Elevated vaginal pH levels and HPV among Senegalese women

Our investigation aimed to explore the extent to which elevated vaginal pH is associated with prevalent HPV infection among a cohort of Senegalese women ages 18-84. Sub-Saharan Africa has the greatest global burden of vaginal dysbiosis and the highest prevalence of HPV infection among women (24%). Globally, Africa has the highest estimated age-standardized cervical cancer incidence and mortality rates at 27.6 and 17.5 per 100,000 cases respectively. While elevated levels of vaginal pH have been associated with vaginal inflammation and infection, evidence demonstrating the nature of the relationship between vaginal pH and HPV infection are not well characterized. Among a cohort of menopausal/post-menopausal Senegalese women, we observed a 3.01-fold increase in HPV in women with vaginal pH levels between 5.0-5.9 relative to women with vaginal pH levels between 4.0-4.9 (95% CI[1.24,7.30], p=0.02). For women with vaginal pH levels between 5-5.9 there was a 3.48-fold increase in the aOR of any HPV infection relative to women with vaginal ph levels between 4.0-4.9 (95% CI [1.38, 8.77], p=.01). Among women of vaginal pH levels ≥7 there was a 4.84-fold increase in the aOR of any HPV infection relative to individuals with vaginal pH levels between 4.0-4.9 (95% CI [1.84-12.71], p=0.001). Our findings suggest the presence of a trend in elevated vaginal pH and the OR of any HPV infection among a sample of women attending Fann and Pikine clinics in Dakar, Senegal, particularly among menopausal/post-menopausal women who are HIV positive.