Determinants for Genital Human Papillomavirus (HPV) Infection in Tunisian Women with Normal Pap smear: Are There Different Risk Profiles for Oncogenic and Nononcogenic HPV Types?
Bibliographic record
Abstract
Background: Most studies of risk factors for HPV infection have focused on overall HPV positivity and have not examined determinants for high-risk and low-risk HPV types separately. Objective: To evaluate the prevalence and type distribution of high-risk and low-risk HPV infection and to describe the risk factors associated with different profiles in Tunisia. Methods: We studied risk determinants for genital HPV infection in a randomly sample of women aged 18 years and older with normal cervical cytology in Tunisia during 2014. All women had a personal interview, a Pap smear, and cervical swabs for HPV DNA detection using a PCR technique. Information on sociodemographic, reproductive, lifestyle characteristics, and health-seeking behaviors was collected. Results: The overall HPV prevalence was 7.5% (IC95% [5.9%-9.0%]). Prevalence of HRHPV was 4.8%(IC95% [3.7%-6.2%]) and LRHPV 3.8%(IC95% [2.8%-4.8%]). Of HPV-positive women, 64.0% (IC95% [53.8%-74.4%]) had high oncogenic HPV types, and 45.3% (IC95% [33.0%-54.8%]) had low oncogenic HPV types. Simple infection was predominant within 76.6% (IC95% [66.3%-83.9%]) of positive women. Younger age and lifetime measures of sexual activity (notably, number of partners) were the main risk factors for the oncogenic HPV types. A statistically increase risk was found in women whose partners had multiple sex partners. Furthermore, a previous sexual infection was associated with the high-risk HPV types. HR-HPV infection risk was observed in women aged less than 30 years, who were smokers, divorced/separated and having a high educational level. In contrast, the most important determinants for nononcogenic HPV infection were contraceptive variables related to the physical protection of the cervix and low standard of living. Conclusions: The results indicate that different risk profiles exist for infections with different HPV groups with high-risk types being the most common types detected. HR-HPV positivity was associated with social determinants, behavioral and sexual characteristics. These results should assist in designing strategies for control of cervical cancer targeting at risk population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".