High-risk HPV and bacterial STIs in a primary screening population in rural Hainan, China: prevalence, co-infection, and association with cervical abnormalities

This study highlights a distinct co-infection ecosystem centered on <i>U. urealyticum</i> in rural women, where <i>C. trachomatis</i> and <i>U. urealyticum</i> drive differentiated risks for early cervical lesions. Consequently, public health strategies should prioritize this underrepresented rural population. Integrating targeted bacterial STIs testing into HPV screening could significantly enhance risk stratification and intervention efficiency in settings with limited resources.