HPV-DNA test access based on self-collection of vaginal samples from women living with HIV/AIDS: pilot implementation in Brazil

Authors

DOI:

https://doi.org/10.5327/DST-2177-8264-2024361499

Keywords:

HIV seropositivity, Human papillomavirus viruses , Mass screening , Uterine cervical neoplasms , Health services

Abstract

Introduction: Women living with HIV/AIDS have a higher frequency of anogenital neoplasms resulting from human papillomavirus (HPV) infection.
The World Health Organization recommends that cervical cancer screening uses molecular tests that amplify viral genetic material, such as HPV-DNA.
In addition to collection by health professionals, self-collection of vaginal samples is a useful tool for expanding access to testing. Objective: To describe
the results of the pilot study that evaluated the acceptability of self-collection of vaginal samples and the applicability of offering HPV-DNA tests with
self-collection of vaginal samples for women living with HIV/AIDS in Brazil. Methods: Descriptive cross-sectional study involving women living with
HIV/AIDS treated in eight HIV-specialty healthcare facilities distributed in all regions of the country from May 2021 to May 2022 and a central laboratory.
Vaginal self-collection was offered, and participants were interviewed about sociodemographic data and impressions of self-collection. Results: In total,
1,919 women living with HIV/AIDS with an average age of 45 years participated in the study. Some type of HPV was detected in 66% (1,267) of cases.
The majority (71.9%) said they preferred self-collection to sample collection by health care professionals. Only 53.8% of participants underwent cytology
at the appropriate frequency, as recommended by the protocol. Conclusion: The results may support the implementation of molecular biology tests to
detect HPV in women living with HIV/AIDS, including the possibility of vaginal self-collection, promoting increased access to cervical cancer screening.
Keywords: HIV seropositivity. Human papillomavirus viruses. Mass screening. Uterine cervical neoplasms. Health services.

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References

Instituto Nacional de Câncer. Estimativa 2020: incidência de câncer no

Brasil. Rio de Janeiro: INCA; 2019.

Programa Conjunto das Nações Unidas sobre o HIV/Aids. HPV e HIV:

dois vírus, uma resposta [Internet]. UNAIDS Brasil; 2018 [cited 2022 Mar

. Available from: https://unaids.org.br/2018/10/hpv-hiv-dois-virus-umaresposta/#:~:

text=

World Health Organization. Global strategy to accelerate the elimination of

cervical cancer as a public health problem and its associated goals and targets

for the period 2020–2030. WHA73.2. Agenda item 11.4. Genebra: WHO; 2020.

Instituto Nacional de Câncer. Detecção precoce do câncer de colo de

útero. Brasil: INCA; 2022 [cited 2022 Mar 8]. Available from: https://

www.gov.br/inca/pt-br/assuntos/gestor-e-profissional-de-saude/controledo-

cancer-do-colo-do-utero/acoes/deteccao-precoce

Instituto Nacional de Câncer. Diretrizes Brasileiras para o rastreamento do

câncer do colo do útero. Rio de Janeiro: INCA; 2016.

Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional de

Saúde: Ciclos de Vida. Rio de Janeiro: IBGE; 2019.

Instituto Nacional de Câncer. Monitoramento das ações de controle do

câncer do colo do útero e mama. Boletim INCA. 2021;12(1).

Instituto Nacional de Câncer. Monitoramento das ações de controle do

câncer de pele. Boletim INCA. 2022;13(1).

Basu P, Ponti A, Anttila A, Ronco G, Senore C, Vale DB, et al. Status of

implementation and organization of cancer screening in The European

Union Member States-Summary results from the second European screening

report. Int J Cancer. 2018;142(1):44-56. https://doi.org/10.1002/ijc.31043

Kim JJ, Burger EA, Regan C, Sy S. Screening for Cervical Cancer in Primary

Care: A Decision Analysis for the US Preventive Services Task Force.

JAMA. 2018;320(7):706-14. https://doi.org/10.1001/jama.2017.19872

Levi JE, Martins TR, Longatto-Filho A, Cohen DD, Cury L, Fuza LM,

et al. High-Risk HPV Testing in Primary Screening for Cervical Cancer

in the Public Health System, São Paulo, Brazil. Cancer Prev Res (Phila).

;12(8):539-46. https://doi.org/10.1158/1940-6207.CAPR-19-0076

World Health Organization. Laboratory diagnosis of sexually transmitted

infections, including human immunodeficiency virus. Genebra: WHO; 2013.

Teixeira JC, Vale DB, Bragança JF, Campos CS, Discacciati MG, Zeferino

LC. Cervical cancer screening program based on primary DNA-HPV

testing in a Brazilian city: A cost-effectiveness study protocol. BMC Public

Health. 2020;20(1):576. https://doi.org/10.1186/s12889-020-08688-4

World Health Organization. WHO guideline for screening and treatment

of cervical pre-cancer lesions for cervical cancer prevention. 2ª ed.

