(P164) HPV prevalence and risk factors among Women Living with HIV attending public health services in Brazil: pilot implementation of HPV-DNA tests based on self-collection of vaginal samples

Background: Women Living with HIV (WLHIV) are more likely to be infected by oncogenic HPV genotypes and four to five times more likely to develop invasive cervical cancer. Considering switching cervical cancer screening with cytology to DNA-HPV testing, a pilot implementation of HPV-DNA tests among WLHIV were conducted using vaginal self-collected samples. We assessed the prevalence of High-risk HPV (HR) (16/ 18/31/33/35/39/45/51/52/56/58/59/68/73/82), Probable high risk (pHR) (26/53/66), and Low Risk (LR) (6/11/40/42/43/44/54/61/70), and risk factors associated with HR and pHR.


Methods: This is a cross-sectional study among WLHIV from 18 to 64 years old. A laboratory and eight HIV healthcare services were part of the pilot network. We used descriptive statistics to describe the sociodemographic and behavioral characteristics of WLHIV with any HPV detection. Univariable analyses were conducted to evaluate risk factors associated with HR or pHR infection in WLHIV.

Results: Between May/2021-May/2022, 2,069 WLHIV were selected, and 1,919 (92.8%) participated in the pilot implementation. The mean age was 45yo, and the median was 44.7yo. The majority were black/brown (67.1%), 60.1% had eight years or more of formal education, and 47.1% reported living maritally with their partners. More than half (57.5%) had their first sexual intercourse between 15-18yo, had 1-2 children (56.6%), and had more than four partners during their lifetime (51.7%). Of 1.914 self-collect samples with valid results, the prevalence of HR was 49.6%, pHR was 16.7%, and LR was 40.0%. HPV 68 (10%), HPV 53 (10%), HPV 16 (8%) and HPV (8%) showed the highest prevalence Age was negatively associated with HR or HR, with the highest prevalence between 18-29yo (82.4%, IC: 75.4% - 87.8%) and the lowest between 50-73yo (71.9%, IC: 67.5% - 76.0%). Having any pHR was more associated with single WLHIV (P = 0.043) and higher alcohol consumption (P =0,028).

Conclusion: The prevalence of HPV among WLHIV, especially HR, is high in Brazil. Considering that HPV is a risk factor even higher among WLHIV, and due to the great sensitivity of the test, this study reinforces the need to implement HPV screening among this population. Self-collection of vaginal sampling was an important strategy to increase test access.