LP is associated with higher mortality, especially short-term- and HIV/AIDS-related mortality. Mid-term-, but not long-term mortality, remained also higher in LP than nLP. LP decreased in MSM and heterosexual men, not in heterosexual women. The groups most affected by LP are low educated, non-Spanish and heterosexual women.

Objectives: To estimate the prevalence and risk factors of high risk human papillomavirus (HPV) infection in migrant female sex workers (FSW) according to age and geographical origin. Methods: Cross sectional study of migrant FSW attending a sexually transmitted infection (STI) clinic in Madrid during 2002. Information on sociodemographic characteristics, reproductive and sexual health, smoking, time in commercial sex work, history of STIs, HIV, hepatitis B, hepatitis C, syphilis, and genitourinary infections was collected. High risk HPV Infection was determined through the Digene HPV Test, Hybrid Capture II. Data were analysed through multiple logistic regression. Results: 734 women were studied. Overall HPV prevalence was 39%; 61% in eastern Europeans, 42% in Ecuadorians, 39% in Colombians, 29% in sub-Saharan Africans, and 24% in Caribbeans (p = 0.057). HPV prevalence showed a decreasing trend by age; 49% under 20 years, 35% in 21-25 years,14% over 36 years% (p,0.005). In multivariate analyses, area of origin (p = 0.07), hormonal contraception in women not using condoms (OR 19.45 95% CI: 2.45 to 154.27), smoking, age, and an interaction between these last two variables (p = 0.039) had statistically significant associations with HPV prevalence. STI prevalence was 11% and was not related to age or geographical origin. Conclusions: High risk HPV prevalence in migrant FSW is elevated and related to age, area of origin, and use of oral contraceptives in women not using condoms. These data support the role of acquired immunity in the epidemiology of HPV infection and identifies migrant FSW as a priority group for sexual health promotion.H uman papillomavirus infection (HPV) is the commonest sexually transmitted infection (STI) worldwide. More than 20 types of papillomavirus have been associated with cervical cancer, the second cause of cancer related mortality in women globally.1-3 Most HPV infections are asymptomatic and resolve spontaneously with cervical smear abnormalities only occurring in those women with persistent HPV infection.4 5 The advent of molecular biology tools in HPV diagnosis has allowed us to identify HPV infection, differentiate HPV types, and discriminate groups of the population with different risks of infection.2 HPV prevalence depends largely on age and on sexual practices.6-8 The prevalence of high risk HPV ranges from 11% in healthy women in Belgium, 9 20% in female university students in the United States 10 to 36% in Italian women at risk for human immunodeficiency virus (HIV) infection 11 and 46% in Spanish women in prisons.12 The highest prevalences of HPV have been described in female sex workers (FSWs) as they have multiple risk factors for HPV infection, such as young age and multiple sexual contacts. [13][14][15][16] There is wide heterogeneity in reported HPV prevalences in FSW from studies in different geographical areas; 43% in Mexico, 14 48% in Japan, 15 and 63% in Calcutta, India. 16 Over the last few years, an increasing proportion of the FSWs in European countries are mi...

Supplemental Digital Content is available in the text

Summaryobjective To obtain baseline information for designing a community-based intervention programme aimed at increasing the cervical cancer screening coverage of women most at risk.methods A population-based survey, using proportional stratified two-stage cluster sampling in Rivas, one of the 16 Departments of Nicaragua. The individuals selected were interviewed at home by one of 26 interviewers, using a structured questionnaire. The questionnaire was designed to elicit (1) knowledge, attitudes and practices concerning sexual and reproductive health and behaviour, (2) risk factors for cervical cancer and (3) the use of health and cervical cancer screening services.results A total of 612 men and 634 women participated in the survey. Of the women who had been sexually active at least 3 years, only 41.1% had undergone screening within that period and were considered adequately screened. Correlates of inadequate screening status included low educational level, exclusive use of public health facilities and lack of knowledge about prevention and symptoms of cervical cancer. Negligence, absence of medical problems, fear, lack of knowledge and economic reasons were the main reasons given for not being screened. Reluctance to be screened in the future was related to lack of knowledge of the disease, inadequate screening status, older age and low educational level.conclusions The current screening programme is not effective in reaching the majority of the population. Complementary activities such as education and information, as well as a more pro-active approach to invite women for screening are necessary.keywords cervical cancer, determinants, population-based survey correspondence Marleen Temmerman,

Migrants, largely from SSA, represent a considerable proportion of AIDS and HIV reports in EU, especially among heterosexual and MTCT infections. Their contribution is higher among female reports. A substantial percentage of diagnoses in MSM are migrants, largely from Western Europe and Latin-America.

No abstract

Objectives: To estimate prevalence and determinants of high risk (HR) human papillomavirus (HPV) by country of origin in women attending a family planning centre (FPC) . Conclusions: Prevalence of HR HPV is more than three times higher in Latin Americans than in Spaniards. Latin American women's HPV prevalence resembles more that of their countries of origin. It is essential that health service providers identify these women as a priority group in current cervical screening programmes T here is substantial intercountry variation in human papillomavirus (HPV) prevalence in women from the general population.1-6 Much of this variation may be attributable to different sampling strategies and diagnostic techniques but, even among population based studies, HPV prevalence is higher in women from Latin America 1 5 and sub-Saharan Africa 4 and lower in Asia 2 and Europe. 3 In Spain, one of the countries with the lowest cervical cancer rates worldwide, 7 the only study that has estimated HPV prevalence in women from general population reported a 3% age adjusted prevalence.3 Rates are, as expected, higher in commercial sex workers (CSWs), including migrant CSWs. Over the past decade a large number of migrants have arrived in Spain; 40% come from Latin America and 50% are women.10 Prevalence of HPV in Latin American women is higher than in Spaniards 1 3 5 but no data are available on prevalence and determinants of HPV infection in these women with an a priori higher risk of cervical cancer in our setting. This study estimates differences by country of origin in the prevalence and risk factors for high risk HPV infection in women attending a family planning centre in Alicante, Spain. SUBJECTS AND METHODSThis was a cross sectional study of women attending a family planning centre (FPC) from May 2003 to January 2004. FPC are open and free of charge to all women irrespective of legal status; none of the women invited to participate in this study refused. A structured questionnaire designed ad hoc was administered by a trained investigator to all participants. Data were collected prospectively. High risk HPV (HR HPV) infection was determined through the Digene HPV Test, Hybrid Capture II (HC-II) which identified types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. In all HC-II positive samples, HPV typing was performed by polymerase chain reaction (PCR) and direct sequencing. DNA was recovered from a 150 ml aliquot of the frozen, stored, alkali denatured specimen and was amplified in suitable samples. MY09/MY11 general consensus primers were used to amplify a 450 pb fragment of HPV L1 gene. Positive samples were sequenced using the Big Dye Terminator Cycle Sequencing Kit with inner PCR primers. HPV type assignation was done by phylogenetic analysis using programs contained in the Phylip 3.5 package.Demographic and clinical differences were compared using x 2 tests. Multiple logistic regression was used to study the relations between HR HPV infection and explanatory variables looking for confounding and interaction. ...

No abstract