HPV and HTLV Infection in Female Sex Workers in Peru

我们提议美国与秘鲁合作检查两种常见的重大公共卫生感染 对女性商业性工作者 (CSW) 的重要性：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)。该研究将在秘鲁的美国海军进行 医学研究中心分队与 Centra de Salud "Alberto Barton" del Callao 合作 与 Silvia Montano 博士合作，作为 NIH 拨款 #R01NS055627-01 的延伸，题为逆转录病毒感染 秘鲁的神经系统。 CSW 感染性传播感染 (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居从事性工作的人。 尽管 HPV 和 HTLV 都会带来严重的潜在健康后果，例如宫颈癌和 HTLV-1 相关脊髓病，秘鲁目前尚无预防计划。本研究的目的是 确定 CSW 中 HPV 和 HTLV 感染的流行率和决定因素，以确定获得 CSW 开始性工作时的 HPV 毒株类型，并检查宫颈阴道 HPV 脱落的相关性 和 HTLV 感染。拟议的研究将通过以下方式实现这些目标： 1) 横断面研究 在 CSAB 和流动诊所接受护理的移民 CSW 以及同等数量的秘鲁 CSW。 参与者将接受由社会工作者进行的结构化、面对面的访谈，内容涉及 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）和工作实践。将获取宫颈和血清学样本 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）A 对过去两个月内开始从事性工作的 CSW 进行前瞻性研究。一百五十名参与者 每人将在一年内接受季度 HPV 检测。 3) 收集 50 个存储的宫颈刷样本 分析 HPV 并与数字阴道镜检查结果和 STI 信息相关联。拟议的 研究将确定秘鲁 CSW 中 HPV 和 HTLV 的患病率，并提供更多信息 关于高危女性 HPV 和 HTLV 感染的获得、排出和传播 这些感染，并阐明可用于在秘鲁制定预防政策的风险因素 其他国家的妇女面临这些感染的高风险。

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.