Human papillomavirus infection and cervical dysplasia in female sex workers in Northeast China: an observational study

Abstract

BackgroundWomen having multiple sex partners are reportedly at an increased risk of HPV infection. However, the prevalence and risk factors of HPV infection in female sex workers (FSWs) vary considerably across racial/ethnic, socioeconomic, and geographic groups. This study aimed to determine the prevalence and risk factors of HPV infection in FSWs in Northeast China.MethodsA total of 309 FSWs identified and approached through a local police office and 1000 healthy subjects from a single factor undergoing annual gynecological examinations in Shenyang were recruited. A liquid-based ThinPrep Pap test and the Hybrid Capture II-based high-risk HPV DNA test, with or without a colposcopic examination, were performed on both FSWs and control subjects. Data on HPV infection and histological and cytological lesions of the cervix were obtained and analyzed. A questionnaire survey was administered to all 309 FSWs with their socio-demographic and behavioral information collected. The association of various socio-demographic and behavioral variables with HPV infection was assessed.ResultsHPV was significantly more prevalent in FSWs (61.90 %) than in healthy control subjects (21.00 %) (P < 0.01), so were cervical lesions (P < 0.01). HPV prevalence in our sample of FSWs fell in the upper range of reported values in FSWs across different countries, and was similar to that for FSWs in the southeast Chinese city of Huzhou but higher than that for FSWs in southwest China, Guangxi, as compared with data from other studies within China. HPV infection in FSWs was significantly associated with the age at first sexual intercourse (OR 0.699, 95 % CI 0.492–0.992) and post-menopause (OR 2.928, 95 % CI 1.099–7.800) (P < 0.05).ConclusionsFSWs are at a substantially high risk of HPV infection and cervical dysplasia development as compared with healthy control subjects in Shenyang, China. Age of first sexual intercourse and post-menopause are two independent risk factors for HPV infection in this special group of population. Intensified and coordinated efforts from government, public health sector, communities and families are needed to reduce the risk of HPV infection in this specific group of population.

Gambaran Hasil Pemeriksaan Sitologi Serviks Wanita Pekerja Seksual Tidak Langsung pada Hotspot Maredan Kecamatan Tenayan Raya Pekanbaru

“…20 Hal yang berbeda didapatkan pada peneltian Jia di Cina 50% WPS melakukan koitus pada usia >20 tahun. 19 Perbedaan ini disebabkan karena tingkat pengetahuan mengenai kesehatan reproduksi WPS di Cina cukup baik. 19 Usia koitus pertama menjadi faktor penting karena menurut teori, wanita yang aktif melakukan hubungan seksual pada usia dibawah 18 tahun memiliki resiko lebih tinggi terkena kanker serviks.…”

“…19 Perbedaan ini disebabkan karena tingkat pengetahuan mengenai kesehatan reproduksi WPS di Cina cukup baik. 19 Usia koitus pertama menjadi faktor penting karena menurut teori, wanita yang aktif melakukan hubungan seksual pada usia dibawah 18 tahun memiliki resiko lebih tinggi terkena kanker serviks. 1,2,9 Hal ini dikarenakan sel epitel serviks yang masih belum matur lebih rentan terhadap infeksi.…”

“…6 Penelitian Jia di Cina pada didapatkan 53% WPS memiliki kelainan sel epithelial. 19 Perbedaan lainnya juga tampak pada penelitian Tideman di Sydney didapatkan hanya 17% WPS yang mengalami kelainan sel epitelial. 26 Hal ini disebabkan oleh regulasi prostitusi pada masing-masing negara, karenadi Australia prostitusi menjadi pekerjaan legal yang diatur secara ketat oleh hukum sehingga WPS mendapatkan pengawasan kesehatan oleh pemerintah secara berkelanjutan.…”

“…19 Hal ini bertolak belakang dengan penelitian Patel di India pada tahun 2013 didapatkan 50% responden telah bekerja lebih dari 10 tahun sebagai WPS. 20 Penelitian Bui di Phnom Penh pada tahun 2013 didapatkan 65% WPS telah bekerja >1 tahun sebagai WPS.…”

Regular condom use tends to decrease cervical lesions in resident-commercial sex workers in Sub-Saharan Africa

“…There exist different methods for cervical lesions screening and the most successful in the reduction of the incidence and mortality in commercial sex workers is the screening by Papanicolaou smear. (4,5) Early detection of cervical lesions has excellent prognosis (4) and is one of the most efficient ways of diagnosing the disease at an early pre-cancerous stage. (5) Cervical lesions in some region revealed a prevalence of 16.5% in resident commercial sex workers in Iran, (2) 12.46% in Hong Kong (3) and 21% in another survey reported in Shenyang, China.…”