1. Introduction

Human immunodeficiency virus (HIV) infection and human papilloma virus (HPV) infection are two global health challenges that are intertwined and together constitute complex issues in clinical practice and public health. HIV infection has become a global epidemic, while HPV is a common sexually transmitted virus that is strongly linked to multiple cancer types, especially cervical cancer [1]. However, when the two viruses co-exist in the same patient, the effects may extend beyond when they are present alone, raising profound concerns about HPV co-infection in people with HIV [2].

The epidemiological trend and public health impact of HPV co-infection in HIV-infected people are the focus of current research. HPV infection in people living with HIV not only increases the risk of malignant diseases such as cervical cancer but also poses challenges for patients' quality of life and clinical management [3]. Therefore, understanding the nature, risk factors and potential impact of HPV co-infection in people living with HIV is critical to improving prevention and treatment strategies.

This paper aims to review and synthesize the latest research on HPV co-infection in people with HIV to fully understand this complex and important issue. We will focus on the impact of HIV infection on HPV co-infection, epidemiological trends, and their potential impact on public health to provide valuable insights for future research and clinical practice.

2. Epidemiological trends

The epidemiological trend of HPV co-infection in HIV-infected people has aroused widespread concern. Studies have shown that the incidence of HPV infection in HIV-infected people is significantly higher than that of non-infected people, a trend that has been confirmed by several studies [4]. For example, a study conducted in the United States found a significant increase in the overall incidence of HPV infection among people living with HIV, particularly high-risk HPV subtypes such as HPV 16 and HPV 18 [5].

In addition, sexual behavior is an important influencing factor for HPV co-infection in HIV-infected people. Multiple sexual partners, non-use of condoms, and high-risk sexual behavior have been identified as risk factors for HPV infection in people with HIV [6]. This suggests the critical role of sex education and health interventions in preventing HPV infection.

Another key trend is the immunological association between HIV status and HPV infection. HIV infection leads to a compromised immune system, which can affect the duration and severity of HPV infection. Therefore, immune status in HIV-infected people is strongly associated with the development and progression of HPV infection [7].

3. Influencing factors

Sexual health education, immunization support, and HAART treatment are important factors in preventing HPV infection. Sexual health education can increase the level of awareness of HPV co-infection among HIV-infected individuals and prompt them to be more proactive in taking preventive measures, including regular HPV screening and understanding the risks of sexual behavior. However, the effectiveness of education may be affected by factors such as cultural and social background, so individualized, culturally sensitive education programs are needed. Immune system support can help control the risk of HPV co-infection among HIV-infected individuals, lower viral load, and reduce the incidence of associated cancers, but it may be affected by individual differences among HIV-infected individuals, and thus individualized treatment protocols are needed to improve the prognosis of HPV co-infection among HIV-infected individuals and to reduce the risk of associated cancers by improving the level of immunity. This is not only a scientific advancement but also a respect for the self-healing power of the patient's body. When it comes to HAART therapy, it is essential to recognize that it is not only a means of HIV management but also a comprehensive intervention for overall patient health. The positive effects of HAART are not only in lowering the HIV viral load but also in potentially lowering the risk of HPV co-infections by improving the function of the immune system. Adherence to HAART therapy, drug resistance, and possible side effects are factors that need to be taken into consideration. This holistic concept of treatment is a reflection of medical progress and a tangible expression of concern for the overall health of the patient.

4. Public health implications

HPV co-infection increases the risk of cancer, which has direct public health implications. Several studies have shown that HPV co-infection among HIV-infected individuals is significantly associated with an increased incidence of cervical and other related cancers. HPV co-infection can lead to clinical conditions such as genital warts and cervical lesions. This not only negatively affects the lives of individual patients but also increases the burden on healthcare resources. Timely screening and management of HPV infection plays an important role in reducing the strain on the healthcare system, but in the process of implementation, we must not overlook some possible challenges.

First, cultural differences and social biases may act as barriers to the implementation of sexual health education, as the topic of sexuality is still considered sensitive and restricted in certain cultural and social settings. This will require the development of more culturally sensitive educational programs that respect patients from different cultural backgrounds and increase public acceptance of sexual health education.

Second, issues of healthcare resources and accessibility may limit the implementation of HPV screening, vaccination, and treatment. Inadequate healthcare services may prevent patients from accessing necessary sexual health services in some areas, so efforts are needed to improve infrastructure and increase healthcare coverage to ensure that all patients have access to necessary sexual health services.

Finally, integration of the healthcare system may be hindered because there may be a need for more synergy between different areas. Addressing this issue will require promoting synergies between other areas of healthcare to ensure that patients have access to comprehensive sexual health services across different healthcare settings.

Nonetheless, by adopting a comprehensive and multifaceted approach, along with improvements in healthcare resources and services, we can hope to overcome these barriers and ensure that the effects of public health significance are maximized and that all patients are able to benefit from relevant sexual health services.

5. Comprehensive analysis and thinking of association

The study summarized the strong association between HIV and HPV, especially the manifestation of HPV infection and related diseases in people living with HIV. The study by Clifford [3] revealed a high prevalence of different HPV types of infection among people living with HIV, suggesting that HIV infection may significantly increase the risk of HPV infection. HPV infection was more likely to persist in HIV-infected people. It was accompanied by an increased risk of cervical disease, which further emphasized that HIV infection may aggravate the severity of HPV infection.

Multiple studies by Palefsky [8] further support the high incidence of HPV-related disease among people living with HIV, especially in the context of highly active antiretroviral therapy. HIV-infected women with more severe immunosuppression carried higher HPV viral loads, increasing the risk of cervical disease. The collective results of these studies highlight the importance of HPV infection and related diseases among people living with HIV.

From my perspective, these findings provide healthcare professionals with valuable insights on how to manage better medical and prevention strategies for people living with HIV. Therefore, the promotion of HPV vaccination and regular screening should be strengthened to reduce the incidence of HPV-related diseases among people living with HIV. At the same time, more research is needed to explore the underlying mechanisms of this association in order to find more effective interventions to improve patient's quality of life and health.

6. Conclusion

The relatively high incidence of HPV co-infection among people living with HIV presents essential challenges and opportunities for sexual health education, clinical management, and public health policy. Preventive measures such as timely HPV screening, cervical cancer prevention, and HPV vaccination are essential to reduce the risk of related cancers. In addition, HAART therapy plays a positive role in reducing the risk of HPV co-infection and improving the quality of life of people living with HIV. Diverse research methods and data sources provide powerful tools for in-depth understanding of this issue.

However, some things could be improved in this study. First, while we have tried to provide multiple research perspectives and perspectives, we may have yet to cover all relevant issues. Further research may be needed to delve into the impact of HPV sub-types, the effectiveness of HPV vaccines in people living with HIV, best practices for screening and treatment, and ways to improve sexual health education. Second, some studies may be limited by sample size, so future studies should consider larger samples to increase reliability.