Factors Associated with Human Papillomavirus Infection among Women in Health Region 10, Thailand: Evidence from HPV DNA Testing and GIS-Linked Spatial Decision Support

Abstract

To determine factors associated with human papillomavirus (HPV) infection among women in Health Region 10, Thailand, and to integrate a GIS-linked spatial decision-support map for cervical cancer prevention. A cross-sectional analytical study used HPV DNA screening data collected between February and September 2023 among 2,086 women aged 20–59 years undergoing cervical cancer screening under the PP Fee Schedule program. Demographic, reproductive, behavioral, and laboratory data were retrieved from structured screening records and laboratory databases. Multiple logistic regression was applied to identify independent factors associated with HPV infection. HPV DNA screening results were aggregated at the provincial level and linked with administrative boundaries to produce a descriptive spatial decision-support map combining HPV positivity, screening volume, and planning signals. The prevalence of HPV infection was 15.1% (314/2,086). High-risk non-16/18 HPV genotypes predominated (11.4%), while HPV-16 and HPV-18 accounted for 2.6% and 1.1%, respectively. Women younger than 30 years had significantly higher odds of HPV infection (AOR = 2.67, 95% CI: 1.13–6.31), whereas a higher number of pregnancies was associated with lower odds of HPV positivity (AOR = 0.87, 95% CI: 0.78–0.97). Province-level mapping showed the highest positivity in Mukdahan (19.2%) and the largest screening volume in Ubon Ratchathani (n = 1,103). HPV infection was relatively common among women in Health Region 10. GIS-linked mapping can strengthen targeted screening, surveillance, and referral microplanning while avoiding unsupported cluster inference when only provincial aggregated data are available.