HPV burden in the Haitian community of Miami, Florida: A community-based participatory research investigation

BACKGROUND: Haitian women residing in Little Haiti in Miami, FL, shoulder a disproportionate burden of cervical cancer. Human Papillomavirus (HPV) is a necessary cause of invasive cervical cancer. Knowing the distribution of HPV genotypes in the population can inform intervention strategies. METHODS: Community Health Workers (CHWs) enrolled eligible Haitian women 18 and older to complete a questionnaire and cervical self-sampling. Samples were analyzed for HPV strain and abnormal cytology. RESULTS: Overall, 242 specimens were available for genetic analysis. Crude prevalence of HPV infection was 20.7%, of those 72% were infected by a HR strain and 32% were associated with abnormal cytology. The age-standardized probabilities of HPV positivity were estimated at 0.22 (18-30), 0.03 (31-40), 0.03 (41-50), 0.05 (51-60), and 0.19 (61+) by increasing age category. Being married, born abroad, and being pregnant at least once were all significantly (p<.05) associated with decreased odds of HPV infection. CONCLUSIONS: These data are the first to estimate the prevalence of HPV positivity and distribution of HPV infection by type in the Haitian immigrant population in the US. The crude prevalence (20.7%) in this sample is lower compared to the estimate (26.8%) for US women aged 14-59. The data indicate higher infection rates in both young and older women but lower for middle-aged women. Examining the distribution and prevalence of HR-HPV genotypes can lead to a more efficient allocation of treatment resources. Additionally, utilizing a CBPR framework has proven successful in building local community capacity to address cervical cancer screening disparities.