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Prevalence and Correlates of Genital Warts in Kenyan Female Sex Workers

Kavanaugh, Barbara E. MPH*; Odem-Davis, Katherine PhD; Jaoko, Walter MBChB, PhD; Estambale, Benson MBChB, PhD; Kiarie, James N. MBChB, MMed, MPH; Masese, Linnet N. MBChB, MPH*‡; Deya, Ruth MBChB*; Manhart, Lisa E. PhD*; Graham, Susan M. MD, MPH, PhD; McClelland, Raymond Scott MD, MPH*‡

doi: 10.1097/OLQ.0b013e318275ec7f
Original Study

Background Our goal in the present study was to investigate the prevalence and correlates of genital warts in a population of female sex workers in Mombasa, Kenya. Because of the high prevalence of human immunodeficiency virus type 1 (HIV-1) in this population, we were particularly interested in the association between HIV-1 infection and genital warts.

Methods We conducted a cross-sectional study of the prevalence and correlates of genital warts among high-risk women in Mombasa, Kenya. Between 2001 and 2007, 1182 women were enrolled, of whom 613 (51.4%) were HIV-1 seropositive. Chi square tests and logistic regression were used to examine the associations between genital warts and potential correlates.

Results Genital warts were identified on clinical examination in 27 (2.3%) women. Women who were HIV-1 seropositive were nearly 8 times as likely to have genital warts compared with HIV-1–seronegative women (odds ratio, 7.69; 95% confidence interval, 2.30–25.6).

Conclusion Understanding the prevalence and correlates of genital warts will help to determine whether coverage for the wart-inducing subtypes 6 and 11 in a human papillomavirus vaccine is an important consideration in resource-limited countries.

Female sex workers in Mombasa had a 2.3% overall prevalence of genital warts. HIV-1-seropositive women were nearly 8 times as likely to have genital warts compared to HIV-1-seronegative women.

From the *University of Washington, Seattle, WA; †Fred Hutchinson Cancer Research Center, Seattle, WA; ‡University of Nairobi, Nairobi, Kenya; and §Kenya Medical Research Institute, Kilifi, Kenya

We wish to acknowledge the study participants, who contributed their time and effort to make this study a success. We also wish to recognize the contributions made by our clinical, laboratory, and administrative staff. We thank the Mombasa Municipal Council for providing clinical space, and Coast Provincial General Hospital for providing laboratory space.

Supported by the National Institutes of Health (NIH; grant P01-HD64915). Infrastructure support for the Mombasa Field Site was received from the University of Washington Center for AIDS Research, an NIH-funded program (P30-AI027757). The Fogarty International Center provided training support for L.N.M. and R.D. (grant 5D43-TW000007).

The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. All authors claim no conflict of interest.

Correspondence: R. Scott McClelland, MD, MPH, University of Washington, Box 359909, 325 Ninth Ave, Seattle, WA 98104. E-mail:

Received for publication March 27, 2012, and accepted June 26, 2012.

© Copyright 2012 American Sexually Transmitted Diseases Association