Providing adolescent-friendly HPV education

Human papillomavirus (HPV) is the most common sexually transmitted infection, affecting more than 6.2 million individuals every year. Most new infections occur in adolescents and young adults shortly after the onset of sexual activity. Nurse practitioners play a key role in preventing HPV infection in teens through adolescent-friendly HPV education, prevention, and vaccination.     

African-American women: health beliefs, lifestyle, and osteoporosis

Cultural beliefs of African-American women, manifested in lifestyle behaviors, may influence osteoporosis development. Genetics may have a positive influence on bone density, but the risks increase from other diseases that may contribute to the development of secondary osteoporosis. Health beliefs, lifestyle behaviors, and secondary osteoporosis causes are explored, focusing on relationships with osteoporosis. African-American women must be informed of the risks involved with some of the traditional health beliefs and practices. Healthcare providers have a challenge and responsibility to explore cultural beliefs with African-American women and to develop an acceptable approach to osteoporosis prevention.     

人乳头瘤病毒疫苗临床应用中国专家共识

人乳头瘤病毒(human papilloma virus,HPV)疫苗接种是预防HPV感染及相关疾病的有效方法,是防控HPV感染相关疾病的一级预防措施。低龄人群接种效果优于高龄人群,性暴露前接种免疫效果最佳。HPV疫苗不仅适用于普通人群,同样推荐用于高危、特殊人群。对于具有遗传易感、高危生活方式和HIV感染的适龄女性优先推荐接种HPV疫苗。适龄女性无论是否存在HPV感染、细胞学是否异常均可接种HPV疫苗。近期有妊娠计划、妊娠期或哺乳期女性不宜接种HPV疫苗。接种HPV疫苗后仍应进行子宫颈癌筛查。     

Exploring the Need of HPV Education Programs in Korean American Communities

Given the significantly higher cervical cancer risks faced by Korea Americans (KA), the aim of this study was to explore cultural influences and barriers affecting human papillomavirus (HPV) vaccination decisions and preferred educational methods to effectively deliver HPV information. Focus groups included 20 KA parents. This study found a lack of knowledge about HPV and the vaccine, along with negative perceptions about the vaccine, affects HPV vaccination decision-making. Ineffective conversations and a lack of HPV vaccine recommendations by health care providers influenced by cultural beliefs were found to be another major barrier. These findings reveal new insights to guide the development of HPV education programs.     

HPV Vaccination: Does It Have a Role in Preventing Penile Cancer and Other Preneoplastic Lesions?

ObjectivesHuman papillomavirus (HPV) is the most common sexually transmitted infection globally, which causes nearly all cervix carcinomas and contributes to oropharyngeal, penile, vulva, vagina, and anal cancers. Despite the role of HPV in several preneoplastic and cancerous lesions in men, male vaccine coverage is low. This article aims to provide insights into the pathophysiology of HPV-related penile cancer and penile intraepithelial neoplasia (PeIN). Moreover, this review endeavors to outline the advantages of implementing HPV vaccination in male vaccination programs and the role of health care providers in this mission.Data SourcesThis is a narrative review of relevant literature. A search on PubMed and Cochrane database was conducted. The following search terms were used: HPV vaccination, gender-neutral vaccination, male, genital warts, penile cancer, vaccine recommendations.ConclusionHPV is responsible for 50.8% of penile cancers globally, 79.8% of PeIN, and 90% of genital warts. In 2009 the Food and Drug Administration licensed the quadrivalent HPV vaccine for use in males, with a potential efficacy of 90% and 77.5% to reduce genital warts and anal intraepithelial neoplasia, respectively. However, the uptake of HPV vaccination in men is low, and gender-neutral vaccination is estimated to be implemented only in 42 countries worldwide. Because data in penile cancer are lacking, further research is needed to study the efficacy of incorporation of HPV vaccines in male vaccination programs on preventing penile cancer and PeIN.Implications for Nursing PracticeNurses and other members of the multidisciplinary team should take every opportunity to recommend HPV vaccination in adolescent men. Moreover, they play an important role in raising community awareness about the incidence of HPV and the related range of diseases. A practical approach is needed to incorporate HPV vaccines in vaccination programs and to optimize vaccination coverage.     

