High-risk human papillomavirus positivity and associated factors among women living with HIV in public health facilities of Mekelle, Northern Ethiopia.

backgroundWorldwide, it is believed that high-risk human papillomavirus (hr-HPV) strains are the root cause of many types of cancers, including cervical cancer, anorectal cancers, vaginal cancers, and penile cancers, with an estimated 922, 728 females diagnosed with HPV-related cancer in 2022. Particularly, in sub-Saharan Africa, the majority of women (55.13%) were affected by hr-HPV, and human immunodeficiency virus (HIV)-positive women have had double-fold higher risk of hr-HPV infection. Evidence is scarce in the study area; therefore, the current study aimed to assess the prevalence of hr-HPV and associated factors among HIV-positive women in public health facilities of Mekelle, Tigray, northern Ethiopia.

methodsA health facility-based cross-sectional study was conducted in five conveniently selected public health facilities of Mekelle, northern Ethiopia, from December 10, 2024, to July 10, 2025. The study included 390 consecutively recruited HIV-positive women, from whom questionnaire-based interviews were made, and provider-collected cervical brush specimens were processed using the Abbot cervi-collect kit in accordance with standard procedures. Following automated deoxyribonucleic acid (DNA) extraction using the Abbot m2000sp, the presence of 14 hr-HPV genotypes was detected using the m2000rt real-time polymerase chain reaction (RT-PCR) assay. Bivariate and multivariate logistic regression analyses were performed to assess the statistical association between the potential factors and hr-HPV status. Finally, statistical significance was declared at p < 0.05, along with the corresponding 95% confidence interval.

resultThe mean ± SD age of the respondents was 42 years (42.82 ± 9.55). The majority, 231/390 (59.2%) of the respondents, were of a normal weight, and with an overall mean Body Mass Index (BMI) of 21.77 ± 3.86 kg/m

conclusionThe findings of the current study indicate a high burden (39.7%) of oncogenic HPV strains among HIV-positive women, though lower than the pooled estimates in sub-Saharan Africa. Notably, HPV-16 and the non-HPV-16/18 high-risk genotypes collectively accounted for the majority of infections. Factors that influenced the presence of high-risk HPV included a history of unprotected sex before marriage, oral contraceptive use, vaginal discharge, genital ulcer disease, lack of awareness regarding HPV and cervical cancer, a shorter duration since ART initiation, frequent ART interruptions, and detectable recent HIV viral loads.