Reduction in the prevalene of human papillomavirus (HPV) vaccine targeted types has been observed within 2-5 years after introduction of HPV vaccine programs in many developed countries, and herd protection among men in female-only vaccination programs has been demonstrated. Little information, however, is available about vaccine impact in low and middle income (LMIC) countries and in countries with a high human immunodeficiency virus (HIV) prevalence. In 2015, Botswana introduced a 2-dose HPV vaccine series among 9-13 year old females and among 9 year old females in subsequent years. This was followed by a baseline HPV prevalence study in 2019 among unvaccinated persons 18-22 years, including females and males without HIV and females living with HIV.