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Trends and Determinants of Human Papillomavirus Concordance Among Human Immunodeficiency Virus-Positive and -Negative Heterosexual Couples in Rakai, Uganda

TitleTrends and Determinants of Human Papillomavirus Concordance Among Human Immunodeficiency Virus-Positive and -Negative Heterosexual Couples in Rakai, Uganda
Publication TypeJournal Article
Year of Publication2017
AuthorsGrabowski, MK, Gravitt, PE, Gray, RH, Serwadda, D, Redd, AD, Kigozi, G, Kong, X, Nalugoda, F, Wawer, MJ, Quinn, TC, Tobian, AAR
JournalJ Infect Dis
Volume215
Pagination772-780
Date PublishedMar 01
ISBN Number0022-1899
Accession Number28011913
KeywordsAdolescent, Adult, Circumcision, Male, Concordance, Female, Follow-Up Studies, Genotype, heterosexuality, HIV, HIV Seronegativity, HIV Seropositivity/complications/*epidemiology, HIV/isolation & purification, human papillomavirus (HPV), Humans, Linear Models, Male, male circumcision, Papillomaviridae/genetics/*isolation & purification, Papillomavirus Infections/complications/*epidemiology, Prevalence, Risk Factors, sexual behavior, Sexual Partners, sexually transmitted infections., Socioeconomic Factors, Uganda, Uganda/epidemiology, Young Adult
Abstract

Background.: Limited data are available on human papillomavirus (HPV) infection among human immunodeficiency virus (HIV)-negative or HIV-positive couples followed longitudinally. Methods.: Genital HPV was assessed in 725 concordant HIV-negative couples and 209 HIV-positive couples enrolled in a male circumcision trial in Rakai, Uganda, using the Roche Linear Array assay, which detects 37 HPV genotypes. Human papillomavirus prevalence and determinants of genotype-specific concordance were assessed at annual visits. Cumulative detection of HPV genotypes over 2 years was also assessed. Results.: At enrollment, HPV infection was detected in 54% of HIV-negative women, 56% of HIV-negative men, and 93% of HIV-positive men and women. For HIV-negative couples, genotypic concordance was 30% at baseline (n = 219/725) and declined significantly with age (adjusted prevelance risk ratio [adjPRR] = 0.53; 95% confidence interval [CI] = 0.28-0.93 comparing women aged >40 years to those aged 15-19 years) and male circumcision (adjPRR = 0.60; 95% CI = 0.47-0.77) and increased among couples with recent intercourse (adjPRR = 1.26; 95% CI = 1.04-1.53). These associations were not seen in HIV-positive couples. Among couples with HPV results at all visits, >/=1 of the same genotypes were detected in both partners in 60% of HIV-negative couples and 96% of HIV-positive couples over 2 years. Conclusion.: Human papillomavirus genotype-specific concordance is more common in HIV-positive couples, and irrespective of HIV status, the majority of couples exhibit HPV concordance over 2 years.

PMCID

PMC5388028