The prevalence of invasive cervical cancer (ICC) is high in Nigeria, with over 12,000 new cases responsible for over 8,000 deaths of women annually. This has been attributed to a large population of women with HIV infection who are 6 times at risk of developing ICC than women without HIV. We examined the distribution and prevalence of HPV genotypes among HIV-positive and HIV-negative women with ICC in Nigeria. We utilized baseline data and DNA samples from cervical tissue obtained from a prospective cohort study in Nigeria between March 2018 and September 2022. High-throughput next-generation amplicon sequencing of the HPV L-1 gene was used to identify and classify HPV genotypes from cervical samples. Logistic regression models were used to estimate associations between HIV and HPV infections. All statistical analyses were performed on Stata/BE 17.0 software. The study included 349 women (185 HIV-/ICC+, 64 HIV+/ICC+, 100 and HIV+/ICC-). The mean (SD) of HIV-positive women with ICC was 49.5 (10.9) years, compared to 47.0 (8.8) in HIV-positive women without ICC and 58.8 (12.9) in HIV-negative women with ICC, p <0.001. We tested 286 women (82.0%) for HPV and found HIV-positive women with ICC had a higher prevalence of HR-HPV, 77.6%, compared to 60.0% among HIV-negative women with ICC (p < 0.001). HIV-positive women showed the highest proportion of multiple HPV infections at 8.2%, compared to 1.4% among HIV-negative women with ICC and 2.1% without ICC (p < 0.001). HPV16 or HPV18 accounted for 65.1% (95% CI: 56.4, 72.9) of all HPV. The commonest HR-HPV detected included HPV16 (45.8%), HPV18 (19.4%), HPV45 (9.3%) and HPV35 (6.2%). Others Included HPV52 (5.4%), HPV59 (3.9%), and HPV58 (3.1%). LR-HPV genotypes had HPV11 (2.3%), HPV61 (1.6%), and HPV81 (1.6%). In multivariable models, the odds ratios comparing HIV-positive to HIV-negative women were 3.26 (95% CI: 1.44, 7.35; p = 0.004) for HR-HPV and 3.87 (95% CI: 2.71, 5.04; p < 0.001) for any HPV infections. In conclusion, HIV-positive women had the highest prevalence of HR-HPV and were associated with increased odds of acquiring HPV infection, highlighting the importance of understanding how long-term HIV infection may promote cervical cancer development
