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Volume 5
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Age-Specific Distribution and Factors Associated with High-Risk HPV Infection and Cervical Lesions Among HIV-Positive and -Negative Women in Maputo, Mozambique: Findings from the HPV-ISI Study

by
Alberto Sineque
1,2,*,
Célia Nhambe
3,
Júlia Sebastião
3,
Nilza Cossa
3,
Cacilda Massango
3,
Zita Sidumo
3,
Susanna Ceffa
4,
Fausto Cicacci
5,
Jahit Sacarlal
6 and
Maria Clara Bicho
7,8
1
Department of Biological Sciences, Eduardo Mondlane University, Maputo 257, Mozambique
2
Centre for Functional Ecology—One Health, Department of Life Sciences, University of Coimbra, 3001-401 Coimbra, Portugal
3
DREAM Program, Community of Sant’Egidio, Maputo 279, Mozambique
4
DREAM Program, Community of Sant’Egidio, 00153 Rome, Italy
5
Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
6
Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo 257, Mozambique
7
Institute for Preventive Medicine and Public Health, Faculty of Medicine, University of Lisboa, 1649-028 Lisbon, Portugal
8
Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisboa, 1649-028 Lisbon, Portugal
*
Author to whom correspondence should be addressed.
Venereology 2026, 5(1), 4; https://doi.org/10.3390/venereology5010004
Submission received: 1 November 2025 / Revised: 28 December 2025 / Accepted: 8 January 2026 / Published: 13 January 2026
Versions Notes

Abstract

Background/Objective: High-risk Human papillomavirus (hrHPV) is the leading cause of premalignant lesions and cervical cancer (CC), affecting disproportionally women living with HIV. Mozambique is among the countries with a heavy triple-burden of HIV, hrHPV infections and CC which accounts for more than 5300 new cases and 3800 deaths each year. In this study, we assessed the age-specific distribution and factors associated with hrHPV and cervical lesions among HIV-positive and -negative women from HPV-ISI (HPV Innovative Screening Initiative) study in Maputo, Mozambique. Methods: This cross-sectional study included 1248 non-pregnant women aged ≥18 years who attended CC screening at the DREAM Sant’Egídio Health Centre between July 2021 and April 2022. Screening involved visual inspection with acetic acid (VIA) and high-risk HPV DNA testing. Sociodemographic, lifestyle, and reproductive data were collected through a routine questionnaire. Logistic regression assessed associations between risk factors and hrHPV infection or cervical lesions. Age-specific hrHPV prevalence, partial HPV16/18 genotyping, and abnormal cytology rates were further analyzed by HIV status. Results: The mean age of participants was 43.0 ± 8.6 years. Overall hrHPV prevalence was 28.0%, being higher among HIV-positive women (46.8%) than HIV-negative women (23.8%). Non-16/18 hrHPV genotypes predominated across all age groups. VIA positivity was 11.1%, most frequently involving less than 75% of the cervical area and was more common among younger women (30–45 years) and those living with HIV. Increasing age was associated with lower odds of hrHPV infection (OR = 0.98, 95% CI: 0.97–1.00; p = 0.017), as was higher parity (≥3 deliveries vs. nulliparity: OR = 0.58, 95% CI: 0.36–0.94; p = 0.029). Contraceptive use (OR = 1.65, 95% CI: 1.15–2.38; p = 0.007) and a partially or non-visible squamocolumnar junction (SCJ) (OR = 2.88, 95% CI: 1.74–4.79; p < 0.001) were associated with higher odds of VIA positivity. Conclusions: hrHPV infection and cervical lesions were more frequent in younger and HIV-positive women, highlighting the need for strengthened targeted screening within HIV care services in Mozambique.
Keywords: women; HPV; cervical cancer; risk factors; human immunodeficiency virus women; HPV; cervical cancer; risk factors; human immunodeficiency virus

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MDPI and ACS Style

Sineque, A.; Nhambe, C.; Sebastião, J.; Cossa, N.; Massango, C.; Sidumo, Z.; Ceffa, S.; Cicacci, F.; Sacarlal, J.; Bicho, M.C. Age-Specific Distribution and Factors Associated with High-Risk HPV Infection and Cervical Lesions Among HIV-Positive and -Negative Women in Maputo, Mozambique: Findings from the HPV-ISI Study. Venereology 2026, 5, 4. https://doi.org/10.3390/venereology5010004

AMA Style

Sineque A, Nhambe C, Sebastião J, Cossa N, Massango C, Sidumo Z, Ceffa S, Cicacci F, Sacarlal J, Bicho MC. Age-Specific Distribution and Factors Associated with High-Risk HPV Infection and Cervical Lesions Among HIV-Positive and -Negative Women in Maputo, Mozambique: Findings from the HPV-ISI Study. Venereology. 2026; 5(1):4. https://doi.org/10.3390/venereology5010004

Chicago/Turabian Style

Sineque, Alberto, Célia Nhambe, Júlia Sebastião, Nilza Cossa, Cacilda Massango, Zita Sidumo, Susanna Ceffa, Fausto Cicacci, Jahit Sacarlal, and Maria Clara Bicho. 2026. "Age-Specific Distribution and Factors Associated with High-Risk HPV Infection and Cervical Lesions Among HIV-Positive and -Negative Women in Maputo, Mozambique: Findings from the HPV-ISI Study" Venereology 5, no. 1: 4. https://doi.org/10.3390/venereology5010004

APA Style

Sineque, A., Nhambe, C., Sebastião, J., Cossa, N., Massango, C., Sidumo, Z., Ceffa, S., Cicacci, F., Sacarlal, J., & Bicho, M. C. (2026). Age-Specific Distribution and Factors Associated with High-Risk HPV Infection and Cervical Lesions Among HIV-Positive and -Negative Women in Maputo, Mozambique: Findings from the HPV-ISI Study. Venereology, 5(1), 4. https://doi.org/10.3390/venereology5010004

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