title: Factors associated with high-risk HPV positivity in a low-resource setting in sub-Saharan Africa.
abstract: OBJECTIVE
  We sought to determine demographic and behavioral factors associated with human papillomavirus (HPV) positivity in a community-based HPV self-collection cervical cancer screening pilot project.
  
  
  METHODS
  HPV self-collected samples were obtained from 199 women aged 30-69 years in the impoverished urban Ugandan community of Kisenyi, during September through November 2011. Demographic and behavioral information was collected. Descriptive statistics and a logistic regression model were used to analyze factors associated with HPV positivity.
  
  
  RESULTS
  There was overwhelming acceptance of HPV self-collection in this community. High-risk HPV prevalence was found to be 17.6%. Lower levels of formal education (adjusted odds ratio [AOR], 0.40; 95% confidence interval [CI], 0.08-2.03) were associated with higher prevalence of HPV as was use of oral contraception (AOR, 2.01; 95% CI, 0.83-4.90) and human immunodeficiency virus status (AOR, 0.43; 95% CI, 0.14-1.37).
  
  
  CONCLUSIONS
  Screening should be targeted and prioritized for women with lower levels of education, oral contraceptive use, and human immunodeficiency virus positivity as they have the highest HPV prevalence in this low-resource population.
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Sheona M
authors.initials: SM
authors.lastname: Mitchell
authors.affiliation: Department of Obstetrics and Gynecology, Mulago Hospital, Makerere University, Kampala, Uganda.
authors.forename: Musa
authors.initials: M
authors.lastname: Sekikubo
authors.affiliation: Department of Obstetrics and Gynecology, Mulago Hospital, Makerere University, Kampala, Uganda.
authors.forename: Christine
authors.initials: C
authors.lastname: Biryabarema
authors.affiliation: Department of Obstetrics and Gynecology, Mulago Hospital, Makerere University, Kampala, Uganda.
authors.forename: Josaphat J K
authors.initials: JJ
authors.lastname: Byamugisha
authors.affiliation: British Columbia Center for Disease Control, Vancouver, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.
authors.forename: Malcolm
authors.initials: M
authors.lastname: Steinberg
authors.affiliation: Program for Appropriate Technology in Health, Seattle, WA.
authors.forename: Jose
authors.initials: J
authors.lastname: Jeronimo
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia's Women's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Money
authors.affiliation: British Columbia's Women's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Jan
authors.initials: J
authors.lastname: Christilaw
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Center for Disease Control, Vancouver, British Columbia, Canada. Electronic address: gina.ogilvie@bccdc.ca.
authors.forename: Gina S
authors.initials: GS
authors.lastname: Ogilvie
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006295:Health Resources; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000821:virology*; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000821:virology*; D014626:Vaginal Smears
keywords: cervical cancer screening; human papillomavirus; low-resource settings; self-collection