HPV vaccine

The incidence and the mortality from the disease have decreased dramatically in developed countries with increased use of cytologic screening and treatment of preinvasive disease. However, in developed countries including Japan, cervical cancer tends to affect younger women who may be responsible for young children. Therefore, the social consequences of the disease can be still tremendous. For cervical cancer prevention, vaccination programs against the two major cancer-causing types (HPV16 and 18) started in the world. We all look with eager anticipation towards the prospects of HPV vaccines and the perspective of eradicating cervical cancer in the not too distant future.     

New Quadrivalent HPV Vaccine Developments

Abstract

Human papillomavirus infection is the most prevalent sexually transmitted disease in the world and is responsible for cervical, vulvar, and vaginal cancers, as well as genital warts. A vaccine against HPV types 6, 11, 16, and 18 has been available since 2006 and has been approved for the prevention of cervical cancer, cervical precancers, and genital warts. Recently, the vaccine also received approval for the prevention of vulvar and vaginal cancers in women aged 9 to 26 years. Although Guillain-Barré syndrome and death have been reported in women who received the vaccine, an analysis of available data by the US Food and Drug Administration found no association between the vaccine and these adverse events. Since post-vaccination syncope is common among young women, providers should ensure that patients remain seated when vaccinated and under observation for at least 15 minutes following vaccination.     

HPV in Men is a Women's Health Issue

Human papillomavirus (HPV) is associated with several types of cancer in both women and men, including cervical cancer, anal cancer and head and neck cancer. Public health efforts to educate consumers about HPV and vaccination have largely focused on women. This article summarizes three recent studies in which researchers examined issues regarding male attitudes and acceptance of the human papillomavirus (HPV) vaccine. All three papers suggest that vaccination of males would be beneficial to both men and women in reducing the overall HPV-related health burden. Here, the three studies are summarized and evaluated, and implications for nursing practice are discussed.     

Update on vaccination against human papillomavirus (HPV)

HPV vaccine offers a new approach to preventing HPV and associated conditions. The vaccine has mainly been studied in young women, and clinical trials have supported its efficacy in preventing genital warts and cervical precancers caused by targeted HPV types. While health care experts and others endorse the use of the vaccine, they disagree on making it mandatory. For now, lawmakers would like further discussion and debate before pushing legislation to make the vaccine a legal requirement.     

鹰潭地区女性宫颈 HPV 感染率及其基因分型特点

目的：探讨鹰潭地区女性宫颈人乳头瘤病毒（HPV）感染率及其病毒基因分型特点,为该地区宫颈癌防治提供更科学、可靠的临床数据。方法回顾分析2011年1月至2013年6月来鹰潭市人民医院铁路分院门诊妇科就诊及体检的妇女4165例,采用核酸扩增和反向点杂交技术对23种 HPV 基因型进行检测,然后对检测结果进行分析。结果在4165例患者中,HPV阳性者有1311例,感染率为31．48％;一重感染率为20．86％,二重感染率为6．27％,三重感染率为2．76％,四重感染率为0．84％,四重以上感染率为0．72％。感染率最高的基因型别是 HPV 52型,占12．43％,其次为 HPV 43、58、16型。＞20～25岁者感染率最高,为43．19％。结论鹰潭地区女性宫颈 HPV 感染率有较高的区域性,以 HPV 52、43、58、16等亚型感染居多。     

Race,Ethnicity, and Income Factors Impacting Human Papillomavirus Vaccination rates

Background

Human papillomavirus (HPV) infection and cervical cancer disproportionately affect low-income and minority women. HPV vaccines have the potential to either reduce or exacerbate racial disparities in HPV-related diseases and cervical cancers, depending on the equitability of vaccine uptake.

Objectives

This review aims to identify barriers and facilitators of equitable uptake of HPV vaccination among low-income and minority girls. This review discusses factors related to race, ethnicity, and income that are associated with initiation and completion rates of the 3-dose HPV vaccine series and presents targets for intervention.

Methods

We reviewed relevant English-language literature to identify current vaccination rates and factors associated with vaccine uptake. Study findings related to race (black, Latino, Asian), and incomes were summarized.

