{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T02:34:08Z","timestamp":1787625248095,"version":"build-2736575974"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T00:00:00Z","timestamp":1658102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Par\u00e1 State Amazonian Research Foundation","award":["FAPESPA \u2013 ICAAF 014\/2012"],"award-info":[{"award-number":["FAPESPA \u2013 ICAAF 014\/2012"]}]},{"DOI":"10.13039\/501100006506","name":"Brazilian Ministry of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006506","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The Human Papillomavirus (HPV) and <jats:italic>Chlamydia trachomatis<\/jats:italic> are the most prevalent Sexually Transmitted Infections (STIs) worldwide, and are associated cervical cancer and pelvic inflammatory disease, respectively. However, 80% of women testing positive are asymptomatic. In the Amazon region, young women, in particular, are widely exposed to the infections and their consequences.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Determine the prevalence of sexual infection by HPV and <jats:italic>C<\/jats:italic>. <jats:italic>trachomatis<\/jats:italic> in young, sexually-active women treated at a university health program in a large city of the Brazilian Amazon region.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We amplified the <jats:italic>L1 gene<\/jats:italic> of HPV. We amplified <jats:italic>ompA<\/jats:italic> gene of <jats:italic>C<\/jats:italic>. <jats:italic>trachomatis<\/jats:italic> by nested PCR, and the study participants filled in a questionnaire on their social, epidemiological, and reproductive health characteristics. The data were analyzed using the Odds Ratio, to evaluate the degree of association of these variables with the observed infections.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>The prevalence of infection by HPV was 15.5% (47\/303). This infection was recorded in 32.2% of the women of less than 25 years of age (OR:3.02 [CI95%] = 1.32\u20136.92; <jats:italic>p<\/jats:italic> = 0.014), 17.9% of the single women (OR: 2.41 [CI95%] = 1.22\u20134.75; <jats:italic>p<\/jats:italic> = 0.014), 23.8% of the women that reported having first sexual intercourse at less than 15 years of age (OR: 2.22 [CI95%] = 1.16\u20134.23; <jats:italic>p<\/jats:italic> = 0.021), 20% of those that reported having had more than one sexual partner during their lifetime (OR: 3.83 [CI95%] = 1.56\u20139.37; <jats:italic>p<\/jats:italic> = 0.003), and in 28.3% that use oral contraceptives (CI95% = 1.33\u20135.43; <jats:italic>p<\/jats:italic> = 0.008). The prevalence of sexual infection by <jats:italic>C<\/jats:italic>. <jats:italic>trachomatis<\/jats:italic> was 4.6% (14\/303), and this bacterium was present in 16.1% of the young women of less than 25 years of age (OR: 2.86 [CI95%] = 1.33\u20135.43; <jats:italic>p<\/jats:italic> = 0.008).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>We found a high prevalence of HPV in young, unmarried women who started their sex lives early, who had several sexual partners in their lives and who used oral contraceptives. The prevalence of <jats:italic>C<\/jats:italic>. <jats:italic>trachomatis<\/jats:italic> was high only in young women. Our data are in accordance with other studies in Brazil and in the world and may serve to base the formulation of diagnostic and screening measures for these infections in women in the Amazon.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0270874","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T17:24:52Z","timestamp":1658165092000},"page":"e0270874","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":16,"title":["High prevalence of sexual infection by human papillomavirus and Chlamydia trachomatis in sexually-active women from a large city in the Amazon region of Brazil"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0253-7277","authenticated-orcid":true,"given":"Leonardo Miranda","family":"dos Santos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5484-0553","authenticated-orcid":true,"given":"Josiellem Damasceno","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilary Acha","family":"Mbakwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akim Felipe Santos","family":"Nobre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo Covre","family":"Vieira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen Francis","family":"Ferrari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anderson Raiol","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edna Aoba Yassui","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Farias","family":"Guerreiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00edsa Silva","family":"de Sousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,7,18]]},"reference":[{"issue":"5","key":"pone.0270874.ref001","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1097\/PGP.0000000000000556","article-title":"HPV 