Human Papillomavirus epidemiology among women seeking HIV care at two Ugandan rural hospitals

Background Persistent human papillomavirus (HPV) infection is a significant precursor to cervical abnormalities and invasive cancer. While the causal relationship between specific HPV types and cervical cancer is established, little is known about the distribution of HPV types among women living with HIV (WLWH) in Uganda. We aimed to describe the epidemiology of HPV types among women living with HIV at Mityana and Kiboga Hospitals in rural central Uganda. Methods A retrospective review of demographic and clinical data, including age and antiretroviral therapy (ART) history, was conducted among WLWH tested for HPV between July 2021 and July 2022. Real-time Polymerase Chain Reaction assay (RT-PCR) detected HPV 16, 18/45, and other pooled high-risk types. HPV infections were categorized into single, double, and multiple subtypes. Statistical analysis involved Chi-square tests and modified Poisson regression with robust standard error models to evaluate associations and identify factors linked with HPV infection. Results Among 1305 WLWH, the overall prevalence of HPV infection was 39.1%. HPV16 and HPV18/45 were the most common genotypes, with a prevalence of 8.1% and 8.2%, respectively. Multiple HPV infections were observed in 18.4% of cases, with combinations of HPV 16, HPV 18/45, and other high-risk HPV types. Increasing age was significantly associated with a lower prevalence of HPV infection (PR = 0.97; 95% CI: 0.95–0.99; p = 0.003). Conclusion The study highlights a high prevalence of HPV infection among WLWH in rural Uganda, with specific genotypes and risk factors identified. These findings underscore the importance of comprehensive cervical cancer prevention programs, including HPV vaccination, regular screening. Further research is needed to validate these findings and evaluate the effectiveness of interventions to reduce the burden of HPV-related diseases among WLWH in Uganda.