Human papillomavirus prevalence in male and female university students in Gaborone, Botswana

Abstract

In 2015, Botswana introduced the quadrivalent human papillomavirus (HPV) vaccine as a two-dose schedule in girls aged 9–13 years. We sought to establish a baseline HPV prevalence in unvaccinated young adults in Botswana. HIV-uninfected men and women aged 18–22 years were recruited from the University of Botswana in Gaborone during October 2019–February 2021. Demographic and behavioural characteristics were self-reported during structured interviews. Self-collected vaginal and penile swabs were tested for 28 HPV types using Seegene Anyplex II HPV28. We compared any HPV type, quadrivalent vaccine (HPV 6, 11, 16, 18)-type and non-quadrivalent vaccine-type prevalence in men and women and evaluated the risk factors for prevalence of any HPV type. A total of 493 men and 500 women were included in the analysis. Compared to men, women had higher prevalence of any HPV type (63.0% versus 31.4%, P < 0.001), vaccine-type HPV (21% versus 9.7%, P < 0.001) and non-vaccine-type HPV (60.4% versus 28.4%, P < 0.001). Higher prevalence of any HPV type in men and women was associated with having ≥2 sex partners in the past 12 months; always using condoms in the past 3 months was associated with a lower HPV prevalence. These data provide baseline information for future evaluation of the population impact of the HPV vaccination programme, including potential herd effects in men.

Cervical human papillomavirus genotypes in a high HIV setting: A scoping review of a decade of human papillomavirus epidemiological research in Botswana

“…Regardless of the genotyping method used, the positivity rate for HPV-16 in HIV-positive women with precancerous lesions to cancer is between 45% and 47.7% ( 26 , 27 , 29 ), and between 4.5% and 26.1% for HPV-18 ( 26 – 29 ). These values are much lower (1.5% to 14%, and 0.5% to 15%, for HPV-16 and HPV-18, respectively) when young subjects are studied ( 19 , 20 , 25 ), and this is consistent with the natural history of HPV infection. The results of all genotyping assays were in good agreement for the HPV-16 genotype, whereas different methods showed very different results for HPV-18 genotype ( Table 2 ).…”

“…Twelve studies from Botswana met the criteria for inclusion, with a total of 2,284 young subjects (18 to 22 years of age) who were free of cervical lesions ( 19 , 20 , 25 ); 559 who had cervical cancer or pre-cancer ( 26 – 29 ) and 1,731 who were unclassified as having any malignancies ( 30 – 34 ). Details on each of the included studies are presented in Tables 1 , 2 .…”

“…Four studies (using three different cohorts), totaling 459 cervical cancer cases, examined HPV DNA from biopsies ( 27 – 29 ). Eight studies, totaling 3,945 subjects, examined HPV DNA from cervical cells ( 19 , 20 , 25 , 26 , 31 – 34 ). Finally, one study examined HPV genotypes in 170 women through a serology test ( 30 ).…”

“…In this context, it is critical to clarify that data on the HPV burden in general population of Botswana is still lacking ( 18 ). However, recent data on young university students (aged 18-22 years) show a rate of about 60% HPV positivity ( 19 , 20 ) ( Table 1 ). This evidence emphasizes the need to examine the prevalence of HPV among other age groups in Botswana.…”

Characterization of HPV subtypes in invasive cervical cancer in Botswana patients using a pan-pathogen microarray technology

“…A critical piece of Botswana's efforts to combat cervical cancer is widespread vaccination campaign. Unvaccinated women in Botswana have high prevalence of cervical HPV infection (60%) [ 9 , 10 ]. Introduced in 2015, the national vaccination campaign utilized the quadrivalent HPV vaccine as a two-dose schedule (1, 6–12 months), for in-school girls.…”