A Child Rights and Social Justice Framework for Analyzing Public Policy

Human papilloma virus (HPV) is the most common sexually transmitted infection (STI) in the United States (U.S.). Despite data that supports HPV vaccine as an effective measure to prevent anogenital cancers, vaccine uptake rates in the U.S. have stagnated over the past few years and only one third of adolescents are fully immunized. Adolescents are able to independently access STI diagnosis and treatment in all fifty states and the District of Columbia. However, only California allows adolescents to obtain HPV vaccine without parental consent. This creates a paradox where youth are able to independently receive treatment for HPV infection but not for its prevention. Current approaches to HPV vaccine education and delivery have not been successful at improving immunization rates. In this paper we propose the implementation of a child rights, social justice, and health equity-based approach to frame HPV vaccine policy. Such an approach to vaccine policy will promote children’s participation in medical decision-making. We postulate that by empowering children to be involved in issues pertaining to their health and well-being, they will be more likely to discuss HPV with their peers or families, and potentially be able to make informed independent decisions related to HPV vaccine.

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1641. A Comparison of Human Papilloma Virus Infection Prevalence Trends Pre- and Post-HPV Vaccine Implementation

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1505 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S599-S599

Author(s):

Patrick Ovie. Fueta ◽

Onyema Greg Chido-Amajuoyi

Keyword(s):

United States ◽

Human Papilloma Virus ◽

Hpv Vaccine ◽

Human Papilloma Virus Infection ◽

The United States ◽

Hpv Infection ◽

Infection Prevalence ◽

Transmitted Infection ◽

Papilloma Virus ◽

The Impact

Abstract Background Human papilloma virus (HPV) is the most common sexually transmitted infection in the United States, with an annual incidence rate of approximately 14 million people. The HPV vaccine has been demonstrated to be highly effective in the prevention of HPV infection and HPV-associated diseases. This study aims to evaluate the impact of HPV vaccine on the prevalence of HPV infection in the United States and evaluate the trends of disease prevalence pre- and post-HPV vaccine implementation. Methods We conducted a secondary data analysis of the National Health and Education Survey (NHANES) for trends in HPV infection from 2003 to 2016. The analysis was grouped into a pre-HPV vaccine implementation (2003–2006) cohort including 4064 females, aged 18–59 years; and a post-HPV vaccine implementation (2007–2016) cohort which included 10718 females, aged 18–59 years. Further analysis of HPV infection prevalence, pre- and post-HPV vaccine implementation, stratified by sociodemographic characteristics were conducted. Results The prevalence of HPV infection prior to HPV vaccine implementation was 43.98% (95 CI 42.71%–46.58%) compared with 40.55% (95 C.I 40.55%–40.56%) in the post-HPV vaccine implementation era. Among females with HPV infections in the post-HPV vaccine implementation cohort 82.6 (95% CI 80.41%–83.42%) were unvaccinated. In both cohorts, black females had a significantly higher prevalence of HPV with a prevalence rate of 18.56% (95% CI 18.23%–20.56%) in the pre-HPV vaccine implementation cohort, and 15.61% (95% CI 14.82 – 19.4%) in the post-HPV vaccine implementation cohort. Females with less than high school education had a higher prevalence of HPV in the pre and post- HPV vaccine implementation cohorts with prevalence rates of 25.77% (95% CI 23.44%–28.72%) and 24.96% (95% CI 23.41%–25.67%), respectively. Conclusion The results suggest that HPV infection prevalence has declined since the implementation of HPV vaccine to US national immunization program. Our findings highlight disparities in HPV infection prevalence by race and educational status, and these patterns are in keeping with HPV-associated disease such as warts and HPV-associated cancers. Disclosures All authors: No reported disclosures.

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Effect of Prophylactic Human Papillomavirus (HPV) Vaccination on Oral HPV Infections Among Young Adults in the United States

Journal of Clinical Oncology ◽

10.1200/jco.2017.75.0141 ◽

2018 ◽

Vol 36 (3) ◽

pp. 262-267 ◽

Cited By ~ 80

Author(s):

Anil K. Chaturvedi ◽

Barry I. Graubard ◽

Tatevik Broutian ◽

Robert K.L. Pickard ◽

Zhen-Yue Tong ◽

...

