Prevalence of human papillomavirus and cervical neoplasia among women who have sex with women in Cameroon: A descriptive study

Simon M. Manga, Grace M. Lee, Nicole Ekoue, Madeleine H. Simeni, Kathleen L. Nulah, Mary W. Mbumenyuy, Florence Manjuh, Joseph F. Nkfusai

Abstract

This descriptive study addresses a critical research gap by examining HPV and cervical neoplasia among women who have sex with women (WSW) in Cameroon, an underserved population. WSW typically undergo less frequent cervical cancer screening. We conducted a pilot study in Douala, Cameroon, recruiting WSW through Elle Cameroon, a community organization serving underserved populations. Working within the Cameroon Baptist Convention Health Services, participants underwent HPV screening and Visual Inspection with Acetic Acid (VIA) enhanced by Digital Cervicography (DC). We ran the frequencies and determined the p-values, prevalence odds ratios (POR) and prevalence risk ratios (PRR) using STATA 17. Statistical significance was set at 0.05. Of 26 participants enrolled, 19 (73.1%) provided valid HPV results, with 57.9% (11/19) testing positive for HPV. Also 80.8 % (21/26) of the participants were screened for cervical neoplasia and 19.05% (4/19) were positive. There was no significant association between HPV cervical neoplasia. Those who were HPV positive had 1.4 and 1.3 POR and PRR respectively. Our results suggest high prevalence of oncogenic HPV and cervical neoplasia among WSW in Cameroon. An adequately powered study is needed to further elucidate these findings and address healthcare disparities in this underserved population.

Full Text:

PDF

References

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram

I, Jemal A and Bray F. Global Cancer Statistics 2020:

GLOBOCAN Estimates of Incidence and Mortality

Worldwide for 36 Cancers in 185 Countries. CA

Cancer J Clin. 2021;71(3):209-249.

Marrazzo JM, Koutsky LA, Kiviat NB, Kuypers JM and

Stine K. Papanicolaou test screening and prevalence

of genital human papillomavirus among women who have sex with women. Am J Public Health.

;91(6):947-952.

Power J, McNair R and Carr S. Absent sexual scripts: lesbian

and bisexual women's knowledge, attitudes and

action regarding safer sex and sexual health

information. Cult Health Sex. 2009;11(1):67-81.

Heer E, Peters C, Knight R, Yang L and Heitman SJ.

Participation, barriers, and facilitators of cancer

screening among LGBTQ+ populations: A review of

the literature. Prev Med. 2023;170:107478.

Tat SA, Marrazzo JM and Graham SM. Women Who Have

Sex with Women Living in Low- and Middle-Income

Countries: A Systematic Review of Sexual Health

and Risk Behaviors. LGBT Health. 2015;2(2):91

Jedy-Agba E, Joko WY, Liu B, Buziba NG, Borok M, Korir

A, Masamba L, Manraj SS, Finesse A, Wabinga H,

Somdyala N and Parkin DM. Trends in cervical

cancer incidence in sub-Saharan Africa. Br J Cancer.

;123(1):148-154.

Zhang M, Chen J, Cui M, Jia J, Zhao M, Zhou D, Zhu L and

Luo L. Analysis of the global burden of cervical

cancer in young women aged 15-44 years old. Eur J

Public Health. 2024;34(4):839-846.

Atnafu DD, Khatri R and Assefa Y. Drivers of cervical

cancer prevention and management in sub-Saharan

Africa: a qualitative synthesis of mixed studies.

Health Res Policy Syst. 2024;22(1):21.

Fethers K, Marks C, Mindel A and Estcourt CS. Sexually

transmitted infections and risk behaviours in women

who have sex with women. Sex Transm Infect.

;76(5):345-349.

Muller A. Health for All? Sexual Orientation, Gender

Identity, and the Implementation of the Right to

Access to Health Care in South Africa. Health Hum

Rights. 2016;18(2):195-208.

Tracy JK, Lydecker AD and Ireland L. Barriers to cervical

cancer screening among lesbians. J Womens Health

(Larchmt). 2010;19(2):229-237.

