High-Risk Human Papillomavirus Is Associated with HIV Acquisition among South African Female Sex Workers
Table 1
Distribution of detected HIV cases and risk factors of HIV acquisition.
Factor
Distribution
Number of HIV infections
Mean survival (days)
Univariate HR (95% CI)
Multivariate aHR* (95% CI)
Number of high-risk HPV
0
29.5% (26/88)
5
1148
1
43.2% (38/88)
9
1110
1.5 (1.1 to 2.1)
1.7 (1.01 to 2.7)
2
14.8% (13/88)
5
934
3-4
12.5% (11/88)
6
775
Number of low-risk HPV
0
39.8% (35/88)
7
1134
1
35.2% (31/88)
11
992
1.1 (0.12 to 0.69)
0.77 (0.49 to 1.2)
2
15.9% (14/88)
5
932
3
9.1 (8/88)
2
1136
Age (years)
Less than 24
46.6% (41/88)
18
933
1
1
24 or more
53.4% (47/88)
7
1192
0.29 (0.12 to 0.69)
0.28 (0.079 to 0.97)
Intervention
Placebo
46.6% (41/88)
9
1132
1
1
Nonoxynol-9
53.4% (47/88)
16
1013
1.8 (0.81 to 4.2)
2.0 (0.75 to 5.1)
Education
Less than 6 years
40.9% (36/88)
6
1184
1
1
6 years or more
59.1% (52/88)
19
990
2.7 (1.1 to 6.8)
5.5 (1.6 to 19.6)
Condom use
Never or sometimes
80.7% (71/88)
22
1044
1
1
Often
19.3% (17/88)
3
1175
0.57 (0.17 to 1.9)
0.29 (0.05 to 1.6)
Anal sex
No
56.8% (50/88)
18
1029
1
1
Yes
43.2% (38/88)
7
1137
0.53 (0.22 to 1.3)
0.35 (0.12 to 1.0)
Length of sex work (months)
Less than 24
50.0% (44/88)
13
1045
1
1
24 or more
50.0% (44/88)
12
1091
0.89 (0.41 to 1.9)
1.5 (0.41 to 5.6)
Number of clients per week
Less than 20
46.6% (41/88)
13
1056
1
1
20 or more
53.4% (47/88)
12
1076
0.78 (0.36 to 1.7)
1.4 (0.48 to 3.9)
Trichomonas vaginalis
Negative
64.2% (52/81)
17
1030
1
1
Positive
35.8% (29/81)
6
1109
0.52 (0.21 to 1.3)
1.4 (0.41 to 4.6)
Candida albicans
Negative
63.0% (51/81)
16
1038
1
1
Positive
37.0% (30/81)
7
1129
0.67 (0.28 to 1.6)
0.55 (0.18 to 1.7)
Neisseria gonorrhoeae
Negative
91.3% (73/80)
20
1074
1
1
Positive
8.8% (7/80)
3
1065
1.33 (0.40 to 4.5)
2.3 (0.53 to 9.6)
Chlamydiatrachomatis
Negative
86.5% (64/74)
20
1039
1
1
Positive
13.5% (10/74)
7
1120
0.77 (0.23 to 2.6)
0.25 (0.06 to 1.1)
Syphilis
Negative
73.2% (60/82)
20
1042
1
1
Positive
26.8% (22/82)
4
1138
0.50 (0.17 to 1.5)
0.66 (0.17 to 2.6)
(a) HR: (adjusted) hazard ratio. HPV: human papillomavirus. The following variables were included in the multivariate analysis: number of high-risk HPV, number of low-risk HPV, age, intervention group, education, condom use, anal sex, length of sex work, number of clients per week, infection with Trichomonas vaginalis, infection with Candida albicans, infection with Neisseria gonorrhoea, infection with Chlamydia trachomatis, and infection with syphilis. Increase of hazard ratio of HIV acquisition for an increase of one unit of the number of HPV. The P value corresponds to a linear trend.