Keyword(s):

United States ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Population Level ◽

The United States ◽

Hpv Infection ◽

Vaccine Uptake ◽

The Us ◽

Oral Hpv ◽

Level Effect

Purpose The incidence of human papilloma virus (HPV)–positive oropharyngeal cancers has risen rapidly in recent decades among men in the United States. We investigated the US population–level effect of prophylactic HPV vaccination on the burden of oral HPV infection, the principal cause of HPV-positive oropharyngeal cancers. Methods We conducted a cross-sectional study of men and women 18 to 33 years of age (N = 2,627) within the National Health and Nutrition Examination Survey 2011 to 2014, a representative sample of the US population. Oral HPV infection with vaccine types 16, 18, 6, or 11 was compared by HPV vaccination status, as measured by self-reported receipt of at least one dose of the HPV vaccine. Analyses accounted for the complex sampling design and were adjusted for age, sex, and race. Statistical significance was assessed using a quasi-score test. Results Between 2011 and 2014, 18.3% of the US population 18 to 33 years of age reported receipt of at least one dose of the HPV vaccine before the age of 26 years (29.2% in women and 6.9% in men; P < .001). The prevalence of oral HPV16/18/6/11 infections was significantly reduced in vaccinated versus unvaccinated individuals (0.11% v 1.61%; Padj = .008), corresponding to an estimated 88.2% (95% CI, 5.7% to 98.5%) reduction in prevalence after model adjustment for age, sex, and race. Notably, the prevalence of oral HPV16/18/6/11 infections was significantly reduced in vaccinated versus unvaccinated men (0.0% v 2.13%; Padj = .007). Accounting for vaccine uptake, the population-level effect of HPV vaccination on the burden of oral HPV16/18/6/11 infections was 17.0% overall, 25.0% in women, and 6.9% in men. Conclusion HPV vaccination was associated with reduction in vaccine-type oral HPV prevalence among young US adults. However, because of low vaccine uptake, the population-level effect was modest overall and particularly low in men.

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Digital Gaming Interventions– Utilizing Theories and Evaluation to Increase HPV Vaccination among Young Males (Preprint)

10.2196/preprints.21303 ◽

2020 ◽

Author(s):

Gabrielle Darville ◽

Jade Burns ◽

Tanaka Chavanduka ◽

Charkarra Anderson - Lewis

Keyword(s):

Hpv Vaccine ◽

Game Design ◽

Hpv Vaccination ◽

Intervention Mapping ◽

Health Belief ◽

Theoretical Models ◽

The United States ◽

Vaccine Uptake ◽

Transmitted Infection ◽

Vaccination Rates

UNSTRUCTURED The Human Papillomavirus (HPV) is the most common sexually transmitted infection in the US. HPV attributes to most cancers including anal, oral, cervical and penile. Despite infection rates in the United States recommendations and communication campaigns have traditionally focused on females. Because of this, males lack knowledge of reasons for vaccination, the benefits of being vaccinated and their risks overall. Gaming as a health education strategy can be beneficial for this key demographic because of the popularity and gaming mechanism that can promote behavior change. Objective: This study sought to explore the relationship between gamification and HPV vaccine uptake. Materials and Methods: In total twenty two (n=22) interviews were conducted with experts in the fields of cancer prevention, sexual and reproductive health, public health, game design, technology and health communication on how a game should be developed to increase HPV vaccination rates among males. Results: Overwhelmingly theoretical models such as the health belief model (HBM) were identified with key constructs such as self-efficacy and risk perception. Experts also suggested using intervention mapping and logic models as planning tools for health promotion interventions utilizing a digital game as a medium. Lastly, in game and out of game measures were discussed as assessments for quality and impact by our expert panel. Conclusion: This study shows that interventions should focus on whether greater utilization of serious games and the incorporation of theory and standardized methods can impact the need of young men to vaccinate and complete the series of the HPV vaccine.

