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Roberti J, Ini N, Belizan M, Alonso JP. Barriers and facilitators to vaccination in Latin America: a thematic synthesis of qualitative studies. CAD SAUDE PUBLICA 2024; 40:e00165023. [PMID: 38922226 PMCID: PMC11192573 DOI: 10.1590/0102-311xen165023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 04/01/2024] [Accepted: 04/09/2024] [Indexed: 06/27/2024] Open
Abstract
Vaccines are often undervalued or underused for a variety of reasons, and vaccine hesitancy is a global challenge that threatens vaccine acceptance and the goals of immunization programs. This review aimed to describe the barriers and facilitators to vaccination in Latin America. The study design was a systematic review and thematic synthesis of qualitative studies reporting on the knowledge or attitudes of adults, parents of children at vaccination age, adolescents and health professionals towards vaccination in Latin America. The databases searched were PubMed, CENTRAL, Scopus, LILACS, SciELO, and CINAHL. A total of 56 studies were included. Facilitators included vaccination being recognized as an effective strategy for preventing infectious diseases and as a requirement for access to social assistance programs, schooling or employment. Recommendations from health professionals and positive experiences with health services were also identified as facilitators. The main barriers were lack of information or counseling, structural problems such as shortages of vaccines and limited hours of operation, the inability to afford over-the-counter vaccines or transportation to health facilities, certain religious beliefs, misconceptions and safety concerns. Qualitative research can contribute to understanding perceptions and decision-making about vaccination and to designing policies and interventions to increase coverage.
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Affiliation(s)
- Javier Roberti
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Natalí Ini
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
| | - Maria Belizan
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - Juan Pedro Alonso
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
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Ayo-Ajibola O, Davis RJ, Lin ME, West JD, Kokot NC, Chambers T. Associations Between Risk Perception and HPV Knowledge and Vaccine Uptake: Highlighting the LGBTQ+ Population. Otolaryngol Head Neck Surg 2024; 170:1684-1695. [PMID: 38327242 DOI: 10.1002/ohn.664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/14/2023] [Accepted: 01/13/2024] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Gay and bisexual males and other LGBTQ+ communities are more frequently exposed to factors associated with an increased risk of human papillomavirus (HPV) acquisition. Vaccination is critical to protect against HPV+ head and neck cancer (HNC). We characterized the association of perceived level of risk of contraction with HPV knowledge, and vaccine decision-making. STUDY DESIGN Cross-sectional cohort. SETTING LGBTQ and general survey Reddit forums (control). METHODS A survey was shared amongst the online forums. Descriptive statistics characterized the data. Multivariable logistic regression was used to understand factors associated with vaccination, self-perceived high risk, and knowledge of HPV + HNC. RESULTS Of 718 respondents, most were female (41.09%), Caucasian (59.89%), college-educated (33.01%), and insured (77.15%) with a mean age of 30.75 years. Half were vaccinated (49.16%), with most unvaccinated endorsing interest (60.58%). Few dependents were vaccinated (25.91%), with interest in vaccination among parents of unvaccinated children (38.58%). Knowledge of HIV's association with HPV (62.95%), HPV causing HNC (55.57%), and the vaccine's efficacy against HNC (55.57%) was also moderate. Identifying female (P = .042), a self-perceived high-risk (P < .001), and having vaccinated children (P < .001) increased vaccination likelihood; transgender (P = .021), or lesbian or gay sexual identity (P < .001) decreased likelihood. Personal HNC diagnosis (P < .001), self-vaccination (P < .001), having vaccinated children (P < .001), having anal sex (P = .001) or no knowledge of past HPV status (P < .001) increased likelihood of high self-perceived risk. CONCLUSION Efforts to improve public education regarding the association between HPV and HNC and vaccination efficacy are required to better inform vaccine decision-making among individuals at risk for HPV infection.