Results

Current trends in the United States indicate low uptake among all adolescents, and that rates stagnated between 2011 and 2012. Low-income and minority adolescents are equally or more likely to start the HPV vaccination series than are white and higher-income adolescents, but are less likely to complete all 3 shots. Provider recommendation is a key factor in HPV vaccination, and minorities are less likely to report receiving recommendations for HPV vaccination.

Conclusions

As black, Hispanic, and Asian populations continue to grow in the United States over the next several decades, it is imperative that we not only improve HPV vaccination rates overall, but also focus on high-risk populations to prevent an increase in cervical cancer disparities.     

深圳关外各社区妇女生殖道人乳头瘤病毒感染状况及亚型分析

目的探讨深圳关外宝安、龙华及光明新区各社区健康检查妇女人群人乳头瘤病毒（HPV）感染的情况,为宫颈癌早期发现、早期治疗和预防工作提供科学依据。方法收集2011年2月～2013年2月来深圳关外宝安沙井、龙华及光明新区各社康服务中心进行生殖健康检查的妇女人群3095例,按不同年龄进行分组,分另4采用核酸分子快速杂交技术进行23种HPV亚型感染筛查,并对结果进行统计分析。结果3095例不同社区健康体检妇女人群HPV感染总阳性率达23．46％（726／3095）,HPV感染高峰年龄〈25岁,占31．7％（206／649）,与其它年龄组的HPV感染率比较差异有统计学意义（x2=11．02,P〈0．05）;〉60岁的妇女HPV感染率明显下降[8．4％（9／107）],与其它各年龄组比较差异有统计学显著性意义（x2=53．15,Pdo．01）;单亚型感染率最高是HPVl6（26．67％）,其次是HPV58（15．47％）,HPV6（12．28％）;多亚型感染率最高为HPVl6（23．49％）,其次为HPV58（19．74％）,HPV52（10．38％）。感染以高危型为主,占87．88％（638／726）,低危型占5．92％（43／726）,多亚型感染占6．20％（45／726）。结论深圳关外各社区妇女高危型HPV感染主要以16,58厦52亚型为主,低危型HPV感染主要以6,53亚型为主。〈25岁社区妇女为最易感人群,应加强各区HPV的普查工作,特别注意有性生活史的未婚女性。     

反向斑点杂交技术应用于青少年女性HPV感染检测的研究

目的利用反向斑点杂交技术检测青少年女性的人乳头状瘤病毒(HPV)的感染情况并进行型别分析,为该类人群的HPV感染情况提供流行病学数据。方法应用PCR-反向斑点杂交(RDB)法对85例青少年女性进行23种HPV亚型检测(低危型为HPV6、11、42、43、45和高危型为HPV16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、73、83、MM4)。结果 85例样本中,HPV感染者40例,阳性率为47.06%,高危型占感染例数的50.62%,低危型占49.38%,二型或二型以上混合感染占52.5%(21/40)。结论应大力加强青少年女性HPV感染的宣传和筛查力度;反向斑点技术是很好的青少年女性HPV感染的筛查手段。     

Issues and challenges in implementing cervical cancer screenings in the emergence of HPV vaccination in Thailand

The discovery of the HPV vaccine has been a major breakthrough in preventing cervical cancer and other HPV-related diseases around the globe. Cervical cancer is a significant public health problem in Thailand. Despite the long-time availability of cervical cancer screening programs in Thailand, the uptake among the target female population remains low. HPV vaccines were approved by the Food and Drug Administration of Thailand in 2007. As of March 2011, due to financial limitations, HPV vaccines have still not been included in the national immunization program under the public health benefit plans although individuals has the option to pay privately for the vaccine. This paper discusses the issues and challenges in implementing cervical cancer screening programs in the era of HPV vaccination in Thailand. Recommendations to increase the uptake of cervical cancer screening and further research to inform a policy regarding the cervical cancer screening measures are proposed.     

