Population-based type-specific prevalence of high-risk human papillomavirus infection in Estonia

<p>Abstract</p> <p>Background</p> <p>Effective prophylactic vaccines are available against human papillomavirus (HPV) types 6, 11, 16, and 18 which are licensed for routine use among young women. Monitoring is needed to demonstrate protection against cervical cancer, to verify duration of protection, and assess replacement frequency of non-vaccine types among vaccinated cohorts.</p> <p>Methods</p> <p>Data from a population-based study were used to assess the type-specific prevalence of HPV in a non-vaccinated population in Estonia: 845 self-administered surveys and self-collected vaginal swabs were distributed, 346 were collected by mail and tested for HPV DNA from female participants 18-35 years of age.</p> <p>Results</p> <p>The overall HPV prevalence (weighted estimate to account for the sampling method) in the study population (unvaccinated women aged 18-35) was calculated to be 38% (95% CI 31-45%), with estimated prevalences of high- and low-risk HPV types 21% (95% CI 16-26%), and 10% (95% CI 7-14%), respectively. Of the high-risk HPV types, HPV 16 was detected most frequently (6.4%; 95% CI 4.0-9.8%) followed by HPV 53 (4.3%; 95% CI 2.3-7.2%) and HPV 66 (2.8%; 95% CI 1.3-5.2%).</p> <p>Conclusions</p> <p>We observed a high prevalence of total and high-risk type HPV in an Eastern European country. The most common high-risk HPV types detected were HPV 16, 53, and 66.</p

Refining HIV Risk: The Modifying Effects of Youth, Gender and Education among People Who Inject Drugs in Poland

<div><p>Objective</p><p>The goal of this study was to examine specific factors placing young (aged <30) women who inject drugs at higher risk for HIV, and to establish the need for targeted interventions within this population.</p><p>Methods</p><p>A national cross-sectional sero-survey was conducted in 2004–2005 in six regions in Poland. A snowball sample of ever-injectors was recruited from drug treatment facilities and the surrounding community. Log-binomial regression was used to estimate adjusted prevalence ratios (PRs).</p><p>Results</p><p>A total of 491 injection drug users younger than 30 were recruited, of whom 159 were women and 332 were men. The prevalence of HIV was 16.4% and 9.6% among women and men, respectively. In multivariate analysis, young female injectors whose education terminated at the primary level were more likely to be HIV-positive compared to males with a similar level of education (PR = 3.34, 95% CI = 1.86–6.00) and more highly educated women (PR = 4.16, 95% CI = 2.21–7.82).</p><p>Conclusions</p><p>This study confirms an elevated risk of HIV among under-educated young women. Suggestions for specific interventions to reduce HIV transmission are presented. Additional research is needed to quantify the differential distribution of risk behaviors which amplify their likelihood of transmission.</p></div

Unadjusted prevalence ratios (PR) calculated in univariate analyses and adjusted prevalence ratios (APR) estimated in log-binomial model fitted for young (<30) PWID, with 95% confidence intervals (CI).

*<p>The final log-binomial model used to estimate APRs included the following terms: Gender (females vs. males), Education (primary vs. more than primary sch.), IDU initiation (<5 years ago vs. ≥5 years ago), Needle sharing (ever vs. never), Sex with PWID (ever vs. never), Cohabiting with spouse/partner (yes vs. no) and an interaction term between Gender and Education. Due to significant interaction between Gender and Education, the effect of Gender is presented separately for lower (primary school) and better educated (more than primary school) study participants, just as effect of Education is presented separately for females and males.</p

Sociodemographic characteristics of young (<30) female compared to young male PWID in a cross-sectional study conducted in Poland, 2004–2005.

*<p>in-patient = in-patient treatment facilities and programs; out-patient = community-based programs serving PWID and surrounding community.</p>**<p>may be in more than one category.</p

HIV prevalence with 95% confidence intervals stratified by gender and age, in a cross-sectional study conducted in Poland, 2004–2005.

<p>Of the 748 respondents to the original survey, 137 (18.3%) had a positive test result for HIV. Upon age stratification, females in younger age groups tended to have a higher level of HIV infection compared to males. Overall, HIV prevalence among females and males aged <30 years (analyzed subset of the original dataset) was 16.4% and 9.6%, respectively. Among those ≥30 years, the relative proportions were reversed: HIV prevalence was 21.4% among females and 33.5% among males.</p

Injection risk behaviors of young (<30) female compared to young male PWID.

*<p>when injecting with borrowed needles/syringes.</p>**<p>when injecting with new needles/syringes.</p

New Mother\u27s Knowledge and Attitudes About Perinatal Human Immunodeficiency Virus infection

Objectives: To assess new mothers’ attitudes toward perinatal human immunodeficiency virus (HIV) testing, their knowledge about perinatal HIV, and their trust of government and scientists. Methods: In a cross-sectional survey of 1362 postpartum women at four United States locations in 1997, a standardized interview was administered to new mothers 24–48 hours postpartum to determine their HIV test acceptance, attitudes, and knowledge. Results: Seventy-five percent of women who were offered HIV tests reported being tested. Although 95% of women were aware of perinatal HIV transmission, only 60% knew that HIV can be transmitted through breast-feeding, and only 51% knew of medication to prevent perinatal transmission. Eighty-four percent of women thought that all pregnant women should be tested for HIV, and 60% thought that prenatal HIV testing should be legally mandated. Twenty percent of women indicated mistrust of government and scientists regarding origins of HIV and potential cures for AIDS. Knowledge about perinatal transmission was unrelated to receipt of prenatal HIV tests. When other factors were controlled for, mistrust was not significantly associated with getting tested. Conclusion: Incomplete knowledge of prevention of perinatal HIV transmission and mistrust were prevalent among new mothers. Knowledge deficits or mistrust did not appear to reduce reported prenatal test rates, but our data suggest that future public health efforts need to educate women about methods of preventing perinatal HIV transmission and at enhancing their trust in the public health system