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Affiliation(s)
| | - Ryan J Davis
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Matthew E Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Jonathan D West
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | - Niels C Kokot
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | - Tamara Chambers
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, USA
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Jodry D, Obedin-Maliver J, Flowers L, Jay N, Floyd S, Teoh D, Conageski C, Downs L, Khan MJ. Understanding Sexual and Gender Minority Populations and Organ-Based Screening Recommendations for Human Papillomavirus-Related Cancers. J Low Genit Tract Dis 2023; 27:307-321. [PMID: 37729043 PMCID: PMC10545069 DOI: 10.1097/lgt.0000000000000763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVES Sexual gender minority (SGM) populations are at risk for human papillomavirus (HPV)-related cancers of the anogenital tract and oropharynx and often face barriers to health care. The goals of this document are to clarify language to provide inclusive care for SGM populations and to provide recommendations for screening and prevention of HPV-related cancers in SGM populations. MATERIALS AND METHODS An expert committee convened by the American Society for Colposcopy and Cervical Pathology performed a narrative review of the literature through February 2023. A comprehensive MEDLINE database search was performed for relevant studies. The literature review was divided into categories by organ/topic and by SGM population. Given the variability in available data for several of the categories, recommendations were made based on national guidelines where appropriate or expert opinion where there were less data to support risk-based guidelines. RESULTS Definitions and terminology relevant to SGM populations are presented. The authors advocate the adoption of sexual orientation gender identity data collection and an organ-based screening approach, which is possible with knowledge of patient anatomy, sexual behaviors, and clinical history. This includes screening for cervical cancer per national recommendations, as well as screening for anal, vulvar, vaginal, penile, and oral cancers based on risk factors and shared clinical decision making. The authors recommend consideration of HPV vaccination in all SGM individuals up to age 45 years old who are at risk. CONCLUSIONS An organ-based screening approach is part of a global strategy to create an inclusive care environment and mitigate barriers to screening and prevention of HPV-mediated cancers in SGM populations.
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Affiliation(s)
| | | | - Lisa Flowers
- Emory University School of Medicine, Atlanta, GA
| | - Naomi Jay
- University of California, San Francisco School of Medicine, San Francisco, California
| | - Serina Floyd
- Planned Parenthood of Metropolitan Washington, DC, Washington, DC
| | - Deanna Teoh
- Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN
| | | | - Levi Downs
- Park Nicollet Health Services, Minneapolis, MN
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Ejaz M, Ekström AM, Ahmed A, Haroon A, Ali D, Ali TS, Salazar M. Human Papillomavirus associated prevention: knowledge, attitudes, and perceived risks among men who have sex with men and transgender women in Pakistan: a qualitative study. BMC Public Health 2022; 22:378. [PMID: 35193544 PMCID: PMC8864907 DOI: 10.1186/s12889-022-12775-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/14/2022] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Men who have sex with men (MSM) and transgender individuals are at higher risk of genital warts and anal cancer due to sexually transmitted human papillomavirus infection. This study explores MSM and transgender women's perceptions of Human papillomavirus (HPV) infection and HPV prevention strategies (screening and vaccination) in Pakistan. DESIGN A qualitative study using focus group discussions (FGD) with self-identified MSM, male sex workers and transgender women were conducted between March 2019 to August 2019 in Karachi, Pakistan. METHODS Participants were recruited from community-based organization (CBO) working for MSM and transgender women. A total of 38 men and 10 transgender women took part in 6 FGDs. Discussions were recorded, translated, transcribed verbatim and analyzed using content analysis. RESULTS Three themes were identified from the emerging analysis. These are, 1) Knowledge and risk perceptions about STIs and HPV, 2) Beliefs and attitudes towards HPV prevention, 3) Participant's recommendations for HPV vaccination and anal Pap screening. Participants described lack of knowledge of HPV and its health consequences as HIV is the only focus of attention of the government and the local CBOs. None of participants had heard about HPV prevention including vaccination and anal Pap screening for men but expressed a positive attitude towards prevention. Genital warts and anal cancer were perceived as severe potential consequences of a known risk behaviors. All participants stated they would be interested in taking an HPV vaccine but acknowledged that the provision of services for sexually transmitted infections (STI) are inadequate to meet the needs of key populations and are not prioritized by the government. The main perceived barriers to access HPV prevention included cost and challenges to access public health care services or openly discussing one's sexual orientation with health care providers. Participants generally preferred the CBO for more professional, unbiased staff attitudes that respect patients' integrity, confidentiality and privacy. Most participants thought that in case the government is non-cooperative, CBOs should work in the interest of HPV eradication and generate funds through international funding. CONCLUSIONS The findings from this study can help public health policy and researchers to understand this minority's perspective on HPV prevention. Given the low level of knowledge about HPV infection and its negative health consequences there is a need of HPV education combined with STI education and awareness through HPV brochures to educate the target population effectively.
