HPV and HTLV Infection in Female Sex Workers in Peru

我们建议美国-秘鲁合作检查两种常见的主要公共卫生感染 女性性工作者的重要性：人类乳头瘤病毒(HPV)和人类T细胞 嗜淋巴病毒1型和2型(HTLV)。这项研究将在秘鲁的美国海军进行 医学研究中心支队与“Alberto Barton”Del Callao合作 与西尔维娅·蒙塔诺博士合作，作为美国国立卫生研究院#R01NS055627-01号拨款的延伸，题为 秘鲁的神经系统。性服务工作者患性传播感染(STI)的风险增加，尤其是 那些没有接受常规医疗护理或从其他安第斯国家移民到到性工作岗位的人。 尽管HPV和HTLV都具有显著的潜在健康后果，如宫颈癌和 尽管与L巨细胞病毒相关的脊髓病有关，秘鲁目前没有预防方案。这项研究的目的是 确定CSW中HPV和HTLV感染的流行率和决定因素，以确定获得 暗娼人乳头瘤病毒株分型与宫颈阴道脱落的相关性研究 以及HTLV感染。拟议的研究将通过以下方式解决这些目标：1)对 移民性服务性工作者在CSAB接受护理，并通过流动诊所，以及同等数量的秘鲁性服务性工作者。 参与者将接受由社会工作者管理的关于以下方面的有组织的面对面面试 人口、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。将获取宫颈和血清样本，以 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)A 最近两个月内开展性服务的暗娼前瞻性研究。150人参加 每个人都将接受为期一年的季度HPV检测。3)收集50个储存的宫颈刷子样本 对HPV进行分析，并与数字镜检查结果和性传播感染信息相关联。建议数 研究将确定秘鲁CSW中HPV和HTLV的流行情况，提供更多信息 关于感染HPV和HTLV的高危妇女的感染、脱落和传播 这些感染，并阐明可用于制定秘鲁和 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.