Prevalence of high-risk human papillomavirus and abnormal pap smears in female sex workers compared to the general population in Antwerp, Belgium.
Although female sex workers (FSWs) are a well-known high-risk group for Human Papillomavirus (HPV) infections, few tailored intervention programmes for HPV have been established worldwide. The lack of reliable data on the prevalence of HPV and related cervical lesions hampers the establishment of evidence-based intervention programmes. The objectives of this study were to describe the prevalence of high-risk Human Papillomavirus (hrHPV) infections and abnormal pap smears in FSWs compared to a control group in Antwerp, Belgium.



HPV genotyping and cytology data were analysed from routine Pap smear tests that were collected from both FSWs and the general population (1334 samples for each group) between June 2006 and June 2010. Within the laboratory database, all FSWs were matched 1:1 for age and testing date to determine the ORs of hrHPV genotypes, DNA and cytology outcome.



The prevalence of hrHPV DNA in FSWs was 41.7 % compared to 19.8 % in the age-matched controls with an overall OR of 2.8 (95 % CI: 2.3-3.4). Significant differences were observed in all age groups, and the most significant differences were observed in the cohort under 21 years of age (prevalence of 64.4 % in FSWs versus 14.8 % in controls; OR 10.3 (95 % CI: 5.0-21.2). Significantly more cervical lesions were observed in FSWs, particularly in the 17- to 21-year old age group (OR for LSIL or HSIL: 10.3 (95 % CI: 3.2-33.8). In both groups, HPV 16 was the most prevalent at 12.1 and 6.6 % in the FSW and control groups, respectively. HPV 18 was the 8(th) and 7(th) most frequent genotype at 5.0 and 2.5 % in the FSW and control groups, respectively.



FSWs have a significantly higher prevalence of hrHPV and more abnormal Pap smears than does the general population in Antwerp, Belgium. The hrHPV prevalence in FSWs is similar to that reported in the literature. The need for tailored intervention programmes should be investigated further.
Centre for the Evaluation of Vaccination (CEV), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, B 2610, Antwerp, Belgium. alex.vorsters@uantwerpen.be.
Alex
A
Vorsters
Antwerp Health House for Prostitution, Ghapro vzw, Antwerp, Belgium.
Tine
T
Cornelissen
Centre for the Evaluation of Vaccination (CEV), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, B 2610, Antwerp, Belgium.
Elke
E
Leuridan
Algemeen Medisch Laboratorium (part of National Reference Centre for HPV), Emiel Vloorsstraat 9, 2020, Antwerp, Belgium.|Applied Molecular Biology Research (AMBIOR), University of Antwerp, Antwerp, Belgium.|International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium.
Johannes
J
Bogers
Algemeen Medisch Laboratorium (part of National Reference Centre for HPV), Emiel Vloorsstraat 9, 2020, Antwerp, Belgium.|Applied Molecular Biology Research (AMBIOR), University of Antwerp, Antwerp, Belgium.|International Centre for Reproductive Health (ICRH), Ghent University, Ghent, Belgium.
Davy
D
Vanden Broeck
Algemeen Medisch Laboratorium (part of National Reference Centre for HPV), Emiel Vloorsstraat 9, 2020, Antwerp, Belgium.|Applied Molecular Biology Research (AMBIOR), University of Antwerp, Antwerp, Belgium.
Ina
I
Benoy
Laboratory of Medical Microbiology, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium.|Clinical Microbiology, Antwerp University Hospital, Antwerp, Belgium.
Herman
H
Goossens
Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), Hasselt University, Hasselt, Belgium.|Centre for Health Economics Research and Modeling Infectious Diseases (CHERMID), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.|Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
Niel
N
Hens
Centre for the Evaluation of Vaccination (CEV), Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, B 2610, Antwerp, Belgium.
Pierre
P
Van Damme
D000293:Adolescent; D000328:Adult; D000368:Aged; D001530:Belgium / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D052162:Human papillomavirus 16 / Q000145:classification / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000145:classification / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D015995:Prevalence; D060386:Sex Workers; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D016387:Women's Health; D055815:Young Adult
Cervical cancer; Epidemiology; Female sex workers; Human papilloma virus; Prevention