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Zambrano-Ríos D, Fernández F, Matta-Miramar A, Arbelaez A, Herrera-Castañeda E, Castillo A. Detección del virus del papiloma humano en mucosa oral de mujeres de Cali, Colombia. INFECTIO 2019. [DOI: 10.22354/in.v23i3.791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Introducción: Poco se sabe acerca de la presencia del VPH en la mucosa oral en población sana y cuales son los factores de riesgo que pueden llevar al virus a una infección persistente que conduzca al desarrollo de un carcinoma.Objetivos: en el presente estudio la detección del VPH se realizó en muestras de ADN obtenidas de la mucosa oral de 76 mujeres sanas.Métodos: el VPH se detectó mediante la técnica de PCR anidada para el gen viral L1. La genotipificación se realizó mediante la secuenciación directa del fragmento del gen L1 amplificado por el método de Sanger, seguido de un análisis de porcentajes de identidad.Resultados: el porcentaje de detección de VPH fue de 6.6 por ciento. Los genotipos virales identificados fueron HPV-11, HPV-43 y HPV-72, todos clasificados de bajo riesgo oncológico. Además, se observó que el no uso del condón en este grupo de edad se asoció significativamente con la presencia de VPH en la mucosa oral (p = 0.037).Conclusión: en la presente investigación exploratoria se evidencio una mayor detección de VPH en la mucosa oral de mujeres sanas y su presencia se asocia con una vida sexual activa sin una protección adecuada contra su transmisión.
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Malagón T, Louvanto K, Wissing M, Burchell AN, Tellier PP, El-Zein M, Coutlée F, Franco EL. Hand-to-genital and genital-to-genital transmission of human papillomaviruses between male and female sexual partners (HITCH): a prospective cohort study. THE LANCET. INFECTIOUS DISEASES 2019; 19:317-326. [PMID: 30745276 DOI: 10.1016/s1473-3099(18)30655-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/28/2018] [Accepted: 10/18/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Hand-to-genital contact is hypothesised to be a transmission mode of human papillomavirus (HPV) of the Alphapapillomavirus genus. We compared the relative importance of hand-to-genital and genital-to-genital HPV transmission between sexual partners. METHODS In this prospective cohort study, we recruited and followed up female university students aged 18-24 years and their male sexual partners in Montreal, QC, Canada (2005-11). Participants were eligible if they had initiated sexual activity within the past 6 months. Women were examined at clinic visits at baseline and every 4-6 months for up to 24 months. Men had a baseline visit and a single follow-up visit approximately 4 months later. Partners provided hand and genital swab samples, which we tested for DNA of 36 HPV types using PCR. We assessed predictors of incident type-specific HPV detections using Cox proportional hazards models. FINDINGS Participants were recruited between June 5, 2006, and April 4, 2013. 264 women and 291 men had valid hand samples. The hazard ratio (HR) of incident detection of HPV in genital samples from women was 5·0 (95% CI 1·5-16·4) when her partner was positive for the same HPV type on his hand versus negative, but adjustment for his genital HPV status reduced the HR to 0·5 (0·1-1·8). Similarly, the HR of incident detection of HPV on men's genitals was 17·4 (95% CI 7·9-38·5) when his partner was positive for the same HPV type on her hand versus negative, but adjustment for her genital HPV status reduced the HR to 2·3 (0·9-6·2). Conversely, the HR of type-specific incident detection of HPV in genital samples associated with partner genital HPV positivity was 19·3 (95% CI 11·8-31·8) for women and 28·4 (15·4-52·1) for men after adjustment for their hand HPV status. INTERPRETATION Clinicians can reassure their patients that HPV transmission is unlikely to occur through hand-to-genital contact. The majority of genital HPV infections are likely to be caused by genital-to-genital sexual transmission. FUNDING Canadian Institutes for Health Research, National Institutes of Health, Fonds de la Recherche en Santé du Québec, and Merck & Co.
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Affiliation(s)
- Talía Malagón
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada.
| | - Karolina Louvanto
- Department of Obstetrics and Gynaecology, Turku University Hospital, University of Turku, Turku, Finland
| | - Michel Wissing
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada
| | - Ann N Burchell
- Department of Family and Community Medicine and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada; Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Mariam El-Zein
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada
| | - François Coutlée
- Département de Microbiologie et Infectiologie, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada; Département de Microbiologie et Immunologie, Université de Montréal, Montreal, QC, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, QC, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada
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Morris BJ, Hankins CA, Banerjee J, Lumbers ER, Mindel A, Klausner JD, Krieger JN. Does Male Circumcision Reduce Women's Risk of Sexually Transmitted Infections, Cervical Cancer, and Associated Conditions? Front Public Health 2019; 7:4. [PMID: 30766863 PMCID: PMC6365441 DOI: 10.3389/fpubh.2019.00004] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 01/04/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Male circumcision (MC) is proven to substantially reduce men's risk of a number of sexually transmitted infections (STIs). We conducted a detailed systematic review of the scientific literature to determine the relationship between MC and risk of STIs and associated conditions in women. Methods: Database searches by "circumcision women" and "circumcision female" identified 68 relevant articles for inclusion. Examination of bibliographies of these yielded 14 further publications. Each was rated for quality using a conventional rating system. Results: Evaluation of the data from the studies retrieved showed that MC is associated with a reduced risk in women of being infected by oncogenic human papillomavirus (HPV) genotypes and of contracting cervical cancer. Data from randomized controlled trials and other studies has confirmed that partner MC reduces women's risk not only of oncogenic HPV, but as well Trichomonas vaginalis, bacterial vaginosis and possibly genital ulcer disease. For herpes simplex virus type 2, Chlamydia trachomatis, Treponema pallidum, human immunodeficiency virus and candidiasis, the evidence is mixed. Male partner MC did not reduce risk of gonorrhea, Mycoplasma genitalium, dysuria or vaginal discharge in women. Conclusion: MC reduces risk of oncogenic HPV genotypes, cervical cancer, T. vaginalis, bacterial vaginosis and possibly genital ulcer disease in women. The reduction in risk of these STIs and cervical cancer adds to the data supporting global efforts to deploy MC as a health-promoting and life-saving public health measure and supplements other STI prevention strategies.
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Affiliation(s)
- Brian J. Morris
- School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, NSW, Australia
| | - Catherine A. Hankins
- Faculty of Medicine, McGill University, Montreal, QC, Canada
- London School of Hygiene and Tropical Medicine, Bloomsbury, London, United Kingdom
| | | | - Eugenie R. Lumbers
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine and