Predominance of non-16/18 high-risk human papilloma-virus (HPV) genotypes among female sex workers in Papua, Indonesia: Implications for vaccine coverage.

BackgroundFemale sex workers face high occupational exposure to human papillomavirus (HPV), but to our knowledge no molecular HPV genotyping data have been published for Papua, Indonesia, where cervical screening reaches few women. Non-16/18 genotypes account for a large share of HPV infection across Asia, relevant to vaccine policy. We aimed to measure high-risk HPV (HR-HPV) prevalence, describe the genotypes present, and identify factors associated with HR-HPV positivity among FSWs in Jayapura.MethodsIn this cross-sectional study, female sex workers attending a reproductive health centre in Jayapura, Papua, were recruited by consecutive sampling in August 2025. Cervical specimens were genotyped for HR-HPV with a real-time PCR assay distinguishing HPV16, HPV18 and a pooled channel covering 12 high-risk types. A structured questionnaire recorded age, duration of sex work, condom use, vaccination status, sexually transmitted infection history and sexual contact frequency. Candidate predictors were screened bivariately before multivariable logistic regression.ResultsOf 75 participants, 33 (44%; 95% CI 33-56) were HR-HPV positive. Of these, 30 (91%; 95% CI 76-98) carried at least one non-16/18 genotype, and only three were attributable to HPV16 or HPV18 alone. Three women (4%) reported prior HPV vaccination. After adjustment for sexual contact frequency, each additional year of age was associated with lower odds of HR-HPV positivity (adjusted odds ratio 0.928, 95% CI 0.871-0.990, p = 0.023). The association with sexual contact frequency was positive but not significant (1.322, 95% CI 0.986-1.773, p = 0.062). Condom use was associated bivariately but excluded from the final model owing to unstable estimates.ConclusionsHR-HPV infection is common among female sex workers in Papua and mostly involves non HPV16 and HPV18 genotypes, which the current quadrivalent national programme does not cover. These data support nonavalent vaccination and HPV-DNA screening for female sex workers, and make expanded screening in the general population a priority for provincial health authorities in Papua.