Derek C Johnson1, Pema Lhaki2, Madhav P Bhatta3, Mirjam-Colette Kempf4, Jennifer S Smith5, Pankaj Bhattarai2, Shilu Aryal6, Eric Chamot1, Kiran Regmi6, Sten H Vermund7, Sadeep Shrestha8. 1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA. 2. NFCC/NFCC International, Kathmandu, Nepal. 3. College of Public Health, Kent State University, Kent, OH, USA. 4. School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA Department of Health Behavior, University of Alabama at Birmingham, AL, USA. 5. Department of Epidemiology, University of North Carolina, Chapel Hill, USA. 6. Nepal Family Health Division, Kathmandu, Nepal. 7. Vanderbilt Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA. 8. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA sshrestha@uab.edu.
Abstract
BACKGROUND: In April 2014 we investigated the association of migration of a woman's husband with her high-risk human papillomavirus (HR-HPV) infection status and her abnormal cervical cytology status in the Achham district of rural Far-Western Nepal. METHODS: Women were surveyed and screened for HR-HPV during a health camp conducted by the Nepal Fertility Care Center. Univariate and multivariable statistical tests were performed to determine the association of a husband's migration status with HR-HPV infection and cervical cytology status. RESULTS: In 265 women, the prevalence of HR-HPV was 7.5% (20/265), while the prevalence of abnormal cervical cytology, defined using the Bethesda system as atypical glandular cells of undetermined significance or worse, was 7.6% (19/251). Half of the study participants (50.8%, 130/256) had husbands who had reported migrating for work at least once. Women aged ≤34 years were significantly less likely to test positive for HR-HPV than women aged >34 years (OR 0.22, 95% CI 0.07 to 0.71). HR-HPV infection and abnormal cervical cytology status were not directly associated with a husband's migration. CONCLUSION: Older women were found to have a higher prevalence of HPV than younger women. It is possible that a husband's migration for work could be delaying HR-HPV infections in married women until an older age.
BACKGROUND: In April 2014 we investigated the association of migration of a woman's husband with her high-risk human papillomavirus (HR-HPV) infection status and her abnormal cervical cytology status in the Achham district of rural Far-Western Nepal. METHODS:Women were surveyed and screened for HR-HPV during a health camp conducted by the Nepal Fertility Care Center. Univariate and multivariable statistical tests were performed to determine the association of a husband's migration status with HR-HPV infection and cervical cytology status. RESULTS: In 265 women, the prevalence of HR-HPV was 7.5% (20/265), while the prevalence of abnormal cervical cytology, defined using the Bethesda system as atypical glandular cells of undetermined significance or worse, was 7.6% (19/251). Half of the study participants (50.8%, 130/256) had husbands who had reported migrating for work at least once. Women aged ≤34 years were significantly less likely to test positive for HR-HPV than women aged >34 years (OR 0.22, 95% CI 0.07 to 0.71). HR-HPV infection and abnormal cervical cytology status were not directly associated with a husband's migration. CONCLUSION: Older women were found to have a higher prevalence of HPV than younger women. It is possible that a husband's migration for work could be delaying HR-HPV infections in married women until an older age.
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