Nairobi sex workers at high risk of cervical cancer, study

By Gatonye Gathura

Sex workers in Nairobi are at a high risk of developing cervical cancer mainly due to their type of work as well as high rates of HIV infections.

A study covering 348 sex workers in Nairobi by the Kenya Medical Research Institute and others detected cervical cancer-causing Human Papilloma Virus (HPV), in about a quarter of the women.

The study publication has coincided with the ongoing national cervical awareness week in which the Ministry of Health targeted at screening 5,000 women countrywide.

“Cervical cancer is preventable and curable in its early stages,” said Dr Mary Nyangasi, head of the National Cancer Control Programme.

“Yet many women in Kenya are not aware of the disease, and current screening rates are extremely low. Our aim this week has been to increase public awareness about cervical cancer as a preventable disease.”

Authors of the new study, published last week (16th January 2020) want special attention for HIV positive women because of the high cervical cancer risk they face.

The study reports detecting HPV in 23.6 per cent of the participants with higher rates recorded among HIV positive women compared to the HIV negative group.

A quarter, 24 per cent of participants were HIV-positive. HIV prevalence among female sex workers is estimated at 29.3 per cent.

“The higher prevalence and incidence of HPV and associated high-grade cervical disease observed in HIV positive women indicate that HIV-positive women should be a priority for public health interventions,” says the study.

The team, also with researchers from the University of Nairobi and University of North Carolina, US, says HIV infection is a significant risk factor for developing HPV infection.

Sex workers the study says are at a higher risk of acquiring sexually transmitted disease including HPV due to their higher number of sexual partners and greater frequency of sexual encounters.

The study led by Kristen Sweet and Claire Bosire of the University of North Carolina, US, appears in the International Journal of STD & AIDS.

The team had involved 348 female sex workers in Nairobi, aged 18 to 50 who were followed for 12 months.

Their average age was 28 years; with a median work duration of 16 years though some had been at it for up to 25 years.

The women had on average 10 clients per week but with some having up to 40 clients per week.

Majority of the women, 190 or about 55 per cent were divorced, widowed or separated while about 44 per cent were single or never married. Only three of the women were married or cohabiting.

Many of the women, 134, had started sex before age 16, with the majority having multiple regular partners, reports the study.

Experts explain that all women are at risk of cervical cancer with the disease occurring most often in women over the age of 30.

HPV, the main cause of cervical cancer, Aga Khan University Hospital explains in its website, is a common virus passed from one person to another during sex.

“Most sexually active people will have HPV at some point in their lives, but few women will get cervical cancer. “

Other factors that can increase the risk of cervical cancer are intimacy at an early age, multiple sexual partners, sexually transmitted diseases, HIV and cigarette smoking.

The university advises women aged 25 to 64 to go for pap smear every three years. However, HIV positive women are urged to undergo the procedure every year. 

“A well-proven way to prevent cervical cancer is to go for screening and vaccination in pre-teen children against HPV.”

In October the Ministry of Health launched a cervical cancer vaccination campaign to reach 800,000 ten-year-old girls across the country.

The launch, experts say was informed by the high rates of the disease and the devastation it is having on the lives of women.

Last year, cervical cancer caused 3,286 deaths from 5,250 recorded cases in Kenya. Without any intervention, it is estimated that Kenya will experience at least 6,000 new cases annually by 2025.

It is also estimated that about 63 per cent of cervical cancer cases could be averted if 90 per cent coverage is reached with HPV vaccines.

The HPV vaccine also prevents other types of cancers including anal warts and cancer and tumor of the vulva.

Some data

5,250 cervical cancer cases in 2018

3,286 deaths from cervical cancer in 2018

800,000 number of 10-year old girls to be vaccinated

2 (two) doses of vaccine, six months apart

16 per cent – women screened for cervical cancer

100 per cent survival rate with early detection

47,887 all cases of cancers in Kenya in 2018

32,987 cancer deaths in 2018

About Gatonye Gathura 32 Articles
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