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Affiliation(s)
- Muslima Ejaz
- Department of Global Public Health Karolinska Institutet, Stockholm, Sweden. .,Department of Community Health Sciences, the Aga Khan University, Karachi, Pakistan.
| | - Anna Mia Ekström
- Department of Global Public Health Karolinska Institutet, Stockholm, Sweden
| | - Alyan Ahmed
- Department of Community Health Sciences, the Aga Khan University, Karachi, Pakistan
| | - Aymen Haroon
- Department of Biostatistics and Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, United States
| | - Dania Ali
- Department of Community Health Sciences, the Aga Khan University, Karachi, Pakistan
| | - Tazeen Saeed Ali
- Department of Community Health Sciences, the Aga Khan University, Karachi, Pakistan.,School of Nursing, the Aga Khan University, Karachi, Pakistan
| | - Mariano Salazar
- Department of Global Public Health Karolinska Institutet, Stockholm, Sweden
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Jennings Mayo-Wilson L, Benotsch EG, Grigsby SR, Wagner S, Timbo F, Poteat T, Cathers L, Sawyer AN, Smout SA, Zimmerman RS. Combined effects of gender affirmation and economic hardship on vulnerability to HIV: a qualitative analysis among U.S. adult transgender women. BMC Public Health 2020; 20:782. [PMID: 32456674 PMCID: PMC7249630 DOI: 10.1186/s12889-020-08902-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 05/12/2020] [Indexed: 02/06/2023] Open
Abstract
Background Transgender women (“trans women”), particularly African-American and Latina trans women, have disproportionately high prevalence of HIV in the United States (U.S.). In order to decrease gender dysphoria and overcome discrimination, trans women affirm their gender through social and medical transition, often in contexts of economic hardship and sexual risk. This study qualitatively examined how gender-affirming behaviors enhance or diminish vulnerability to HIV in light of structural and economic barriers to gender transition. Methods We conducted individual interviews with 19 adult trans women in two U.S. cities (Richmond, VA and St. Louis, MO) who reported one or more sexual risk behaviors and recent economic hardship related to employment/income, housing, or food security. Interviews were recorded, transcribed, and analyzed using thematic content analysis. Results The majority (74%) of trans women were racial/ethnic minorities with mean age of 26.3 years. Gender-affirming behaviors varied with 58% of trans women having legally changed their name and gender marker; 79% having initiated hormone therapy; and 11% having not initiated any medical or legal changes. None had undertaken surgical changes. Findings suggested that the process of gender transitioning resulted in both increasing and decreasing HIV risk. The high need for gender affirmation by male sex partners contributed to trans women’s exposure to sexual objectification, sexual risk behaviors, and conflicting interests in HIV prevention messaging. Loss of housing and employment due to transition along with the high costs of transition products and medical visits increased reliance on sex work and created new obstacles in accessing HIV services. Trans women experienced lower HIV risk as they acquired legal and medical transition services, reshaped interactions with sex partners, and received gender-affirming support by others, including health providers, employers, peers, and housing professionals. Sexual abstinence was viewed as a negative consequence of incomplete transition, although characterized as a period of low HIV risk. Conclusions Structural and policy initiatives that promote safe gender transition and economic stability in trans women may play a critical role in reducing HIV in this population. Addressing the harmful pressures for U.S. trans women to conform to perceived feminine stereotypes may also serve an important role.
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Affiliation(s)
- Larissa Jennings Mayo-Wilson
- Indiana University School of Public Health, Department of Applied Health Sciences, Center for Sexual Health Promotion, 1025 E. 7th Street, Bloomington, IN, 47405, USA. .,Johns Hopkins Bloomberg School of Public Health, Department of International Health, Social and Behavioral Interventions Program, 615 N. Wolfe Street, Room E5038, Baltimore, MD, 21205, USA.
