This dissertation research focuses on the risk factors associated with high-risk HPV
infection (HR-HPV) and abnormal cervical cytology in Nepali women residing in
Nepal’s Far-West district of Achham. The first part of this dissertation assesses the HRHPV
test concordance of self-collected vs. clinician-collected cervico-vaginal specimens.
Of 261 women with both clinician- and self-collected cervical samples, 25 tested positive
for HR-HPV, resulting in an overall HR-HPV prevalence of 9.6% (95% Confidence
Interval [CI]: 6.3 – 13.8). The overall Kappa value for clinician- and self-collected tests
was 0.64 (95% CI: 0.48 – 0.84), indicating a “good” level of agreement. The second part
of this dissertation investigates the association between 251 women whose husband’s
migrate for work and their high-risk HPV (HR-HPV) infection status and their abnormal
cervical cytology status. Half of study participants (50.8%) had husbands who reported
migrating for work at least once. Women 34 years and younger were significantly less
likely to test positive for HR-HPV than women older than 34 years (OR 0.22, 95% CI
0.07 – 0.71). HR-HPV infection and abnormal cervical cytology status were not directly
associated with a husband’s migration.