6-associated HSIL\/Squamous Carcinoma in the Anogenital Tract","volume":"38","author":"MZ Liu","year":"2019","journal-title":"Int J Gynecol Pathol"},{"issue":"10167","key":"pone.0270874.ref002","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0140-6736(18)32470-X","article-title":"Cervical Cancer","volume":"393","author":"PA Cohen","year":"2019","journal-title":"Lancet"},{"issue":"4","key":"pone.0270874.ref003","first-page":"300","article-title":"Relation Between Chlamydia trachomatis Infection and Pelvic Inflammatory Disease, Ectopic Pregnancy and Tubal Factor Infertility in a Dutch Cohort of Women Previously Tested for Chlamydia in a Chlamydia Screening Trial","volume":"95","author":"BM Hoenderboom","year":"2019","journal-title":"Sex Transm Infect"},{"issue":"9","key":"pone.0270874.ref004","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1093\/cid\/ciz429","article-title":"Chlamydia Trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients","volume":"69","author":"CDJ Heijer","year":"2019","journal-title":"Clin Infect Dis"},{"key":"pone.0270874.ref005","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.mrrev.2016.07.002","article-title":"Human Papillomavirus Molecular Biology","volume":"772","author":"ME Harden","year":"2017","journal-title":"Review. Mutat Res Rev Mutat Res."},{"issue":"9","key":"pone.0270874.ref006","first-page":"2359","article-title":"Association between Human Papillomavirus and Non-cervical Genital Cancers in Brazil: A Systematic Review and Meta-Analysis","volume":"19","author":"LD Peder","year":"2018","journal-title":"Asian Pac J Cancer Prev"},{"key":"pone.0270874.ref007","article-title":"Chlamydia Trachomatis Targets Mitochondrial Dynamics to Promote Intracellular Survival and Proliferation","author":"Y Kurihara","year":"2019","journal-title":"Cell Microbiol"},{"issue":"8","key":"pone.0270874.ref008","doi-asserted-by":"crossref","first-page":"e0004859","DOI":"10.1371\/journal.pntd.0004859","article-title":"Blinding trachoma: systematic review of rates and risk factors for progressive disease","volume":"10","author":"A.M. Ramadhani","year":"2016","journal-title":"PLOS Neglected Tropical Diseases"},{"issue":"61 Suppl 8","key":"pone.0270874.ref009","doi-asserted-by":"crossref","first-page":"S865","DOI":"10.1093\/cid\/civ756","article-title":"Lymphogranuloma Venereum 2015: Clinical Presentation, Diagnosis, and Treatment","volume":"15","author":"P.B. Stoner","year":"2015","journal-title":"Clinical Infectious Diseases"},{"issue":"1","key":"pone.0270874.ref010","doi-asserted-by":"crossref","first-page":"17","DOI":"10.4103\/ijmm.IJMM_16_341","article-title":"Molecular Typing of Chlamydia trachomatis: An Overview","volume":"35","author":"J Rawre","year":"2017","journal-title":"Indian J Med Microbiol"},{"key":"pone.0270874.ref011","unstructured":"Centers for Disease Control and Prevention. Chlamydia. Sexually Transmitted Disease Surveillance 2018."},{"issue":"5","key":"pone.0270874.ref012","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1200\/JGO.2016.008151","article-title":"Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline","volume":"3","author":"S Arrossi","year":"2017","journal-title":"J Glob Oncol"},{"issue":"12","key":"pone.0270874.ref013","doi-asserted-by":"crossref","first-page":"729","DOI":"10.3390\/v10120729","article-title":"Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing","volume":"10","author":"AC Chrysostomou","year":"2018","journal-title":"Viruses"},{"issue":"2","key":"pone.0270874.ref014","doi-asserted-by":"crossref","first-page":"128","DOI":"10.7326\/0003-4819-147-2-200707170-00172","article-title":"Screening for Chlamydial Infection: U.S. Preventive Services Task Force Recommendation Statement","volume":"147","author":"U.S. Preventive Services Task Force","year":"2007","journal-title":"Ann Intern Med"},{"issue":"3","key":"pone.0270874.ref015","first-page":"319","article-title":"A New National Chlamydia Sentinel Surveillance System in Australia: Evaluation of the First Stage of Implementation","volume":"34","author":"RJ Guy","year":"2010","journal-title":"Commun Dis Intell Q Rep"},{"key":"pone.0270874.ref016","unstructured":"Brasil. Informe t\u00e9cnico sobre a vacina papilomav\u00edrus na aten\u00e7\u00e3o b\u00e1sica. Secretaria de Vigil\u00e2ncia em Sa\u00fade, Departamento de Vigil\u00e2ncia de Doen\u00e7as Trnasmiss\u00edveis, Coordena\u00e7\u00e3o Geral do Programa Nacional de Imuniza\u00e7\u00f5es, Minist\u00e9rio da Sa\u00fade, 2014."},{"key":"pone.0270874.ref017","unstructured":"BRASIL, estrat\u00e9gia de rastreamento do c\u00e2ncer do colo uterino. Minist\u00e9rio da sa\u00fade, 2016."