| | - Eric G Benotsch
- Virginia Commonwealth University, Department of Psychology, 806 West Franklin Street, Richmond, VA, 23284, USA
| | - Sheila R Grigsby
- University of Missouri - St. Louis, College of Nursing, 221 NAB South Campus, University Blvd St. Louis, St. Louis, MO, 63121, USA
| | - Sarah Wagner
- Indiana University School of Public Health, Department of Applied Health Sciences, Center for Sexual Health Promotion, 1025 E. 7th Street, Bloomington, IN, 47405, USA
| | - Fatmata Timbo
- Indiana University School of Public Health, Department of Applied Health Sciences, Center for Sexual Health Promotion, 1025 E. 7th Street, Bloomington, IN, 47405, USA
| | - Tonia Poteat
- University of North Carolina, Department of Social Medicine, CB #7240, Chapel Hill, NC, 27516, USA
| | - Lauretta Cathers
- University of Missouri - St. Louis, College of Nursing, 221 NAB South Campus, University Blvd St. Louis, St. Louis, MO, 63121, USA
| | - Ashlee N Sawyer
- Virginia Commonwealth University, Department of Psychology, 806 West Franklin Street, Richmond, VA, 23284, USA
| | - Shelby A Smout
- Virginia Commonwealth University, Department of Psychology, 806 West Franklin Street, Richmond, VA, 23284, USA
| | - Rick S Zimmerman
- Louisiana State University Health New Orleans School of Nursing, 1900 Gravier Street, Room 5B14, New Orleans, LA, 70112, USA
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León-Maldonado L, Cabral A, Brown B, Ryan GW, Maldonado A, Salmerón J, Allen-Leigh B, Lazcano-Ponce E. Feasibility of a combined strategy of HPV vaccination and screening in Mexico: the FASTER-Tlalpan study experience. Hum Vaccin Immunother 2019; 15:1986-1994. [PMID: 31184976 DOI: 10.1080/21645515.2019.1619401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
There has been a noticeable shift in discussions about cervical cancer, moving from prevention to elimination. Interventions such as FASTER, human papillomavirus (HPV) vaccination and HPV screening are innovative intervention strategies which can be utilized to begin a path to elimination. To explore the feasibility of the FASTER strategy, an evaluation was carried out in eight primary health-care centers within the Tlalpan Health-Jurisdiction of Mexico City between March 2017 and August 2018. A mixed methods approach was used to evaluate three components: infrastructure, patient acceptability, and health-care professionals' perceptions. This included checklists of requirements for the infrastructure rollout of FASTER and interviews with women and health-care professionals. Nearly all (93%) of the 3,474 women aged 25-45 years accepted HPV vaccination as part of a combined vaccination and screening program. The main reason for acceptance was prevention, while having doubts about the vaccine's benefits was the main reason for refusal. Most of the 24 health-care professionals had a positive opinion toward HPV vaccination and identified the need to increase dissemination, inform the population clearly and concisely and currently extend the age range for vaccination. The evaluation of eight primary health-care centers showed they had the necessary infrastructure for the development of a joint HPV prevention strategy, but many centers required improvements to become more efficient. Together these findings suggest that although HPV vaccine acceptance was high, there is the need to increase education and awareness among potential vaccine recipients and health-care professionals to implement the FASTER strategy.
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Affiliation(s)
- L León-Maldonado
- a Cátedra CONACYT- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública , Cuernavaca , Morelos , México.,b Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Autónoma de México , Ciudad de México , México
| | - A Cabral
- c Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública , Cuernavaca , Morelos , México
| | - B Brown
- d Center for Healthy Communities, Department of Social Medicine, Population and Public Health. University of California, Riverside School of Medicine , Riverside , CA , USA
| | - G W Ryan
- e Department of Community and Behavioral Health, University of Iowa College of Public Health. Riverside Dr ., Iowa City , LA , USA
| | - A Maldonado
- f Dirección de Salud Reproductiva, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública , Cuernavaca , Morelos , México
| | - J Salmerón
- b Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Autónoma de México , Ciudad de México , México
| | - B Allen-Leigh
- f Dirección de Salud Reproductiva, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública , Cuernavaca , Morelos , México
| | - E Lazcano-Ponce
- g Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública , Cuernavaca , Morelos , México
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Abstract
Schim van der Loeff et al. weigh the pros and cons of offering HPV vaccines to female sex workers (FSWs). This is a pressing question in areas where the vaccine is not routinely available to all and vaccine resources are limited. In many countries, current FSWs would have missed the opportunity for vaccination as part of nationwide campaigns to reach school-age girls. Offering the HPV vaccine at the time of sex worker registration may protect them from acquiring high risk HPV types from future clients. A critical mistake in academic writing is excluding the population of interest from contributing to discussions about their health. Without the perspective of FSWs as authors, we are not engaging in good participatory practices.
