Adults at High Risk for HIV Infection Have Low Vaccination Rates for Human Papillomavirus



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Adults who are at high risk of being infected with the human immunodeficiency virus (HIV), which causes AIDS, were less likely to be vaccinated against human papillomavirus (HPV), which can cause anal and cervical cancer, according to the results. presented at the AACR's Annual Meeting in Atlanta from March 29 to April 3.

HPV infection is common, and in a healthy individual, it is often eliminated from the body without ever causing disease, said lead author of the study, Lisa T. Wigfall, Ph.D., MCHES, assistant professor in the Division of Education in Health Department of Health and Kinesiology at the College of Education and Human Development at Texas A & M University in College Station. However, since HIV infection compromises the body's immune system, an HIV-positive person may be unable to fight against HPV infection and may be more likely to develop some types of cancer, including anal and cervical cancer of the uterus.

Since 2006, vaccines targeting HPV strains are most likely to cause anal and cervical cancer. The US Centers for Disease Control and Prevention (CDC) recommends that boys and girls under the age of 15 receive two doses of the vaccine, starting at 11 or 12 years of age. Those who start the series of vaccines later, between 15 and 26 years. , you should receive three doses according to the CDC guidelines.

Adherence to vaccination has been slower than public health experts and is currently well below the national target of 80%. As of 2017, about 49 percent of US teenagers were up-to-date with HPV vaccination and 66 percent received the first dose, according to CDC data. Wigfall and colleagues conducted this study to evaluate rates of HPV vaccination for people at high risk of HIV infection.

Researchers used survey data from the Behavioral Risk Factor Surveillance System 2016 (BRFSS) to evaluate HPV vaccination rates in individuals who reported involvement in one or more high-risk behaviors in the year prior to the survey. Of the 486,303 adults who completed the 2016 BRFSS survey, only 16,507, or 3.39%, used injecting drugs and / or engaged in high-risk sexual behaviors and were classified as at high risk for HIV infection.

Among this population, only 416 had complete data. In this group, the researchers found that very few people were fully vaccinated against HPV. Vaccination rates varied among high-risk population groups. Some key findings:

  • About one-quarter, or 25.7%, of gay / bisexual men aged 18-33 started the series of three doses of HPV vaccine, and 6.2% completed the study.
  • About one-quarter of high-risk heterosexual women aged 18-36 completed the three-dose HPV series.
  • Only 11% of high-risk heterosexual men aged 18 to 29 years started the series of three doses of HPV.
  • None of the transgender men and women and non-conforming individuals started vaccination against HPV
  • Vaccination rates were much lower among non-Hispanic black respondents than any other racial / ethnic group

"It was alarming that almost all non-Hispanic blacks in the study had not been vaccinated, especially because of the disproportionate burden of HIV / AIDS among this minority group," Wigfall said.

Wigfall said that one of the possible reasons for the low vaccination rate in high-risk populations is that recommendations for people living with HIV were issued several years after the HPV vaccine was first made available to the general population.

Previous research has shown that the way doctors talk about the HPV vaccine can influence parents' decisions about the vaccination of their teens. Wigfall said that for some high-risk populations in this study, such as gay / bisexual or transgender men, providers may not have addressed the connections between high-risk sexual behavior and HIV / HPV coinfection.

"Gender and sexual orientation are important topics that should not stop us from identifying and targeting HPV vaccination efforts among high-risk populations," Wigfall said.

Wigfall said that, in his view, patient-provider communication about the HPV vaccine should be strengthened for high-risk populations, specifically HIV-positive men and women, as well as HIV-negative and transsexual gay / bisexual men.

In an effort to increase HPV vaccination among high-risk populations, "a necessary first step would be the widespread adoption of HIV testing for all adolescents and adults regardless of perceived risk," she said, noting that the CDC recommends testing since 2006. This recommendation has not been widely followed, leaving thousands of people living with HIV unaware of their HIV status, Wigfall said.


Dealing with the expected challenges after resumption of HPV vaccination


Provided by
American Association for Cancer Research

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Adults at High Risk for HIV Infection Have Low Vaccination Rates for Human Papillomavirus (2019, April 2)
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