Genebra: WHO; 2021.

Ogale Y, Yeh PT, Kennedy CE, Toskin I, Narasimhan M. Self-collection of

samples as an additional approach to deliver testing services for sexually

transmitted infections: A systematic review and meta-Analysis. BMJ Glob

Health. 2019;4(2):e001349. https://doi.org/10.1136/bmjgh-2018-001349

Miranda AE, Silveira MF, Travassos AG, et al. High-risk papillomavirus

infection among women living with human Immunodeficiency virus:

Brazilian multicentric study. J Med Virol. 2017;89(12):2217-23. https://

doi.org/10.1002/jmv.24906

Woo YL, Khoo SP, Gravitt P, Hawkes D, Rajasuriar R, Saville M. The

Implementation of a Primary HPV Self-Testing Cervical Screening Program in

Malaysia through Program ROSE-Lessons Learnt and Moving Forward. Curr

Oncol. 2022;29(10):7379-87. https://doi.org/10.3390/curroncol29100579

Rodrigues LLS, Hardick J, Nicol AF, et al. Sexually transmitted infections

among HIV-infected and HIV-uninfected women in the Tapajós region,

Amazon, Brazil: Self-collected vs. clinician-collected samples. PLoS One.

;14(4):e0215001. https://doi.org/10.1371/journal.pone.0215001

Wang R, Lee K, Gaydos CA, Anderson JR, Keller J, Coleman JS.

Performance of Primary Self-Collected Human Papillomavirus Testing

Among Women Living With Human Immunodeficiency Virus in

the United States. Obstet Gynecol. 2021;137(2):342-4. https://doi.

org/10.1097/AOG.0000000000004238

Mayrand M-H, Duarte-Franco E, Rodrigues I, Walter SD, Hanley J,

Ferenczy A, et al. Human papillomavirus DNA versus Papanicolaou

screening tests for cervical cancer. N Engl J Med. 2007;357(16):1579-88.

https://doi.org/10.1056/NEJMoa071430

Ratnam S, Franco EL, Ferenczy A. Human papillomavirus testing for

primary screening of cervical cancer precursors. Cancer Epidemiol

Biomarkers Prev. 2000;9(9):945-51.

Huh WK, Ault KA, Chelmow D, Davey DD, Goulart RA, Garcia

FAR, et al. Use of primary high-risk human papillomavirus testing for

cervical cancer screening: interim clinical guidance. Obstet Gynecol.

;125(2):330-7. https://doi.org/10.1097/AOG.0000000000000669

Rebolj M, Rimmer J, Denton K, Tidy J, Mathews C, Ellis K, et al.

Primary cervical screening with high risk human papillomavirus testing:

observational study. BMJ. 2019;364:l240. https://doi.org/10.1136/bmj.l240

Zeferino LC, Bastos JB, do Vale DBAP, Zanine RM, Melo YLMF,

Primo WQSP, et al. Guidelines for HPV-DNA testing for cervical cancer

screening in Brazil. Rev Bras Ginecol Obstet. 2018;40(6):360-8. https://

doi.org/10.1055/s-0038-1657754

Teixeira JC, Vale DB, Campos CS, Bragança JF, Discacciati MG, Zeferino

LC. Organization of cervical cancer screening with DNA–HPV testing

impact on early–stage cancer detection: a population–based demonstration

study in a Brazilian city. Lancet Reg Heal. 2022;5:100084. https://doi.

org/10.1016/j.lana.2021.100084

Martins TR, Longatto-Filho A, Cohen D, Viscondi JYK, Fuza LM,

Cury L, et al. Influence of Prior Knowledge of Human Papillomavirus

Status on the Performance of Cytology Screening. Am J Clin Pathol.

;149(4):316-23. https://doi.org/10.1093/ajcp/aqx163

Agorastos T, Chatzistamatiou K, Tsertanidou A, Mouchtaropoulou E,

Pasentsis K, Kitsou A, et al. Implementation of HPV-based Cervical Cancer

Screening Combined with Self-sampling Using a Midwifery Network

Across Rural Greece: The GRECOSELF Study. Cancer Prev Res (Phila).

;12(10):701-10. https://doi.org/10.1158/1940-6207.CAPR-19-0192

Arbyn M, Smith SB, Temin S, Sultana F, Castle P. Detecting cervical

precancer and reaching underscreened women by using HPV testing on

self samples: updated meta-analyses. BMJ. 2018;363:k4823. https://doi.

org/10.1136/bmj.k4823

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Published

2024-08-22

How to Cite

1.
Gaspar P, de Melo Machado H, Bazzo ML, Scherer A, Colusso Álvaro L, Álvares Travassos AG, et al. HPV-DNA test access based on self-collection of vaginal samples from women living with HIV/AIDS: pilot implementation in Brazil. DST [Internet]. 2024 Aug. 22 [cited 2024 Nov. 21];36. Available from: https://bjstd.org/revista/article/view/1412

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