Meta-analysis and Time Series Projection of Human Papillomavirus Prevalence Among Women in Honduras (1990-2023)

<ns3:p> Background Human papillomavirus (HPV) infection represents a major public health challenge in Latin America, with limited epidemiological data available for Honduras. HPV prevalence trends across age groups must be understood to build effective preventative measures. Objective To systematically analyze HPV prevalence among Honduran women from 1990 to 2023 across different age groups, and to project future trends through 2035 using time series forecasting methods. Methods PRISMA 2020 guided our proportions systematic review and meta-analysis. PubMed, Google Scholar, Tz’ibalnaah, and SciELO searches found age-stratified HPV prevalence studies in Honduran women from 1990 to 2023. We used MedCalc v19.7.1 for meta-analysis and Holt-Winters exponential smoothing in Python v3.10.3 for prevalence estimations. Model accuracy was measured by RMSE and MAE. Results Four studies met inclusion criteria, encompassing data from 1999 to 2023. The pooled HPV prevalence was 42% (95% CI: 21.8%), with substantial heterogeneity (I <ns3:sup>2</ns3:sup> &gt; 75%). Age-stratified analysis revealed highest prevalence in women aged 15-24 years (10.65% in 2023, increased from 1.26% in 1999) and declining prevalence in women &gt;35 years. Time series projections indicated continued increasing trends for women &lt;35 years and stabilizing or declining trends for those ≥35 years. The Holt-Winters model demonstrated optimal fit for the 35-44 age group (RMSE=0.26, MAE=0.25), but substantial prediction errors for younger age groups (RMSE=3.77 for ages 25-34) highlight the limitations of forecasting with limited temporal data points. Conclusions HPV prevalence shows divergent age-specific trends in Honduras, with increasing rates among younger women and decreasing rates in older age groups. These findings suggest differential impacts of public health interventions across age cohorts and highlight the need for enhanced vaccination coverage and sexual health education targeting adolescents and young adults. The limited number of temporal observations constrains forecast reliability, emphasizing the need for strengthened epidemiological surveillance systems. </ns3:p>