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Affiliation(s)
- Brandon Brown
- School of Medicine, University of California, Riverside, USA
| | - Alejandra Cabral
- Fielding School of Public Health, University of California, Los Angeles, USA
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Parisi SG, Basso M, Scaggiante R, Andreis S, Mengoli C, Cruciani M, Del Vecchio C, Menegotto N, Zago D, Sarmati L, Andreoni M, Palù G. Oral and anal high-risk human papilloma virus infection in HIV-positive men who have sex with men over a 24-month longitudinal study: complexity and vaccine implications. BMC Public Health 2019; 19:645. [PMID: 31138232 PMCID: PMC6537447 DOI: 10.1186/s12889-019-7004-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/17/2019] [Indexed: 01/06/2023] Open
Abstract
Background Few studies focused on longitudinal modifications over time of high-risk HPV (HR-HPV) at anal and oral sites in HIV+ men who have sex with men (MSM). Methods We described patterns and longitudinal changes of HR-HPV detection and the prevalence of HR-HPV covered by the nonavalent HPV vaccine (vax-HPV) at oral and anal sites in 165 HIV+ MSM followed in an Italian hospital. The samples were collected at baseline and after 24 months (follow-up). The presence of HPV was investigated with Inno-LiPA HPV Genotyping Extra II. Results Median age was 44 years (IQR 36–53), median CD4+ cell count at nadir was 312 cells/mm3 (IQR 187–450). A total of 120 subjects (72.7%) were receiving successful antiretroviral therapy (ART). At baseline and follow-up, the frequency of HR-HPV was significantly higher in the anal site (65.4% vs 9.4 and 62.4% vs 6.8%, respectively). Only 2.9% of subjects were persistently HR-HPV negative at both sites. All oral HR-HPV were single at baseline vs 54.6% at baseline at the anal site (p = 0.005), and all oral HR-HPV were single at follow-up vs 54.4% at anal site at follow-up (p = 0.002). The lowest rate of concordance between the oral and anal results was found for HR-HPV detection; almost all HR-HPV positive results at both anal and oral sites had different HR-HPV.The most frequent HR-HPV in anal swabs at baseline and follow-up were HPV-16 and HPV-52.At follow-up at anal site, 37.5% of patients had different HR-HPV genotypes respect to baseline, 28.8% of subjects with 1 HR-HPV at baseline had an increased number of HR-HPV, and patients on ART showed a lower frequency of confirmed anal HR-HPV detection than untreated patients (p = 0.03) over time. Additionally,54.6 and 50.5% of patients had only HR-vax-HPV at anal site at baseline and follow-up, respectively; 15.2% had only HR-vax-HPV at baseline and follow-up. Conclusions We believe that it is important testing multiple sites over time in HIV-positive MSM. ART seems to protect men from anal HR-HPV confirmed detection. Vaccination programmes could reduce the number of HR-HPV genotypes at anal site and the risk of the first HR-HPV acquisition at the oral site. Electronic supplementary material The online version of this article (10.1186/s12889-019-7004-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Saverio Giuseppe Parisi
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy.
| | - Monica Basso
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy.
| | - Renzo Scaggiante
- Infectious Diseases Unit, Padova Hospital, Via Giustiniani, 2 -, 35128, Padova, Italy
| | - Samantha Andreis
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - Carlo Mengoli
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - Mario Cruciani
- Center of Diffusive Diseases, ULSS 9, Via Campania 1, 37136, Verona, Italy
| | - Claudia Del Vecchio
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - Nicola Menegotto
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - Daniela Zago
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Tor Vergata University, Viale Oxford, 81, 00133, Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, Tor Vergata University, Viale Oxford, 81, 00133, Rome, Italy
| | - Giorgio Palù
- Department of Molecular Medicine, University of Padova, Via Gabelli 63, 35100, Padova, Italy
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García-Muentes GD, Mendoza-García MA, Burgos-Galárraga RI, Ollague K, Vargas-Wachter C, Ruiz-Cabezas JC. Frequency and distribution of HPV genotypes in 800 genital samples of Ecuadorian men and women from the city of Guayaquil. Rev Inst Med Trop Sao Paulo 2019; 61:e41. [PMID: 31432990 PMCID: PMC6710005 DOI: 10.1590/s1678-9946201961041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/16/2019] [Indexed: 11/22/2022] Open
Abstract
Even though there are data published on HPV epidemiology in Ecuador, the
distribution of genotypes in Guayaquil, the largest city in the country, has not
been previously determined in a study including including both, men and women.
The present study aimed to determine the distribution of 37 HPV genotypes in
genital samples from Ecuadorian men and women living in the city of Guayaquil.
