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Human papillomavirus, HIV and other sexually transmitted infections among women attending antenatal, well woman and sexual health clinics in Papua New Guinea.

Human papillomavirus, HIV and other sexually transmitted infections among women attending antenatal, well woman and sexual health clinics in Papua New Guinea.

Papua New Guinea (PNG) is estimated to have among the highest prevalences of HIV and STIs in the Asia-Pacific. The prevalence of maternal syphilis is among the highest in the world. Cervical cancer is the most common cancer among women in PNG and a leading cause of premature death. Despite this burden of disease, limited epidemiological data are available to inform evidence-based policy.

Methods: Cross-sectional bio-behavioural surveys are underway to investigate the epidemiology of human papillomavirus (HPV ), HIV and other STIs among 2500 women attending antenatal (ANC), well woman (WWC) and sexual health clinics (SHC) in six provinces in PNG. DNA extracted from vaginal swabs is being tested for C. trachomatis, N. gonorrhoeae and T. vaginalis by real-time PCR, and HPV genotyping conducted using the Roche LinearArray kit. Participants are offered voluntary HIV counselling and testing and asked to provide venepuncture specimens for syphilis and Herpes simplex Type-2 (HSV-2) serology.

Results: At end-May 2013, 872 women had been enrolled at nine participating clinics (ANC:435; WWC:103; SHC:334). High HPV/STI prevalences have been observed at all sites. The prevalence of HPV infection was 56.1%, 27.5% and 50.6% among ANC, WWC and SHC attendees respectively. Vaccine preventable HPV types 16 and 18 were the most prevalent high-risk types in all settings. Among ANC attendees at five sites, HIV prevalence was 1.6%; C. trachomatis, 20.9%; N. gonorrhoeae, 7.1%; T. vaginalis, 19.6%; HSV-2, 38.6%; and active syphilis, 4.0%.

Conclusion: This research is providing the first geographical, age and type-specific prevalence data on HPV infection in PNG. Study findings will inform evidence-based public health policy on HPV and cervical cancer control in PNG, including the introduction of polyvalent HPV vaccines for primary cervical cancer prevention. This work will also inform national policy on the elimination of mother to child transmission of HIV and syphilis.

Speakers: Andrew Vallely
Areas of Interest / Categories: Australian Society for HIV 2015

Australian Society for HIV 2015

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