Human Papillomavirus Infection and Cervical Cytology Among Vulnerable Women in Rome, Italy

Background: Vaccination against human papillomaviruses (HPVs) and cervical cancer screening represent effective tools for preventing this neoplasia, but access to health services is limited for vulnerable women. We investigated prevalence of high-risk HPV and abnormal cervical cytology, as well as knowledge about HPV and the HPV vaccine, among homeless and migrant women in Rome, Italy. Methods: Cytologic samples in PreservCyt (Hologic) were employed for liquid-based cytology (ThinPrep Processor 5000, Hologic) and high-risk HPV DNA testing (Xpert HPV assay, Cepheid). Socio-demographic data, anamnestic, and behavioral data were retrieved from electronic archives. A questionnaire was employed to assess knowledge about HPV and HPV vaccination. Results: A total of 134 women were included (median age: 43 years; interquartile range, IQR: 34-50), mostly coming from Central-South America (69, 51.5%). Of the 127 cytologic specimens collected, one (0.8%) was invalid for the HPV test and five (3.9%) were unsatisfactory for the morphological evaluation. High-risk HPV positivity was found in 18 women of the 126 women with a valid HPV test (14.3%). A total of 10 women of the 122 women with an adequate cytology (8.2%) had abnormal cytology. Overall, 57/134 women (42.6%) had never heard of HPV or were unsure about it. Only 29 of the 77 women who had heard of HPV (37.7%) knew of the HPV vaccine, and only 2 had been vaccinated in the entire study group (1.5%). Conclusions: Tailored preventive strategies and comprehensive information campaigns should be developed and implemented to enhance awareness of HPV infection and actively promote vaccination among women in vulnerable groups.