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Evaluation of a Perinatal Human Papillomavirus Program

10.28971/542018mm66 ◽

2018 ◽

Author(s):

Melissa Maher

Keyword(s):

Human Papillomavirus ◽

Hpv Vaccine ◽

Sexual Debut ◽

The United States ◽

Hpv Infection ◽

Pilot Program ◽

Postpartum Visit ◽

Transmitted Infection ◽

Advanced Nursing Practice ◽

Vaccination Rates

Human papillomavirus (HPV) is recognized as the most prevalent sexually transmitted infection in the United States. Prevention of HPV infection is possible with the efficacy of HPV vaccine noted to be nearly 100% when introduced prior to sexual debut. In addition, vaccination post-sexual initiation could have a significant impact on reducing HPV infection and HPV-associated cancers in women. Much focus has been placed on vaccinating adolescents against HPV. However, strategies to increase vaccination rates among females ages 18-26, who remain eligible for vaccination, must be examined. A program evaluation was undertaken to assess the effectiveness of a newly developed pilot program for women ages 19-26 that incorporates assessment of vaccine eligibility during the prenatal period to increase uptake and completion of HPV vaccine postpartum. Data collected from the perinatal vaccination pilot program was performed retrospectively. Through a chart review, postpartum patients age 19-26 were identified and specific areas of focus were examined: whether an HPV dose was administered to vaccine eligible individuals during the inpatient period; whether an additional dose was administered at an ambulatory postpartum visit; and whether a subsequent dose was given at an ambulatory visit if warranted. Data analysis was conducted. Frequencies and percentages in relation to numbers of patients and HPV doses were calculated. Finally, implications for advanced nursing practice were discussed.

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Polish Medical Students’ Knowledge Regarding Human Papillomavirus’s Ways of Transmission, Risk of Cancer Development and Vaccination, and Their Intention to Recommend Vaccination

Vaccines ◽

10.3390/vaccines9070776 ◽

2021 ◽

Vol 9 (7) ◽

pp. 776

Author(s):

Tomasz Milecki ◽

Maciej Michalak ◽

Jakub Milecki ◽

Michał Michalak ◽

Radosław Kadziszewski ◽

...

Keyword(s):

Medical Students ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Hpv Infection ◽

Early Years ◽

Vaccine Uptake ◽

Transmission Risk ◽

Cancer Development ◽

General Level ◽

Risk Of Cancer

Introduction: Human papillomavirus (HPV) is associated with six types of cancer in men and women. A vaccine against HPV, preferably administered before initial sexual intercourse, has been proven to be highly effective in preventing these cancers. An effective healthcare provider recommendation has significant influence on HPV vaccine uptake; therefore, it is critical that medical students receive comprehensive training in this area. Aim: The aim of the study was to assess the knowledge of medical students regarding Human Papillomavirus’s (HPV) ways of transmission, risk of cancer development, and vaccination against HPV. This study also investigated factors among medical students that would affect their intention to recommend HPV vaccination to others. Materials and Methods: The study was conducted among 1061 (678 women and 383 men) medical students who filled in our questionnaire. The medical students were divided into two subgroups: (1) pre-clinical medical students (MS pre-clinical; first-to third-year students; n = 683) and (2) clinical medical students (MS clinical; fourth-to six-year students; n = 378). Results: A total259 (24.41%) of the 1061 medical students were vaccinated against HPV. We found a significant improvement in the general level of knowledge in the later years of education (4–6) compared to the early years of education (1–3). However, it was demonstrated that, despite medical education advancements, there are still significant gaps of knowledge about the relationship between HPV infection and cancers other than cervical cancer, as well as in relation to the routes by which HPV is transmitted. Medical students’ intentions to recommend HPV vaccine to others were related to their own HPV-related knowledge and their own vaccination status. Conclusion: Medical students have gaps of knowledge regarding particular issues and aspects of HPV. It is necessary to further educate medical students in the field of prevention and in the treatment of lesions caused by HPV infection. Medical students’ intention to recommend the HPV vaccine can be improved by including them and members of their families in the HPV vaccination program.

