title: Rapid acquisition of HPV around the time of sexual debut in adolescent girls in Tanzania.
abstract: No reports exist on genotype-specific human papillomavirus (HPV) acquisition in girls after first sex in sub-Saharan Africa, despite high HPV prevalence and cervical cancer incidence.
  
  
  
  We followed 503 HP-unvaccinated girls aged 15-16 years in Mwanza, Tanzania, 3-monthly for 18 months with interviews and self-administered vaginal swabs. Swabs were tested for 13 higHRisk and 24 low-risk HPV genotypes. Incidence, clearance and duration of overall HPV and genotype-specific infections were calculated and associated factors evaluated.
  
  
  
  A total of 106 participants reported first sex prior to enrolment (N = 29) or during follow-up (N = 77). One was HIV-positive at the final visit. The remaining 105 girls contributed 323 adequate specimens. Incidence of any new HPV genotype was 225/100 person-years (pys), and incidence of vaccine types HPV-6, -11, -16 and -18 were 12, 2, 2 and 7/100 pys, respectively. Reporting sex in the past 3 months and knowing the most recent sexual partner for a longer period before sex were associated with HPV acquisition. Median time from reported sexual debut to first HPVinfection was 5 months, and infection duration was 6 months.
  
  
  
  This is the first description of HPV acquisition after first sex in sub-Saharan Africa where the incidence of cervical cancer is amongst the highest in the world. HPV incidence was very high after first sex, including some vaccine genotypes, and infection duration was short. This very high HPV incidence may help explain high cervical cancer rates, and supports recommendations that the HPV vaccine should be given to girls before first sex.
authors.affiliation: Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK Mwanza Intervention Trials Unit, Mwanza, Tanzania catherine.houlihan@lshtm.ac.uk.
authors.forename: Catherine F
authors.initials: CF
authors.lastname: Houlihan
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Kathy
authors.initials: K
authors.lastname: Baisley
authors.affiliation: Unit of Infections and Cancer, Institut Català d'Oncologia, Barcelona, Spain.
authors.forename: Ignacio G
authors.initials: IG
authors.lastname: Bravo
authors.affiliation: Mwanza Intervention Trials Unit, Mwanza, Tanzania MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Saidi
authors.initials: S
authors.lastname: Kapiga
authors.affiliation: Unit of Infections and Cancer, Institut Català d'Oncologia, Barcelona, Spain CIBER ESP, Barcelona, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: de Sanjosé
authors.affiliation: National Institute for Medical Research, Mwanza, Tanzania.
authors.forename: John
authors.initials: J
authors.lastname: Changalucha
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Ross
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Hayes
authors.affiliation: Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK Mwanza Intervention Trials Unit, Mwanza, Tanzania.
authors.forename: Deborah
authors.initials: D
authors.lastname: Watson-Jones
mesh_terms: D000293:Adolescent; D052685:Alphapapillomavirus / Q000145:classification*; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D030361:Papillomavirus Infections / Q000453:epidemiology*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D012044:Regression Analysis; D012307:Risk Factors; D012574:Schools; D012725:Sexual Behavior; D013636:Tanzania / Q000453:epidemiology; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*
chemical_list: D053918:Papillomavirus Vaccines
keywords: Human papillomavirus; sexual debut; sub-Saharan Africa