High risk HPV among HIV positive women with normal and abnormal cervical cytology in Bahir Dar, north west Ethiopia
Cervical cancer is a malignant tumor that arises from the cells of the uterine cervix, primarily caused by persistent infection with human papillomavirus (HPV). Women living with HIV are at a heightened risk of infection with high-risk HPV types. This study aimed to determine the prevalence and type-specific distribution of HPV among HIV-positive women with cervical cytologic abnormalities in Bahir Dar, northwestern Ethiopia. A facility-based cross-sectional study was conducted among HIV-positive women in this region between January and March 2025. A total of 344 women were enrolled. Of these, 171 (49.7%) had a high-risk HPV (HR-HPV) infection. The type-specific distribution among the positive cases was as follows: HPV16, 37 (21.6%); HPV18, 15 (8.8%); HPV16 with other types, 24 (14.0%); HPV18 with other types, 7 (4.1%); both HPV16 and HPV18, 6 (3.5%); and other high-risk types, 82 (47.9%). Cytological analysis revealed that 81 women (23.55%) had abnormalities, while 263 (76.45%) had normal results. Among the abnormal cases, the findings were: 26 (32.1%) ASC-US, 22 (27.2%) LSIL, 14 (17.3%) ASC-H, 9 (11.1%) LSIL-H, and 10 (12.3%) HSIL. The study also found that HIV-positive women aged 31 and older had significantly higher odds of HR-HPV infection compared to younger women, with the peak risk observed in the 41-50 age group. Additional risk factors included higher parity, an early sexual debut, and having multiple sexual partners. Given the high prevalence of HR-HPV and its strong association with abnormal cytology, targeted preventive measures including enhanced screening, vaccination, and patient education are crucial for HIV-positive women, particularly in low-resource settings like northwestern Ethiopia.