title: Spousal migration and human papillomavirus infection among women in rural western Nepal.
abstract: In April 2014 we investigated the association of migration of a woman's husband with her high-risk human papillomavirus (HR-HPV) infection status and her abnormal cervical cytology status in the Achham district of rural Far-Western Nepal.
  
  
  
  Women were surveyed and screened for HR-HPV during a health camp conducted by the Nepal Fertility Care Center. Univariate and multivariable statistical tests were performed to determine the association of a husband's migration status with HR-HPV infection and cervical cytology status.
  
  
  
  In 265 women, the prevalence of HR-HPV was 7.5% (20/265), while the prevalence of abnormal cervical cytology, defined using the Bethesda system as atypical glandular cells of undetermined significance or worse, was 7.6% (19/251). Half of the study participants (50.8%, 130/256) had husbands who had reported migrating for work at least once. Women aged ≤34 years were significantly less likely to test positive for HR-HPV than women aged >34 years (OR 0.22, 95% CI 0.07 to 0.71). HR-HPV infection and abnormal cervical cytology status were not directly associated with a husband's migration.
  
  
  
  Older women were found to have a higher prevalence of HPV than younger women. It is possible that a husband's migration for work could be delaying HR-HPV infections in married women until an older age.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Derek C
authors.initials: DC
authors.lastname: Johnson
authors.affiliation: NFCC/NFCC International, Kathmandu, Nepal.
authors.forename: Pema
authors.initials: P
authors.lastname: Lhaki
authors.affiliation: College of Public Health, Kent State University, Kent, OH, USA.
authors.forename: Madhav P
authors.initials: MP
authors.lastname: Bhatta
authors.affiliation: School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA Department of Health Behavior, University of Alabama at Birmingham, AL, USA.
authors.forename: Mirjam-Colette
authors.initials: MC
authors.lastname: Kempf
authors.affiliation: Department of Epidemiology, University of North Carolina, Chapel Hill, USA.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
authors.affiliation: NFCC/NFCC International, Kathmandu, Nepal.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Bhattarai
authors.affiliation: Nepal Family Health Division, Kathmandu, Nepal.
authors.forename: Shilu
authors.initials: S
authors.lastname: Aryal
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Chamot
authors.affiliation: Nepal Family Health Division, Kathmandu, Nepal.
authors.forename: Kiran
authors.initials: K
authors.lastname: Regmi
authors.affiliation: Vanderbilt Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA sshrestha@uab.edu.
authors.forename: Sadeep
authors.initials: S
authors.lastname: Shrestha
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D063426:Human Migration; D006801:Humans; D000067562:Late Onset Disorders / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012424:Rural Population / Q000706:statistics & numerical data*; D018454:Spouses; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology*
keywords: Cervical cancer; HPV; Migration; Nepal