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Colón-López V, Rivera-Figueroa V, Arroyo-Morales GO, Medina-Laabes DT, Soto-Abreu R, Rivera-Encarnación M, Díaz-Miranda OL, Ortiz AP, Wells KB, Vázquez-Otero C, Hull PC. Content analysis of digital media coverage of the human papillomavirus vaccine school-entry requirement policy in Puerto Rico. BMC Public Health 2021; 21:1286. [PMID: 34210308 PMCID: PMC8248762 DOI: 10.1186/s12889-021-11311-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 06/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11–12 years old. Evidence suggests that the content of media coverage may impact people’s perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR. Methods A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix to summarize each article’s content about the policy and 2) qualitative analysis using a grounded theory approach. Results The search resulted in 34 articles obtained from 17 online local and international news outlets that reported the policy's implementation. Analyses showed that 61% of the news articles did not mention the number of required doses, and 79% discussed the new policy concerning cancer prevention. In 2017, news coverage focused mostly on describing the policy, while 2018 coverage focused on controversies surrounding the implementation. Neutral emergent codes included: 1) Description of the policy; 2) Information about HPV related cancers; and 3) General information about HPV vaccine. Negative emergent codes included: 1) infringement to patient and parental autonomy; 2) Hesitancy from the political sector, and 3) Hesitancy from groups and coalitions. Positive content included: 1) knowledge and acceptance of HPV vaccine for cancer prevention; 2) importance of education and protective sexual behaviors; and 3) new vaccination law proposal. Conclusions Most of the media coverage in PR was neutral and included limited information related to the vaccine, HPV, and HPV-related cancers. Neutral and negative themes could influence public concerns regarding the new policy, as well as HPV vaccination rates in PR.
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Affiliation(s)
- Vivian Colón-López
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico. .,Department of Health Services Administration, Evaluation Research of Health Systems Science Program, School of Public Health, Medical Science Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico.
| | - Vilnery Rivera-Figueroa
- Department of Health Services Administration, Evaluation Research of Health Systems Science Program, School of Public Health, Medical Science Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico
| | - Glizette O Arroyo-Morales
- Department of Health Services Administration, Evaluation Research of Health Systems Science Program, School of Public Health, Medical Science Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico
| | - Diana T Medina-Laabes
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Roxana Soto-Abreu
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Manuel Rivera-Encarnación
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Olga L Díaz-Miranda
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico
| | - Ana P Ortiz
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, PO Box 36302, San Juan, 00936-3027, Puerto Rico.,Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, PO Box 70184, San Juan, 00936-8184, Puerto Rico
| | - Katelyn B Wells
- Association of Immunization Managers, 620 Hungerford Dr. Suite 29, Rockville, MD, 20850, USA
| | - Coralia Vázquez-Otero
- Harvard T.H. Chan School of Public Health Dana-Farber Cancer Institute, NCI Postdoctoral Fellow, 450 Brookline Ave., LW 633, Boston, MA, 02215, USA
| | - Pamela C Hull
- Department of Behavioral Science, College of Medicine, Markey Cancer Center, University of Kentucky, 2365 Harrodsburg Rd, Suite A230, Lexington, KY, 40504-3381, USA
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Human Papillomavirus Correlates With Histologic Anal High-Grade Squamous Intraepithelial Lesions in Hispanics With HIV. J Low Genit Tract Dis 2018; 22:320-325. [PMID: 29975333 DOI: 10.1097/lgt.0000000000000416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To estimate the magnitude of association between anal infection with high-risk human papilloma virus (HR-HPV) types and severity of biopsy-confirmed histopathological anal squamous intraepithelial lesions (SILs) among a clinic-based sample of HIV-infected adults in Puerto Rico. METHODS This cross-sectional study analyzed data from medical records of adult patients who visited a specialized anal neoplasia clinic from June 2015 to December 2017 (n = 239); sociodemographics, behavioral risk factors, medical history, clinical data, and pathology reports were collected. The magnitude of association between anal HR-HPV and severity of anal SIL, adjusted for potential confounders, was assessed using a multinomial logistic model. RESULTS A 78.7% of patients had anal HR-HPV infection, 43.9% had histopathological low-grade SIL (LSIL), and 37.7% had histopathological high-grade SIL (HSIL). The prevalence of anal HR-HPV infection was 63.6% among patients with no anal SIL, 70.5% for those with LSIL and 95.6% for those with HSIL. After adjusting for different predictors, patients with anal HR-HPV infection were more likely to have HSIL (odds ratio, 11.0; 95% confidence interval, 3.2-37.2) than those without anal HR-HPV infection, whereas no significant excess was observed for LSIL (odds ratio, 1.4; 95% confidence interval, 0.6-3.1). CONCLUSIONS This study showed a strong association between anal HR-HPV infection and HSIL. Likewise, a high prevalence of anal HR-HPV infection and presence of anal SIL was observed among HIV-infected individuals. Our result highlights the importance of screening for anal HR-HPV infection and anal SIL and optimizing strategies for HPV vaccination in HIV-infected individuals.