Johnson SE, Holder-Hayes E, Tessman GK, King BA,

Alexander T and Zhao X. Tobacco Product Use

Among Sexual Minority Adults: Findings From the

-2013 National Adult Tobacco Survey. Am J

Prev Med. 2016;50(4):e91-e100.

Aguayo F, Munoz JP, Perez-Dominguez F, Carrillo-Beltran

D, Oliva C, Calaf GM, Blanco R and Nunez-Acurio

D. High-Risk Human Papillomavirus and Tobacco

Smoke Interactions in Epithelial Carcinogenesis.

Cancers (Basel). 2020;12(8).

DeGregorio G, Manga S, Kiyang E, Manjuh F, Bradford L,

Cholli P, Wamai R, Ogembo R, Sando Z, Liu Y,

Sheldon LK, Nulah K, Welty T, Welty E and Ogembo

JG. Implementing a Fee-for-Service Cervical Cancer

Screening and Treatment Program in Cameroon:

Challenges

and

;22(7):850-859.

Opportunities.

Oncologist.

Liu Z, Rashid T and Nyitray AG. Penises not required: A

systematic review of the potential for human

papillomavirus horizontal transmission that is non

sexual or does not include penile penetration. Sex

Health. 2016;13(1):10-21.

Aguayo F, Muñoz JP, Perez-Dominguez F, Carrillo-Beltrán

D, Oliva C, Calaf GM, Blanco R and Nuñez-Acurio

D. High-risk human papillomavirus and tobacco

smoke interactions in epithelial carcinogenesis.

Cancers (Basel). 2020;12(8):1-18.

Manga SM, Ye Y, Nulah KL, Manjuh F, Fokom-Domgue

J, Scarinci I and Tita AN. Human Papillomavirus

Types and Cervical Cancer Screening among Female

Sex Workers in Cameroon. Cancers (Basel).

;16(2).

Simo RT, Godlove A, Nono D, Paulin H, Dongmo F,

Faustin P, Etet S, Fonyuy BK, Hervé A, Kamdje N,

Yanou NN and Telefo B. Prevalence of precancerous

cervical lesions and high-risk human papillomavirus

types in Yaounde, Cameroon. jidc.org. 2021.

Catarino R, Vassilakos P and Tebeu P. Risk factors

associated with human papillomavirus prevalence

and cervical neoplasia among Cameroonian women.

Clinical Microbiology and Infection. 2016.

Curmi C, Peters K and Salamonson Y. Lesbians' attitudes

and practices of cervical cancer screening: a

qualitative

study.

;14:153.

BMC Womens Health.

Bailey JV, Kavanagh J, Owen C, McLean KA and Skinner

CJ. Lesbians and cervical screening. Br J Gen Pract.

;50(455):481-482.

Obón-Azuara B, et al. Gaps in sexual health research about

women who have sex with women. A scoping review.

Gac Sanit. 2022;36(5):439-445.

Keuroghlian A. Healthcare worker training to improve

quality of care for sexual and gender minority people

in sub‐Saharan Africa: learning from efforts in

Uganda. J Int AIDS Soc. 2021.

Marrazzo JM. Barriers to infectious disease care among

lesbians. Emerg Infect Dis. 2004;10(11):1974-1978.

Jessani A, Berry-Moreau T, Parmar R, Athanasakos A,

Prodger JL and Mujugira A. Healthcare access and

barriers to utilization among transgender and gender

diverse people in Africa: a systematic review. BMC

Public Health. 2024;2(1).

Chepkorir J, Perrin N, Kivuti-Bitok L, Gallo J and Gross D.

Barriers and Opportunities for HPV Self-Sampling in

Underserved Rural Communities: Insights from a

Mixed Methods Study. Preprints. 2025.

Otieno JA, Were L, Nyanchoka M, Olwanda E, Mulaku M,

Sem X, Kohli M, Markby J, Muriuki A, Ochodo E,

Bertoni M, Antinyan A and Rangel V. Human

papillomavirus self-sampling versus provider

sampling in low-and middle-income countries: a

scoping review of accuracy, acceptability, cost,

uptake. Front Public Health. 2024;12:1439164.

Refbacks

  • There are currently no refbacks.