Baseline characteristics of the HOMINY (human papillomavirus, human immunodeficiency virus, and oral microbiota interplay in Nigerian youth) prospective longitudinal cohort.
This baseline analysis of 1,075 Nigerian mothers and children stratified by HIV infection or exposure found very low HPV awareness and vaccination and limited maternal cervical cancer screening before implementation of Nigeria’s national HPV vaccination program.
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This baseline analysis of 1,075 Nigerian mothers and children stratified by HIV infection or exposure found very low HPV awareness and vaccination and limited maternal cervical cancer screening before implementation of Nigeria’s national HPV vaccination program.
Research significance
The evidence identifies major HPV-prevention gaps among Nigerian families affected by HIV; it supports, but does not test, the hypothesis that targeted vaccination, education, and screening programs could reduce future HPV-associated cancer risk in this population.
Source abstract
BACKGROUND: The HOMINY (Human Papillomavirus, Human Immunodeficiency Virus, and Oral Microbiota Interplay in Nigerian Youth) cohort is a prospective longitudinal study established to investigate oral HPV infection and the oral microbiome among mother-child pairs with and without HIV in Nigeria. The objective of this analysis was to describe baseline demographic and clinical characteristics of the cohort, including HPV awareness, HPV vaccination, and cervical cancer screening practice by HIV status. METHOD: Mothers (aged ≥ 18) and children (aged 9-18) were prospectively enrolled at the University of Benin Teaching Hospital. Participants were grouped by HIV infection and exposure status. Baseline demographic, behavioral, and HPV-related data were collected using standardized questionnaires, medical record review, and case report forms. Group differences were assessed using parametric and non-parametric tests. RESULTS: A total of 1,075 participants were enrolled. Among mothers, 68% were HIV-positive. Awareness of HPV (<7%) and the HPV vaccine (3.0%) was low with fewer than 1% having received HPV vaccination, and only 19.1% reported ever undergoing cervical cancer screening. Mothers living with HIV reported younger age at sexual debut, more lifetime sexual partners, and lower education attainment than HIV-uninfected mothers. Among children, awareness of HPV and the HPV vaccine was virtually absent, and only one child reported HPV vaccination. Birth characteristics differed by HIV status, with Caesarian sections and other perinatal exposures being higher among HIV-exposed groups. CONCLUSION: Baseline findings demonstrate substantial gaps in HPV awareness, vaccination, and cervical cancer screening among families affected by HIV before implementation of Nigeria's national HPV vaccination program. This highlights critical prevention gaps and sustained cancer risk, underscoring urgent needs for targeted HPV and HIV prevention in Nigerian youth. As the largest prospective mother-child cohort focused on oral HPV and HIV in sub-Saharan Africa, HOMINY provides an important foundation for future longitudinal studies of oral HPV infection, the oral microbiome, and the impact of HPV vaccination.