Understanding the Two-Dose HPV Vaccine Schedule

Recent advances in human papillomavirus (HPV) science have led to updates to national HPV vaccine recommendations. This column takes a second look at two recent studies that provide evidence to support the current two-dose HPV vaccination schedule for youth ages 9 to 14 years. This short review will help nurses and other clinicians understand the health and economic benefits of the current dosing recommendation. Nurses are leaders in national vaccination efforts; therefore, it is vital that they remain up to date on the latest evidence that supports vaccination practice as well as health counseling and HPV vaccine recommendations.     

On surmounting the barriers to HPV vaccination: we can do better

The major impediment to increased human papillomavirus (HPV) vaccination coverage in young males and females is lack of health care provider recommendation. Despite its efficacy in preventing cervical cancer, HPV vaccination in females (49.5%) and males (37.5%) ages 13 through 17 falls well below the Centers for Disease Control and Prevention’s (CDC) Healthy People 2020 target of 80% coverage. Parents’ willingness to vaccinate their child has been shown to be much higher when physicians share personal vaccination decisions for their own children as well as what other parents have done at that particular clinic. Furthermore, the vaccine must be presented presumptively as a “bundle” along with the rest of the standard adolescent vaccine panel. Multiple exemplars presented including in several European countries, low-income countries and Rwanda, demonstrate that school-based health care systems dramatically increase vaccination coverage. Finally, acceptability for vaccination of males must improve by increasing provider recommendation and by presenting the HPV vaccine as a penile, anal and oropharyngeal cancer prevention therapy in males and not merely a vaccine to prevent cervical cancers in females. Paediatricians, obstetrician/gynaecologists and primary care physicians should consider these data as a call-to-action.

• Key messages

• ??Despite recent efforts in the US, only 49.5% of females and only 37.5% of males ages 13 through 17 have received all recommended HPV vaccine doses. These numbers fall well below the 80% target set forth by the Healthy People 2020 initiative.

• ??According to the CDC, if health care providers increase HPV vaccination rates in eligible recipients to 80%, it is estimated that an additional 53,000 cases of cervical cancer could be prevented during the lifetime of those younger than 12 years. Furthermore, for every year that the vaccination rate does not increase, an additional 4400 women will develop cervical cancer.

• ??First and foremost, healthcare providers (HCPs) must make a strong recommendation to vaccinate patients and these recommendations must become routine, including for males.

• ??It is clear that HPV vaccination rates improve significantly when vaccine administration occurs at designated, well-organized sites such as school-based vaccination programmes. Furthermore, HPV vaccination should be a high school requirement and offered in the standard adolescent vaccine panel as a bundle with Tdap and MenACWY vaccines in order to promote maximum adherence.

• ??Finally, research on immunogenicity and antibody titre longevity needs to be done in newborns. The HPV vaccine may be recommended in the newborn panel of vaccines to avoid any issues of sexualization and misplaced fears of sexual disinhibition, akin to the success of the Hepatitis B vaccine in the 1980s.

• ??The HPV vaccine is a vaccine against cancer and should be aggressively marketed as such. As healthcare providers, we need to make every effort to overcome barriers, real or perceived, to protecting our population from potential morbidity and mortality associated with this virus.

     

889例基于PCR反向点杂交技术的HPV检测回顾性分析

目的分析该院妇产科及泌尿外科就诊的患者HPV感染者比例,HPV高危及低危各亚型的分布及各年龄组高危型HPV优势亚型的分布特点,了解该地区HPV感染情况,为该地区宫颈癌的预防和针对该地区的疫苗研制提供参考依据。方法采用PCR反向点杂交技术检测2014-2015年来该院就诊的889例女性患者宫颈脱落细胞,共检测26种HPV亚型,其中高危型17种,低危型9种。结果 889例细胞样本中,检出HPV阳性者168例,阳性率为18.9%,以单一感染为主,高危亚型检测出142例,占总阳性例数的84.5%。共检出了24种HPV亚型,仅高危亚型HPV45及低危亚型HPV57未检出。检出率排名前三的HPV高危亚型分别为HPV52、HPV16、HPV58,中青年妇女以HPV16和HPV52为优势感染亚型,60岁的妇女主要感染HPV58。结论可据此针对不同年龄研发和采用不同亚型疫苗,防治宫颈癌,提高本地区女性健康水平。