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HPV vaccination conversations should be strengthened for high-risk HIV populations

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Adults who are at high risk of contracting the human immunodeficiency virus (HIV) were less likely than the general population to be vaccinated against human papillomavirus (HPV), according to a study presented at the AACR Annual Meeting on April 2, 2019. 

This HPV vaccination study is important since an HIV infection compromises the body’s immune system, says the Centers For Disease Control and Prevention (CDC). 

Which means, an HIV-positive person may be unable to fight off an HPV infection and may be more prone to developing some types of cancer. 

The study’s lead author, Lisa T. Wigfall, Ph.D., MCHES, in the College of Education and Human Development at Texas A&M University, reported some of the key findings in a press release:

  • 25.7 percent of gay/bisexual males aged 18-33 years had initiated the three-dose HPV vaccine series, and 6.2 percent had completed it,
  • About 25 percent of high-risk heterosexual females aged 18-36 had completed the three-dose HPV series,
  • Only 11 percent of high-risk heterosexual males aged 18-29 had initiated the three-dose HPV series,
  • None of the transgender men and women and gender-nonconforming individuals had initiated HPV vaccination, and,
  • 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 were unvaccinated, especially given the disproportionate burden of HIV/AIDS among this minority group,” Dr. Wigfall said. 

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

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

Dr. Wigfall said ‘patient-provider communication about the HPV vaccine should be strengthened for high-risk populations, specifically, HIV-positive males or females, as well as HIV-negative gay/bisexual men and transgender individuals.’ 

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Wigfall and colleagues used data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) survey to assess HPV vaccination rates in individuals who reported engaging in one or more high-risk behaviors in the year before the survey. 

Previous research has shown that the way physicians talk about the HPV vaccine can influence parents’ decisions on whether to vaccinate their adolescents. 

Since 2006, vaccines have been available that target the HPV strains most likely to cause anal and cervical cancer.

The U.S. Centers for Disease Control and Prevention (CDC) recommends that adolescent boys and girls up to 15 years of age receive two doses of the HPV vaccine, beginning at age 11 or 12. 

Those who start the vaccine series later, at ages 15 through 26, should receive three doses, according to CDC guidelines.  

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This study was funded by a career development award from the National Cancer Institute (NCI) under grant number K01CA175239. Wigfall noted that her opinions are her own, and do not necessarily represent the official views of the NCI.