The Community of Sant'Egidio (Italian: Comunità di Sant'Egidio) is a lay Catholic association dedicated to social service, founded in 1968 under the leadership of Andrea Riccardi. The group grew and in 1973 was given a home at the former Carmelite monastery and church of Sant'Egidio in Rome, Italy. In 1986 it received recognition from the Roman Curia of the Holy See as an international association of the faithful. Its activities include the Church's evening prayer together daily as a stimulus for lending assistance to a whole spectrum of needy persons: "lonely and non-self-sufficient elderly, immigrants and homeless people, terminally ill and HIV/AIDS patients, children at risk of deviance and marginalization, nomads and the physically and mentally handicapped, drug addicts, victims of war, and prisoners." The community also has a high profile in the area of peace negotiations, in addressing the AIDS epidemic in Africa, and in its opposition to capital punishment. It takes an ecumenical approach in all of its work.Sant'Egidio is a network of small communities of fraternal life, currently present in 73 countries distributed as follows: Europe (23), Africa (29), Asia (7), North America (8), South America (5). There are an estimated 50,000 members.
Background/Objective: High-risk Human papillomavirus (hrHPV) is the leading cause of premalignant lesions and cervical cancer (CC), affecting disproportionally women living with HIV. Mozambique is among the countries with a heavy triple-burden of HIV, hrHPV infections and CC which accounts for more than 5300 new cases and 3800 deaths each year. In this study, we assessed the age-specific distribution and factors associated with hrHPV and cervical lesions among HIV-positive and -negative women from HPV-ISI (HPV Innovative Screening Initiative) study in Maputo, Mozambique. Methods: This cross-sectional study included 1248 non-pregnant women aged ≥18 years who attended CC screening at the DREAM Sant’Egídio Health Centre between July 2021 and April 2022. Screening involved visual inspection with acetic acid (VIA) and high-risk HPV DNA testing. Sociodemographic, lifestyle, and reproductive data were collected through a routine questionnaire. Logistic regression assessed associations between risk factors and hrHPV infection or cervical lesions. Age-specific hrHPV prevalence, partial HPV16/18 genotyping, and abnormal cytology rates were further analyzed by HIV status. Results: The mean age of participants was 43.0 ± 8.6 years. Overall hrHPV prevalence was 28.0%, being higher among HIV-positive women (46.8%) than HIV-negative women (23.8%). Non-16/18 hrHPV genotypes predominated across all age groups. VIA positivity was 11.1%, most frequently involving less than 75% of the cervical area and was more common among younger women (30–45 years) and those living with HIV. Increasing age was associated with lower odds of hrHPV infection (OR = 0.98, 95% CI: 0.97–1.00; p = 0.017), as was higher parity (≥3 deliveries vs. nulliparity: OR = 0.58, 95% CI: 0.36–0.94; p = 0.029). Contraceptive use (OR = 1.65, 95% CI: 1.15–2.38; p = 0.007) and a partially or non-visible squamocolumnar junction (SCJ) (OR = 2.88, 95% CI: 1.74–4.79; p < 0.001) were associated with higher odds of VIA positivity. Conclusions: hrHPV infection and cervical lesions were more frequent in younger and HIV-positive women, highlighting the need for strengthened targeted screening within HIV care services in Mozambique.
Background: Cervical cancer is one of the most common cancers in women, particularly among women living with HIV (WLWH). Persistent infection with high-risk oncogenic human papillomavirus (Hr-HPV) is the primary etiological factor. However, data on Hr-HPV prevalence among WLWH in Kinshasa, Democratic Republic of the Congo, remain poorly documented. This study aimed to determine the prevalence of Hr-HPV infection and identify associated risk factors in this population. Methods: A cross-sectional study was conducted among WLWH aged 25-65 years receiving antiretroviral therapy at the DREAM Centre in Kinshasa. Cervical samples were collected and analyzed using multiplex PCR for detection of Hr-HPV genotypes. Sociodemographic data and risk factors were collected via questionnaires, and associations with Hr-HPV infection were assessed using multivariate logistic regression. Results: A total of 436 women were included. The prevalence of Hr-HPV infection was 47.25%. HPV types 16 and 18 (alone or in co-infection) were detected in 23.79% of participants. In multivariate logistic regression analysis, WHO clinical stage 3-4 (aOR 1.75; 95% CI 1.16-2.64; p=0.008), HIV viral load >=1000 copies/mL (aOR 3.08; 95% CI 1.28-7.42; p=0.012), and antiretroviral therapy duration <2 years (aOR 0.52; 95% CI 0.29-0.93; p=0.028) were significantly associated with Hr-HPV infection. Conclusions: Nearly one in two WLWH in Kinshasa was infected with Hr-HPV, and one in four carried HPV-16/18 genotypes. Advanced HIV disease and uncontrolled viral replication were strongly associated with Hr-HPV infection. These findings underscore the urgent need to integrate systematic Hr-HPV screening into HIV care programs, particularly for women with advanced clinical stage or persistent viremia. Keywords: Human papillomavirus, Prevalence, Risk factors, HIV, Kinshasa. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No funding was received for this study. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Ethics Committee of the School of Public Health of the University of Kinshasa granted ethical approval for this work (approval number: ESP/CE/31/2022). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data generated or analyzed during the current study are included within the manuscript. Additional data are available from the corresponding author on reasonable request.
