Performance of vaginal self-sampling for human papillomavirus testing among women living with HIV in Botswana

Elliott, Tamara, Kohler, Racquel E, Monare, Barati, Moshashane, Neo, Ramontshonyana, Kehumile, Muthoga, Charles, Wynn, Adriane, Howett, Rebecca, Luckett, Rebecca, Morroni, Chelsea ORCID: https://orcid.org/0000-0002-2026-6039 and Ramogola-Masire, Doreen (2019) 'Performance of vaginal self-sampling for human papillomavirus testing among women living with HIV in Botswana'. International Journal of STD & AIDS, Vol 30, Issue 12, pp. 1169-1176.

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Abstract

In Botswana, where human immunodeficiency virus (HIV) prevalence remains high, cervical cancer is the leading cause of cancer deaths in women. Multiple organizations recommend high-risk human papillomavirus (hr-HPV) testing as a screening tool; however, high coverage may not be feasible with provider-collected samples. We conducted the first assessment of self- versus provider-collected samples for hr-HPV testing in HIV-positive women in Botswana and report prevalence of hr-HPV and histological outcomes. We recruited HIV-positive women ≥25 years attending an HIV clinic in Gaborone. Self- and provider-collected samples from participants were tested for hr-HPV using Cepheid GeneXpert. Women testing positive for any hr-HPV returned for colposcopy. We used unweighted κ statistics to determine hr-HPV agreement. We report that 31 (30%) of 103 women tested positive for any hr-HPV. The most common genotypes were HPV 31/33/35/52/58. Overall agreement between self- and provider-collected samples for any hr-HPV was 92% with a κ of 0.80. Ten of the 30 hr-HPV-positive women attending colposcopy had CIN2+ (33%). In conclusion, in this HIV-positive population, there was excellent agreement between self and provider samples, and self-sampling may play an important role in screening programs in high HIV burden settings with limited resources like Botswana.

Item Type:	Article
Subjects:	QW Microbiology and Immunology > Viruses > QW 160 Viruses (General). Virology WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1177/0956462419868618
Depositing User:	Rachel Dominguez
Date Deposited:	10 Oct 2019 13:26
Last Modified:	24 Jan 2020 16:03
URI:	https://archive.lstmed.ac.uk/id/eprint/12728

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