{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T14:43:04Z","timestamp":1754145784828,"version":"3.41.2"},"reference-count":28,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/100000098","name":"Clinical Center","doi-asserted-by":"publisher","award":["UM1CA121947"],"award-info":[{"award-number":["UM1CA121947"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Washington & Fred Hutchinson Cancer Research, Center Center for AIDS Research, NIH","award":["P30-AI27757"],"award-info":[{"award-number":["P30-AI27757"]}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["T32 HD075731"],"award-info":[{"award-number":["T32 HD075731"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["D43 TW009340"],"award-info":[{"award-number":["D43 TW009340"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2024,12,23]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Evidence of self-collection human papillomavirus (HPV)-RNA testing in cervical cancer screening is limited among women with HIV (WHIV). Most studies are in low-risk patient populations in high-income countries. We examine the prevalence of high-risk HPV (hrHPV) using the APTIMA HPV-RNA assay on self-collected versus provider-collected specimens, and the associated risk factors for high-grade cervical intraepithelial neoplasia (CIN2\/3) among women engaged in sex work in Kenya. Among WHIV, we examine the performance of both collection methods for the detection of CIN2\/3.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants were aged \u226518 years, non-pregnant and had no previous treatment for cervical precancer. The screening process included self-collection of cervicovaginal samples using a Viba cytobrush (Rovers), provider-collected cervical samples, visual inspection with acetic acid (VIA) and Pap smear. The APTIMA HPV Assay (Hologic) was used to detect E6\/E7 oncogene RNA of 14 hrHPV types in both self-collected and on provider-collected samples. Risk factors for CIN2\/3 were determined via multivariable logistic regression. We estimated test characteristics for each screening method for CIN2\/3 detection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 400 women (194 WHIV, 206 women without HIV) underwent screening between 2013 and 2018, with 399 valid HPV results. WHIV had a higher prevalence of hrHPV by self-collection compared with women without HIV (44.0% vs 29.6%, p&lt;0.05) and CIN2\/3 (19.0% vs 9.7%, p&lt;0.05). After adjusting for age and HIV status, hrHPV-positivity increased the risk of CIN2\/3 by 13 to 20 times. Among WHIV, the sensitivity for CIN2\/3 detection was similar between self-collection (85% (66-96)) and provider-collection (93% (76-99)), both of which were higher than the sensitivity of high-grade cytology (high-grade squamous intraepithelial lesion cut-off) (47% (95% CI 23 to 72)). The specificity for both collection methods (self: 66% (95% CI 57 to 75) and provider: 67% (95% CI 58 to 75)) was lower than cytology (85% (95% CI 78 to 91)).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Self-collection for HPV-RNA testing performed similarly to provider-collection among WHIV. For WHIV, while the higher sensitivity of HPV-RNA testing compared with cytology for the detection of clinically relevant cervical disease is important, the lower specificity supports the inclusion of a triage test in the screening algorithm.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/sextrans-2024-056159","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T20:30:46Z","timestamp":1743539446000},"page":"301-306","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Self-collection for high-risk HPV-RNA detection among HIV-seropositive and HIV-seronegative women engaged in sex work in Kenya"],"prefix":"10.1136","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5770-6966","authenticated-orcid":false,"given":"Fan","family":"Lee","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica Yasmine","family":"Islam","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Program, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Musila","family":"Mutua","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya"},{"name":"Department of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Kabare","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya"},{"name":"Department of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Griffins","family":"Manguro","sequence":"additional","affiliation":[{"name":"Ghent University Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wairimu","family":"Waweru","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya"},{"name":"Department of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kishor N","family":"Mandaliya","sequence":"additional","affiliation":[{"name":"Pathcare Laboratories, Mombasa, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juma","family":"Shafi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya"},{"name":"Department of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R Scott","family":"McClelland","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya"},{"name":"Department of Medicine, University of Washington, Seattle, Washington, USA"},{"name":"Department of Global Health, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer S","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"},{"name":"The University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,1]]},"reference":[{"key":"2025071705300644000_101.5.301.1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F"},{"key":"2025071705300644000_101.5.301.2","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000455"},{"key":"2025071705300644000_101.5.301.3","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1016\/j.ajog.2014.12.003","article-title":"Incidence of cervical precancers among HIV-seropositive women","volume":"212","author":"Massad","year":"2015","journal-title":"Am J Obstet Gynecol"},{"key":"2025071705300644000_101.5.301.4","doi-asserted-by":"crossref","DOI":"10.1097\/QAI.0b013e31829cb7c3","article-title":"Invasive cervical cancer risk among HIV-infected women is a function of CD4 count and screening","volume":"63","author":"Abraham","year":"2013","journal-title":"J Acquir Immune Defic 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