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Risk of Anal Cancer in Women With a Human Papillomavirus-Related Gynecological Neoplasm: Puerto Rico 1987-2013. J Low Genit Tract Dis 2018; 22:225-230. [PMID: 29649025 DOI: 10.1097/lgt.0000000000000395] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of the study was to estimate the magnitude of the association between HPV-related gynecological neoplasms and secondary anal cancer among women in Puerto Rico (PR). MATERIALS AND METHODS We identified 9,489 women who had been diagnosed with a primary cervical, vaginal, or vulvar tumor during 1987-2013. To describe the trends of invasive cervical, vulvar, vaginal, and anal cancer, the age-adjusted incidence rates were estimated using the direct method (2000 US as Standard Population). Standardized incidence ratios (observed/expected) were computed using the indirect method; expected cases were calculated using 2 methods based on age-specific rates of anal cancer in PR. The ratio of standardized incidence ratios of anal cancer was estimated using the Poisson regression model to estimate the magnitude of the association between HPV-gynecologic neoplasms and secondary anal cancer. RESULTS A significant increase in the incidence trend for anal cancer was observed from 1987 to 2013 (annual percent change = 1.1, p < .05), whereas from 2004 to 2013, an increase was observed for cervical cancer incidence (annual percent change = 3.3, p < .05). The risk of secondary anal cancer among women with HPV-related gynecological cancers was approximately 3 times this risk among women with non-HPV-related gynecological cancers (relative risk = 3.27, 95% CI = 1.37 to 7.79). CONCLUSIONS Anal cancer is increasing among women in PR. Women with gynecological HPV-related tumors are at higher risk of secondary anal cancer as compared with women from the general population and with those with non-HPV-related gynecological cancers. Appropriate anal cancer screening guidelines for high-risk populations are needed, including women with HPV-related gynecological malignancies and potentially other cancer survivors.
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Colón-López V, González-Barrios D, De León SM, Girona-Lozada G, Machin M, Charneco E, Frias-Belén O, Román L, Ortiz AP. Population-Based Study of Tobacco Use Among People Living With HIV in Puerto Rico. Subst Use Misuse 2018; 53:420-425. [PMID: 28850293 DOI: 10.1080/10826084.2017.1334064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Despite substantial advances in the era of highly active antiretroviral therapy, HIV-positive persons are at high risk of tobacco-related disease and mortality. This study describes the prevalence and sociodemographic factors associated with current tobacco use among HIV-positive men and women 18 years and older receiving HIV care in Puerto Rico. METHODS Data from the 2009 Medical Monitoring Project (MMP) was used. A three-stage sampling design was conducted to obtain annual cross-sectional probability samples of HIV-infected adults in care. Factors associated with current tobacco use were identified using logistic regression models. All analyses were performed using STATA version 11.0. RESULTS The estimated prevalence of current cigarette use among the population was 29.0% (95%CI: 23.5%-35.2%), daily smoking was reported in 76.7% of them. Multivariate logistic regression models, showed that male drug users (injected and noninjected) were up to nine times more likely to be current smokers (OR = 9.9; 95%CI = 3.1, 31.5) as compared to nonusers. CONCLUSION Findings highlight the need for smoking cessation strategies in this population, particularly among male HIV+ drug users.
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Affiliation(s)
- Vivian Colón-López
- a Cancer Control and Population Sciences Program, Comprehensive Cancer Center , University of Puerto Rico San Juan , Puerto Rico.,b Department of Health Services Administration, Graduate School of Public Health, Medical Sciences Campus , University of Puerto Rico , San Juan , Puerto Rico
| | - Daisy González-Barrios
- c UPR-MDACC Partnership for Excellence in Cancer Research Program , University of Puerto Rico , San Juan , Puerto Rico
| | | | | | - Mark Machin
- a Cancer Control and Population Sciences Program, Comprehensive Cancer Center , University of Puerto Rico San Juan , Puerto Rico
| | - Eileen Charneco
- c UPR-MDACC Partnership for Excellence in Cancer Research Program , University of Puerto Rico , San Juan , Puerto Rico
| | - Orquidea Frias-Belén
- c UPR-MDACC Partnership for Excellence in Cancer Research Program , University of Puerto Rico , San Juan , Puerto Rico
| | - Leticia Román
- c UPR-MDACC Partnership for Excellence in Cancer Research Program , University of Puerto Rico , San Juan , Puerto Rico
| | - Ana Patricia Ortiz
- a Cancer Control and Population Sciences Program, Comprehensive Cancer Center , University of Puerto Rico San Juan , Puerto Rico.,e Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus , University of Puerto Rico , San Juan , Puerto Rico
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