Prevalence and factors associated with high-risk human papillomavirus infection in women living with HIV/AIDS at a referral center: a cross-sectional study, Vitória, 2021-2022

Objective To analyze the prevalence of high-risk human papillomavirus (HPV) infection in women living with HIV/AIDS and to identify associated risk factors and genotypic diversity by RT-PCR. Methods This was a cross-sectional study of HIV-positive cisgender women treated at an HIV/AIDS referral center in Espírito Santo between May 2021 and May 2022. The study included women aged 18-64 on antiretroviral therapy with no cognitive or clinical deficits. For HPV detection and genotyping, vaginal self-collection was carried out for real-time polymerase chain reaction (RT-PCR). Sociodemographic, behavioral, laboratory, and clinical data were analyzed using Fisher’s exact and chi-square tests to verify associations with HPV. Poisson regression with robust variance was used to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). A p-value<0.05 was considered significant. Results Of the 207 self-collected samples, 100.0% were valid for RT-PCR. HPV prevalence was 60.4%, with genotypes 58, 68, and 52 being the most common. In the adjusted analysis, detectable HIV/AIDS viral load was associated with a 37.0% increase in the probability of HPV infection (PR 1.37; 95%CI 1.00; 1.88). HPV-18 was associated with five times more alterations in cervical cytopathology. Conclusion Women with HIV/AIDS had a high prevalence of high-risk HPV, predominantly genotype 58, with a higher probability of infection associated with detectable viral load. The validity of the self-collected samples proves the efficacy of the technique in HPV screening, reinforcing its potential in the prevention of cervical cancer.