IPROC iproc Iproceedings 2369-6893 JMIR Publications Toronto, Canada v4i1e10590 10.2196/10590 Abstract Abstract Determinants for Genital Human Papillomavirus (HPV) Infection in Tunisian Women with Normal Pap smear: Are There Different Risk Profiles for Oncogenic and Nononcogenic HPV Types? Khader Yousef Letaief Hejer Hechaichi A Bouguerra H Saffar F Chelly S Cherif A Rejaibi S Mechala M Chahed K Bougatef S Kouni M Ardhaoui M Ennaifer E Boubaker S Corresponding Author: Hejer Letaief hejerletaief@gmail.com Jan-Dec2018 29 03 2018 4 1 e10590 29 3 2018 29 3 2018 ©Hejer Letaief, A Hechaichi, H Bouguerra, F Saffar, S Chelly, A Cherif, S Rejaibi, M Mechala, K Chahed, S Bougatef, M Kouni, M Ardhaoui, E Ennaifer, S Boubaker. Originally published in Iproceedings (http://www.iproc.org), 29.03.2018. 2018

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 Background

Most studies of risk factors for HPV infection have focused on overall HPV positivity and have not examined determinants for high-risk and low-risk HPV types separately.

 Objective

To evaluate the prevalence and type distribution of high-risk and low-risk HPV infection and to describe the risk factors associated with different profiles in Tunisia.

 Methods

We studied risk determinants for genital HPV infection in a randomly sample of women aged 18 years and older with normal cervical cytology in Tunisia during 2014. All women had a personal interview, a Pap smear, and cervical swabs for HPV DNA detection using a PCR technique. Information on sociodemographic, reproductive, lifestyle characteristics, and health-seeking behaviors was collected.

 Results

The overall HPV prevalence was 7.5% (IC95% [5.9%-9.0%]). Prevalence of HRHPV was 4.8%(IC95% [3.7%-6.2%]) and LRHPV 3.8%(IC95% [2.8%-4.8%]). Of HPV-positive women, 64.0% (IC95% [53.8%-74.4%]) had high oncogenic HPV types, and 45.3% (IC95% [33.0%-54.8%]) had low oncogenic HPV types. Simple infection was predominant within 76.6% (IC95% [66.3%-83.9%]) of positive women. Younger age and lifetime measures of sexual activity (notably, number of partners) were the main risk factors for the oncogenic HPV types. A statistically increase risk was found in women whose partners had multiple sex partners. Furthermore, a previous sexual infection was associated with the high-risk HPV types. HR-HPV infection risk was observed in women aged less than 30 years, who were smokers, divorced/separated and having a high educational level. In contrast, the most important determinants for nononcogenic HPV infection were contraceptive variables related to the physical protection of the cervix and low standard of living.

 Conclusions

The results indicate that different risk profiles exist for infections with different HPV groups with high-risk types being the most common types detected. HR-HPV positivity was associated with social determinants, behavioral and sexual characteristics. These results should assist in designing strategies for control of cervical cancer targeting at risk population.