BackgroundCervical cancer is one of the most common cancers in women, particularly among women living with HIV. High-risk human papillomavirus (Hr-HPV) is the main causative agent of this cancer, but the prevalence of Hr-HPV infection among women living with HIV in Kinshasa remains poorly documented. The objective of this study was to determine this prevalence and identify associated risk factors.MethodsA cross-sectional study was conducted among women living with HIV aged 25–65 years receiving antiretroviral therapy at the DREAM Center in Kinshasa. Participants were consecutively recruited among eligible women attending the center during the study period. Cervical samples were collected using the Abbott Cervi–Collect kit and analyzed for Hr-HPV genotyping using the Abbott RealTime HPV assay on the m2000 platform, a real-time PCR method detecting HPV-16, HPV-18, and a pooled group of 12 additional high-risk HPV types with an internal β-globin control for sample quality assurance. Sociodemographic and clinical data were collected using structured questionnaires.ResultsA total of 436 women were included in the analysis. The prevalence of Hr-HPV infection was 47.7%. Of these, 23.79 % were infected with oncogenic HPV-16 and−18 types (alone or in co-infection with other types). In a logistic regression analysis, WHO clinical stage 3 and 4, duration of antiretroviral therapy for less than 2 years, and HIV viral load greater than or equal to 1,000 copies/ml showed statistically significant associations with Hr-HPV infection, with adjusted ORs of 1.75 (1.16–2.64; p = 0.008), 1.91 (1.07–3.41; p = 0.028), and 3.13 (1.30–7.54; p = 0.011), respectively.ConclusionsThis study reveals a high prevalence of Hr-HPV infection among women living with HIV in Kinshasa. Non-16/18 HPV types were predominant, while HPV-16 and HPV-18 were detected in approximately one in four Hr-HPV-positive women. Advanced HIV disease (WHO clinical stages 3 and 4), unsuppressed HIV viral load, and shorter duration of antiretroviral therapy were independently associated with Hr-HPV infection. These findings underscore the potential value of broader HPV vaccine coverage, including higher-valent vaccines, alongside strengthened cervical cancer screening as part of comprehensive cervical cancer prevention strategies.
Over the past four decades, the HIV epidemic in sub-Saharan Africa has shifted from an acute, high-mortality phase to an era of widespread antiretroviral therapy (ART), driven by global scale up and the introduction of potent regimens such as dolutegravir-based combinations. While viral suppression is now increasingly achievable, the central challenge has evolved toward maintaining durable virological control across the life course. We argue that program success can no longer be defined by the mere attainment of suppression, but by the sustained maintenance of undetectable viral load and preservation of drug effectiveness at the population level. From a virological perspective, incomplete suppression, including persistent low-level viremia, creates predictable conditions for resistance selection over time, even with high-genetic barrier agents. In settings where CD4 monitoring is infrequent, gradual immune deterioration may go unnoticed despite apparently acceptable viral load thresholds. Emerging integrase inhibitor resistance should therefore be interpreted as a systems-level warning signal rather than an isolated clinical event. We discuss dolutegravir as an extraordinary yet finite therapeutic resource, the risks of functional monotherapy when nucleoside backbones are compromised, and the role of postfailure strategies, including protease inhibitor-anchored regimens, within optimized care pathways. Central to this approach is recognizing diagnostics-viral load monitoring, CD4 assessment, and targeted genotypic resistance testing-as essential clinical infrastructure. Sustaining ART gains in Africa requires moving from "minimum for all" toward differentiated, high-quality lifelong care integrated within broader public health platforms.
