval, Québec, QC, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec—Université Laval, Québec, QC, Canada
| | | | - Fernand A. Guédou
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec—Université Laval, Québec, QC, Canada
- Centre de Santé de Cotonou-1, Dispensaire des Infections Sexuellement Transmissibles (DIST), Cotonou, Benin
| | - Ella Goma-Matsétsé
- Centre de Santé de Cotonou-1, Dispensaire des Infections Sexuellement Transmissibles (DIST), Cotonou, Benin
| | - Amadou Koné
- Centre Universitaire de Recherche Clinique (UCRC), Bamako, Mali
- Des Techniques et Des Technologies de Bamako, Université des Sciences, Bamako, Mali
| | - Luc Béhanzin
- Centre de Santé de Cotonou-1, Dispensaire des Infections Sexuellement Transmissibles (DIST), Cotonou, Benin
| | - Sidy Traoré
- Centre Hospitalier Universitaire Gabriel Toure, Bamako, Mali
| | - Marlène Aza-Gnandji
- Centre de Santé de Cotonou-1, Dispensaire des Infections Sexuellement Transmissibles (DIST), Cotonou, Benin
| | - Bintou Keita
- Association de Recherche de Communication et d’Accompagnement à Domicile de personnes Vivant avec le VIH (ARCAD-SIDA), Bamako, Mali
| | - Julie Guenoun
- Département de Microbiologie et Infectiologie, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada
| | - François Coutlée
- Département de Microbiologie et Infectiologie, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada
| | - Michel Alary
- Département de Médecine Sociale et Préventive, Université Laval, Québec, QC, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec—Université Laval, Québec, QC, Canada
- Institut National de Santé Publique du Québec, Québec, QC, Canada
- * E-mail:
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