Genital samples included in daily diagnostic routine were analyzed by the 37 HPV
GenoArray Diagnostic Kit (Hybribio® Ltd., Sheung Wan, Hong Kong). The
relative frequency of detectable genotypes was determined. HPV relative
frequency according to sample characteristics, including sex and age groups, was
compared using c2 test. From the 800 samples (400 men and 400 women),
411 (51.38%) were positive for HPV DNA. The obtained frequency was higher among
samples from men (253/400 or 63.25%) in comparison to samples from women
(158/400 or 39.50%), with a p value <0.05. Samples from men showed a higher
frequency of HPV genotypes 6, 16, 18 and 11, while among samples from women
genotypes 39, 16, 6 and 58 were the most frequent. Considering male and female
samples together, genotypes 6, 16, 39 and 11 presented the highest frequencies.
HPV DNA was detected in half of the studied samples, with a higher frequency
among samples from men. Genotype 39 was the most frequent among women, and
ranked third when samples from men and women are analyzed together.
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Affiliation(s)
| | | | | | | | | | - Juan Carlos Ruiz-Cabezas
- Sociedad de Lucha Contra el Cáncer, Ecuador; Universidad de Especialidades Espíritu Santo, Ecuador
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Human Papillomavirus Knowledge, Attitudes, Practices, and Prevalence Among Men Who Have Sex With Men in Monrovia, Liberia. J Low Genit Tract Dis 2018; 22:326-332. [PMID: 30256337 DOI: 10.1097/lgt.0000000000000436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to assess human papillomavirus (HPV) prevalence, knowledge, attitudes, and practices, among men who have sex with men (MSM) in Monrovia, Liberia. MATERIALS AND METHOD This cross-sectional study was conducted with 107 MSM, aged 18 to 58 years, completing questionnaires and anal HPV screenings. Using peer-educators and direct community involvement, demographics, risk factors, and HPV knowledge data were collected. RESULTS Forty-eight participants (45%) were HPV positive and 21 participants (19.6%) self-identified as HIV positive. When examining HPV risk factors, 22 participants reported first sexual experience before the age of 15 years. Approximately half of participants (n = 58, 54.2%) have receptive anal sex and 40 (37.4%) reported more than 20 lifetime sexual partners. Eight participants (7.5%) had no formal education and 80 (74.8%) were not formally employed. Two-thirds of participants (64%) had never heard of HPV. Education was not significantly correlated with HPV knowledge. χ tests of independence were performed, and the relation between oral and anal sex and HPV knowledge was significant (χ (1) = 5.08, p < .05; χ (1) = 4.18, p < .05), respectively, such that those who engaged in oral and anal sex had lower levels of HPV knowledge. CONCLUSIONS Among the MSM population, HPV prevalence is high, as are high-risk practices. Participants lack HPV knowledge, independent of educational achievement, and are eager to receive educational information. Future studies should focus on identifying additional risk factors and implementing public health educational interventions.
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Ortiz-Martinez Y, Vega-Useche L, Londoño-Martinez JC, Mozo-Pacheco S. Knowledge on human papillomavirus among transgender women in Colombia. Br J Vener Dis 2018; 94:191. [DOI: 10.1136/sextrans-2017-053475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/10/2017] [Indexed: 11/04/2022]
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Brown B, Poteat T, Marg L, Galea JT. Human Papillomavirus-Related Cancer Surveillance, Prevention, and Screening Among Transgender Men and Women: Neglected Populations at High Risk. LGBT Health 2017; 4:315-319. [DOI: 10.1089/lgbt.2016.0142] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Brandon Brown
- Department of Social Medicine and Population Health, Center for Healthy Communities, School of Medicine, University of California, Riverside, Riverside, California
| | - Tonia Poteat
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Logan Marg
- Department of Sociology, University of California, Riverside, Riverside, California
| | - Jerome T. Galea
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
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Attitudes towards Human Papilloma Virus Vaccination in the Latin American Andean Region. Healthcare (Basel) 2017; 5:healthcare5030055. [PMID: 28885601 PMCID: PMC5618183 DOI: 10.3390/healthcare5030055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 08/31/2017] [Accepted: 09/06/2017] [Indexed: 12/26/2022] Open
Abstract
This commentary explores the distribution of human papilloma virus (HPV) and HPV-related diseases, and factors affecting attitudes towards HPV, HPV-related diseases, and HPV vaccination in the Latin American Andean region. Lack of knowledge of HPV, known negative attitudes or incorrect assumptions about HPV, HPV-related diseases, and HPV vaccination provide a basis upon which to develop targeted HPV awareness and preventive health media campaigns. For maximal effect, media campaigns should use the internet, radio, and television to address health care providers, parents, and students. Additional programming can be developed for clinics to use in-house with their clients. Ministries of Education, Finance, and Health all have roles to play to increase national HPV, HPV-related diseases, and HPV vaccination awareness.
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