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HPV Vaccine Beliefs and Correlates of Uptake Among Hispanic Women and Their Children on the US-Mexico Border

Cancer Control ◽

10.1177/1073274820968881 ◽

2020 ◽

Vol 27 (1) ◽

pp. 107327482096888

Author(s):

Jessica Calderón-Mora ◽

Tamanna Ferdous ◽

Navkiran Shokar

Keyword(s):

Hpv Vaccine ◽

Hispanic Women ◽

Educational Interventions ◽

Vaccine Uptake ◽

Adult Women ◽

Full Time ◽

Transmitted Infection ◽

Mexico Border ◽

Hpv Vaccine Uptake ◽

Us Mexico Border

Introduction: Human Papilloma Virus (HPV) is the most common sexually transmitted infection nationally. Although preventable, uptake of the HPV vaccine is low. The purpose of this study was to describe HPV vaccine knowledge and beliefs and psychosocial correlates of vaccine uptake among adult females and their children in a US-Mexico border community. Materials and Methods: We conducted a survey of uninsured women aged 21-65 years living in Texas who were due for cervical cancer screening. We utilized descriptive statistics to report demographic and psychosocial variables. We used logistic regression analysis to identify correlates of prior vaccine uptake. Results: 599 women completed surveys: mean age was 44.69 years, 97.8%, were Hispanic and 86% were Spanish speaking; 5% had been vaccinated. Awareness of HPV infection & HPV vaccine was 81.6% & 68.6% respectively. Scores for mean perceived susceptibility was low and mean perceived benefits was high; the mean score for knowledge was 3.69 out of 6. Common parental barriers to child vaccination were cost, lack of accessibility and lack of information. Correlates of past HPV vaccine uptake among adult women were younger age, monthly income of $2,500-$5,000, full-time employment, US birth, and higher perceived severity of HPV. Older age was a correlate of vaccine uptake for daughters. Discussion and Conclusion: Findings revealed low HPV vaccine uptake among adult Hispanic women, but high vaccine acceptability for their sons and daughters. Culturally tailored educational interventions are needed to improve HPV knowledge and HPV vaccine uptake among adults and their children.

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Review of Evidence and Recommendation for Human Papillomavirus (HPV) Vaccination of Canadian Males Over the Age of 26 Years

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475420911635 ◽

2020 ◽

Vol 24 (3) ◽

pp. 285-291 ◽

Cited By ~ 2

Author(s):

Alex Derstenfeld ◽

Kyle Cullingham ◽

Zhuo Cai Ran ◽

Ivan V. Litvinov

Keyword(s):

Human Papillomavirus ◽

Sexually Transmitted Infection ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Older Men ◽

Hpv Infection ◽

Transmitted Infection ◽

Vaccination Programs ◽

Sexually Transmitted ◽

Control And Prevention

Human papillomavirus (HPV) remains the most common sexually transmitted infection with a lifetime incidence of over 75%. Based on US data from the Centers for Disease Control and Prevention (CDC), 64% of invasive HPV-associated cancers are attributable to HPV 16 or 18 (65% for females; 63% males) and may be prevented by vaccination with either the quadrivalent or nonavalent HPV vaccine. Public HPV vaccination programs are now the norm for women aged 9-45 years and men aged 9-26 years in Canada. Yet, only recently have guidelines begun to consider vaccination of men older than 26 years of age. There now exist compelling reasons to recommend vaccination against HPV amongst males >26 years of age. Recognizing that the risks posed by HPV infection persist beyond 26 years of age, that the vaccination of men aged 26-45 years with HPV vaccine confers immunogenicity at levels demonstrably efficacious against HPV-related diseases, and that the Food and Drug Administration recently expanded the HPV vaccination to include older men, it is argued that HPV vaccination in men older than 26 years of age should be routinely recommended.

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