},{"issue":"2","key":"pone.0270874.ref018","doi-asserted-by":"crossref","first-page":"e0229154","DOI":"10.1371\/journal.pone.0229154","article-title":"Prevalence of human papillomavirus (HPV) in Brazil: A systematic review and meta-analysis","volume":"15","author":"V Colpani","year":"2020","journal-title":"PLoS One"},{"issue":"2","key":"pone.0270874.ref019","doi-asserted-by":"crossref","first-page":"134","DOI":"10.3855\/jidc.6474","article-title":"Genotyping and prevalence of Chlamydia trachomatis infection among women in Bel\u00e9m, Par\u00e1, northern Brazil","volume":"10","author":"DM Brasiliense","year":"2016","journal-title":"J Infect Dev Ctries"},{"issue":"3","key":"pone.0270874.ref020","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1590\/0037-8682-0169-2016","article-title":"Prevalence and factors associated with Chlamydia trachomatis infection among women with HIV in S\u00e3o Paulo","volume":"49","author":"Pinto Vm","journal-title":"Rev Soc Bras Med Trop"},{"key":"pone.0270874.ref021","first-page":"101","article-title":"Alta incid\u00eancia da infec\u00e7\u00e3o urogenital por Chlamydia trachomatis em mulheres parturientes de Bel\u00e9m, Estado do Par\u00e1, Brasil","volume":"7","author":"LM Santos","year":"2016","journal-title":"Revista Pan-Amaz\u00f4nica de Sa\u00fade (Online)"},{"key":"pone.0270874.ref022","doi-asserted-by":"crossref","first-page":"27","DOI":"10.5123\/S2176-62232017000300004","article-title":"Preval\u00eancia da infec\u00e7\u00e3o endocervical de Chlamydia trachomatis em universit\u00e1rias do Estado do Par\u00e1, regi\u00e3o Amaz\u00f4nica, Brasil","volume":"8","author":"WL Santos Ulian","year":"2017","journal-title":"Revista Pan-Amaz\u00f4nica de Sa\u00fade (Online)"},{"key":"pone.0270874.ref023","doi-asserted-by":"crossref","first-page":"e0207853","DOI":"10.1371\/journal.pone.0207853","article-title":"High prevalence of sexual Chlamydia trachomatis infection in young women from Maraj\u00f3 Island, in the Brazilian Amazon","volume":"13","author":"L.M. Santos","year":"2018","journal-title":"PLoS One"},{"key":"pone.0270874.ref024","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1590\/s1678-9946201961006","article-title":"High prevalence of Chlamydia trachomatis in pregnant women attended at Primary Health Care services in Amazon, Brazil","volume":"61","author":"MJN Azevedo","year":"2019","journal-title":"Rev Inst Med Trop Sao Paulo"},{"issue":"4","key":"pone.0270874.ref025","doi-asserted-by":"crossref","first-page":"e0215001","DOI":"10.1371\/journal.pone.0215001","article-title":"Sexually transmitted infections among HIV-infected and HIV-uninfected women in the Tapaj\u00f3s region, Amazon, Brazil: Self-collected vs. clinician-collected samples","volume":"14","author":"LLS Rodrigues","journal-title":"PLoS One"},{"issue":"4","key":"pone.0270874.ref026","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1177\/0956462418809297","article-title":"Chlamydia trachomatis infection in women living in remote areas in Amazonas, Brazil-a self-collection screening experience","volume":"30","author":"D Rocha","year":"2019","journal-title":"Int J STD AIDS"},{"key":"pone.0270874.ref027","article-title":"Human Papillomavirus and Chlamydia Trachomatis Infections in Adolescents and Young Women: Prevalence and Risk Factors","author":"AA Ribeiro","year":"2020","journal-title":"Diagn Cytopathol"},{"issue":"5","key":"pone.0270874.ref028","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1177\/0956462419898982","article-title":"Prevalence and Risk Factors Associated With Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium Among Women in Pelotas, Southern Brazil","volume":"31","author":"MF Silveira","year":"2020","journal-title":"Int J STD AIDS"},{"key":"pone.0270874.ref029","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1136\/sextrans-2011-050309","article-title":"HIV and Sexually Transmitted Infections at the borderlands: Situational analysis of sexual health in the Brazilian Amazon","volume":"88","author":"A Benzaken","year":"2012","journal-title":"Sex Transm Infect"},{"issue":"4","key":"pone.0270874.ref030","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1177\/0956462418809297","article-title":"Chlamydia trachomatis infection in women living in remote areas in Amazonas, Brazil-a self-collection screening experience","volume":"30","author":"D Rocha","year":"2019","journal-title":"Int J STD AIDS"},{"key":"pone.0270874.ref031","first-page":"209","article-title":"The use of polymerase chain reaction amplification for the detection of genital human papillomaviruses","volume":"7","author":"MM Manos","year":"1989","journal-title":"Cancer Cells"},{"key":"pone.0270874.ref032","doi-asserted-by":"crossref","first-page":"16","DOI":"10.25259\/Cytojournal_24_2021","article-title":"Squamous intraepithelial lesions (SIL: LSIL, HSIL, ASCUS, ASC-H, LSIL-H) of Uterine Cervix and Bethesda System","volume":"18","author":"A Alrajjal","year":"2021","journal-title":"Cytojournal"},{"issue":"8","key":"pone.0270874.ref033","doi-asserted-by":"crossref","first-page":"2649","DOI":"10.1128\/JCM.00451-07","article-title":"Development of real-time PCR assays for genotyping of Chlamydia trachomatis","volume":"45","author":"H Jalal","year":"2007","journal-title":"Journal of Clinical and Microbiology"},{"key":"pone.0270874.ref034","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13027-015-0017-x","article-title":"Prevalence of type-specific HPV among female university students from northern Brazil","volume":"10","author":"RC Vieira","year":"2015","journal-title":"Infect Agent Cancer"},{"key":"pone.0270874.ref035","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1055\/s-0037-1604027","article-title":"Prevalence of Human Papillomavirus Infection and Cervical Cancer Screening among Riverside Women of the Brazilian Amazon","volume":"39","author":"D Duarte","year":"2017","journal-title":"Rev Bras Ginecol E Obstetr\u00edcia"},{"key":"pone.0270874.ref036","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/1750-9378-9-25","article-title":"Prevalence of human papillomavirus infection and phylogenetic analysis of HPV-16 E6 variants among infected women from Northern Brazil","volume":"9","author":"BP Tameg\u00e3o-Lopes","year":"2014","journal-title":"Infect Agent Cancer"},{"issue":"04","key":"pone.0270874.ref037","first-page":"769","article-title":"Prevalence of genital HPV infection in urban and rural women in the Eastern Brazilian Amazon","volume":"27","author":"DdaS Pinto","year":"2011","journal-title":"Cad Saude Publica"},{"key":"pone.0270874.ref038","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.pedhc.2010.06.015","article-title":"Uptake of the human papillomavirus vaccine: a review of the literature and report of a quality assurance project","volume":"26","author":"B Cassidy","year":"2012","journal-title":"J Pediatr Health Care"},{"issue":"08","key":"pone.0270874.ref039","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1001\/jama.297.8.813","article-title":"Prevalence of HPV infection among females in the United States","volume":"297","author":"EF Dunne","year":"2007","journal-title":"JAMA"},{"key":"pone.0270874.ref040","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.ejogrb.2020.02.014","article-title":"Oral contraceptives use and risk of cervical cancer-A systematic review & meta-analysis","volume":"247","author":"S Asthana","year":"2020","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"pone.0270874.ref041","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1186\/s12889-020-08688-4","article-title":"Cervical cancer screening program based on primary DNA-HPV testing in a Brazilian city: a cost-effectiveness study protocol","volume":"20","author":"JC Teixeira","year":"2020","journal-title":"BMC Public Health."},{"key":"pone.0270874.ref042","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ijid.2014.03.1389","article-title":"Sexually transmitted bacterial infections among young women in Central Western Brazil","volume":"25","author":"YA Lima","year":"2014","journal-title":"International Journal of Infectious Diseases"},{"issue":"1","key":"pone.0270874.ref043","first-page":"80","article-title":"Clinical and epidemiological profile of sexually transmitted diseases in children attending a referral center in the city of Manaus, Amazonas, Brazil","volume":"86","author":"CBR Ribas","year":"2011","journal-title":"An Bras Dermatol"},{"issue":"6","key":"pone.0270874.ref044","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.bjid.2016.09.004","article-title":"Anogenital Infection by Chlamydia Trachomatis and Neisseria Gonorrhoeae in HIV-infected Men and Women in Salvador, Brazil","volume":"20","author":"AG Travassos","year":"2016","journal-title":"Braz J Infect Dis"},{"issue":"12","key":"pone.0270874.ref045","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1086\/657321","article-title":"Cervical Human Papillomavirus Prevalence in 5 Continents: Meta-Analysis of 1 Million Women with Normal Cytological Findings","volume":"202","author":"L Bruni","year":"2010","journal-title":"J Infect Dis"},{"issue":"9","key":"pone.0270874.ref046","doi-asserted-by":"crossref","first-page":"e1197","DOI":"10.1016\/S2214-109X(19)30279-7","article-title":"Epidemiology of Chlamydia Trachomatis in the Middle East and North Africa: A Systematic Review, Meta-Analysis, and Meta-Regression","volume":"7","author":"A Smolak","year":"2019","journal-title":"Lancet Glob Health"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0270874","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T17:25:51Z","timestamp":1658165151000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0270874"}},"subtitle":[],"editor":[{"given":"Ivan","family":"Sabol","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,7,18]]},"references-count":46,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0270874","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,18]]}}}