This study in female sex workers (FSWs) aimed (1) to estimate type-specific human papillomavirus (HPV) incidence and persistence in Cotonou (Benin) and Bamako (Mali); (2) to identify the factors associated with incident and persistent type-specific high-risk HPV (HR-HPV) infection.
A one-year prospective cohort study on cervical cancer screening, HPV and HIV infections was conducted among FSWs in Cotonou and Bamako, from 2017 to 2019. Poisson regression models assessed factors associated with HR-HPV incidence, while log-binomial regression was performed to identify factors associated with HR-HPV persistence. The adjusted relative risk (ARR) with 95% confidence interval (95%CI) were estimated.
HR-HPV incidence was 46.98 per 1000 women-months (predominant types HPV16, HPV35 and HPV59). Factors associated with incident HR-HPV were age < 20 years (ARR = 15.10; 95%CI: 3.29-69.19), sexual debut <18 years (ARR = 6.92; 95%CI:1.97-24.27) and sex work duration ≤1 year (ARR = 7.40; 95%CI:1.84-29.69). HR-HPV persistence at 12 months was 38.7% (most persistent types: HPV59, HPV52 and HPV51). HR-HPV persistence was higher in chlamydia- (p = 0.031) and HIV-positive (p < 0.001) women and multiple-type HPV infections (p < 0.001).
FSWs in West Africa are at high risk of incident and persistent HR-HPV infection, suggesting an urgent need of cervical cancer screening for this population.

Copyright © 2021. Published by Elsevier Ltd.