title: Higher incidence and persistence of high-risk human papillomavirus infection in female sex workers compared with women attending family planning.
abstract: BACKGROUND
  There are no data on the incidence and persistence of high-risk human papillomavirus (HR-HPV) infections in female sex workers (FSWs). We aimed to describe and compare the rates of incidence and persistence of HR-HPV infections in FSWs and women from the general population (WGP) who attended healthcare facilities between May 2003 and December 2006 in Alicante, Spain.
  
  
  METHODS
  Women with an established HR-HPV infection at study entry were evaluated for the analysis of HR-HPV persistence, and those testing negative for HR-HPV infection at entry were evaluated for the analysis of incidence. HR-HPV infection was determined by the Digene HC2 HR HPV DNA Test.
  
  
  RESULTS
  A total of 736 women - 592 WGP and 144 FSWs - were followed for a median of 16.8 months. Global incidence and persistence rates were 3.98 per 100 woman-years (95% confidence interval (CI) 2.91-5.45) and 26.81 per 100 woman-years (95% CI 20.08-35.79), respectively. In the multivariate analysis, only commercial sex work was associated with a statistically significant higher incidence (relative risk (RR) 4.72, 95% CI 2.45-9.09) and persistence (RR 1.93, 95% CI 1.08-3.46) of HR-HPV infection.
  
  
  CONCLUSIONS
  Our data show that FSWs have both a higher incidence and a higher persistence of HR-HPV than WGP and should be prioritized in HPV-related cancer screening programs.
authors.affiliation: Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029 Madrid, Spain. cgonzalezb@isciii.es
authors.forename: C
authors.initials: C
authors.lastname: González
authors.forename: M
authors.initials: M
authors.lastname: Torres
authors.forename: J
authors.initials: J
authors.lastname: Canals
authors.forename: E
authors.initials: E
authors.lastname: Fernández
authors.forename: J
authors.initials: J
authors.lastname: Belda
authors.forename: M
authors.initials: M
authors.lastname: Ortiz
authors.forename: J
authors.initials: J
authors.lastname: Del Amo
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D003267:Contraception; D004279:DNA, Viral; D005260:Female; D060005:Genotyping Techniques; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology*; D012307:Risk Factors; D060386:Sex Workers; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology*; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral