HPV and HTLV Infection in Female Sex Workers in Peru

我们建议美国-秘鲁合作，检查两种主要公共卫生常见感染 女性商业性工作者（CSW）中重要性：人乳头瘤病毒（HPV）和人T细胞 嗜淋巴细胞病毒1型和2型（HTLV）。这项研究将在秘鲁的美国海军进行 医学研究中心支队和健康中心“Alberto巴顿”德尔卡劳合作 Silvia Montano博士，作为NIH资助#R01NS055627-01的扩展，题为逆转录病毒感染， 秘鲁的神经系统。CSW感染性传播感染的风险增加，特别是 那些得不到常规医疗护理或从其他安第斯国家移徙从事性工作的人。 虽然HPV和HTLV都具有显著的潜在健康后果，如宫颈癌， HTLV-1相关的脊髓病，秘鲁目前没有预防计划。本研究的目的是 确定CSW中HPV和HTLV感染的患病率和决定因素， 暗娼HPV分型及其宫颈-阴道脱落相关因素的研究 和HTLV感染。拟议的研究将通过以下方式实现这些目标：1）对 在CSAB和通过移动的诊所接受治疗的移徙性女性工作者，以及同样数量的秘鲁性女性工作者。 参与者将接受由社会工作者管理的结构化面对面访谈， 人口统计学、移民和经济特征、病史、性行为（包括性行为） 网络和性传播感染/艾滋病毒知识）和工作做法。将采集宫颈和血清学样本， 检测HPV、HTLV和其他STI。将进行数字阴道镜检查以评估宫颈异位。2)一 对过去两个月内开始从事性工作的CSW进行的前瞻性研究。150名参与者 每个人都将接受为期一年的季度HPV检测。3)收集50个储存的宫颈刷样本， 分析HPV，并与数字阴道镜检查结果和STI信息相关。拟议 研究将确定秘鲁CSW中HPV和HTLV流行率，提供更多信息 关于高危女性HPV和HTLV感染的获得、脱落和传播， 这些感染，并阐明风险因素，可用于制定预防政策，在秘鲁， 妇女感染这些疾病的风险很高的其他国家。

We propose a United States-Peru collaboration to examine two common infections of major public health importance in female commercial sex workers (CSW): human papilloma virus (HPV) and human T-cell lymphotropic virus types 1 and 2 (HTLV). The research would be conducted in Peru at the U.S. Naval Medical Research Center Detachment and the Centra de Salud "Alberto Barton" del Callao in collaboration with Dr. Silvia Montano, as an extension of NIH grant #R01NS055627-01, entitled Retrovirus Infections of the Nervous System in Peru. CSW are at increased risk for sexually transmitted infections (STI), particularly those who do not receive routine medical care or who migrate for sex work from other Andean countries. Although both HPV and HTLV carry significant potential health consequences, such as cervical cancer and HTLV-l-associated myelopathy, no prevention programs currently exist in Peru. The aims of this study are to determine the prevalence and determinants of HPV and HTLV infections in CSW, to define the acquisition of HPV strain types in CSW initiating sex work, and examine the correlates of cervico-vaginal shedding of HPV and HTLV infections. The proposed study would address these aims through: 1) A cross-sectional study of migrant CSW receiving care at CSAB and via a mobile clinic, as well as an equal number of Peruvian CSW. Participants will receive a structured, face-to-face interview administered by a social worker regarding demographic, migration and economic characteristics, medical history, sexual behavior (including sexual networks and STI/HIV knowledge) and work practices. Cervical and serological samples will be obtained to test for HPV,HTLV, and other STI. Digital colposcopy will be performed to evaluate for cervical ectopy. 2) A prospective study of CSW who initiated sex work within the last two months. One hundred fifty participants will each receive quarterly HPV testing for one year. 3) A collection of 50 stored cervical brush samples will be analyzed for HPV and correlated with digital colposcopic findings and STI information. The proposed study would define HPV and HTLV prevalences among CSW in Peru, provide additional information regarding acquisition, shedding and transmission of HPV and HTLV infections in women at highest risk for these infections, and elucidate risk factors that could be used to develop prevention policies in Peru and other countries with women at high risk for these infections.