Background: Female sex workers (FSWs) are at high risk for sexually transmitted infections (STIs), including infection with human papillomavirus (HPV) and cervical cancer due to occupational exposure. The objective of this study was to estimate the prevalence of HPV, HPV types, and precancerous lesions of the cervix among FSWs in Cameroon. Material and Methods: In this cross-sectional study, FSWs in Cameroon aged 30 years and above were screened for cervical cancer using high-risk HPV testing and genotyping and visual inspection with acetic acid and Lugol’s iodine (VIA/VILI) enhanced using digital cervicography (DC) simultaneously. Those who were positive for VIA/VILI-DC were provided treatment with thermal ablation (TA) immediately for cryotherapy/TA-eligible lesions while lesions meeting the criteria for large loop excision of the transformation zone (LLETZ) were scheduled at an appropriate facility for the LLETZ procedure. HPV-positive FSWs without any visible lesion on VIA/VILI-DC were administered TA. Bivariate analyses were conducted to compare demographic and clinical characteristics. Crude and adjusted logistic regression models were computed for HPV infection status and treatment uptake as outcomes in separate models and their ORs and 95% confidence intervals (95% CI) were reported. Results: Among the 599 FSWs aged 30 years and older that were screened for HPV and VIA/VILI-DC, 62.1% (95% CI: (0.58–0.66)) were positive for one or more HPV types. HPV type 51 had the highest prevalence (14%), followed by types 53 (12.4%) and 52 (12.2%). Type 18 had the lowest prevalence of 2.8% followed by type 16 with 5.2%. In the multivariable model, HIV-positive FSWs were 1.65 times more likely to be infected with HPV compared to their HIV-negative counterparts (AOR: 1.65, CI: 1.11–2.45). A total of 9.9% of the 599 FSWs were positive for VIA/VILI-DC. Conclusion: The prevalence of HPV infection among FSWs in Cameroon is higher than the worldwide pooled FSW prevalence. HPV types 51 and 53 were the most prevalent, while types 18 and 16 were the least prevalent. HIV status was the only variable that was significantly associated with infection with HPV.
背景：女性性工作者因职业暴露面临性传播感染的高风险，包括人乳头瘤病毒感染及宫颈癌。本研究旨在评估喀麦隆女性性工作者中HPV感染率、HPV型别分布以及宫颈癌前病变的患病情况。材料与方法：在这项横断面研究中，对喀麦隆30岁及以上的女性性工作者同时采用高危HPV检测与分型、醋酸联合卢戈碘液肉眼观察结合数字化宫颈成像技术进行宫颈癌筛查。VIA/VILI-DC阳性者中，符合冷冻/热消融治疗标准的病变立即接受热消融治疗；符合转化区大环切除术标准的病变则被转诊至相应机构安排手术。对于HPV阳性但VIA/VILI-DC未见明显病变者亦实施热消融治疗。通过双变量分析比较人口学与临床特征，并分别以HPV感染状态和治疗接受情况为结局变量建立粗及校正逻辑回归模型，报告其比值比及95%置信区间。结果：在599名接受HPV和VIA/VILI-DC筛查的30岁及以上女性性工作者中，62.1%（95% CI：0.58–0.66）感染一种或多种HPV型别。HPV 51型感染率最高（14%），其次为53型（12.4%）和52型（12.2%）；18型感染率最低（2.8%），16型次之（5.2%）。多变量模型显示，HIV阳性女性性工作者感染HPV的风险是HIV阴性者的1.65倍（校正后OR：1.65，CI：1.11–2.45）。599名研究对象中VIA/VILI-DC阳性率为9.9%。结论：喀麦隆女性性工作者HPV感染率高于全球女性性工作者汇总数据，其中51型和53型最为常见，18型和16型最为少见。HIV感染状态是唯一与HPV感染显著相关的变量。
Human Papillomavirus Types and Cervical Cancer Screening among Female Sex Workers in Cameroon
肿瘤(癌症)患者之家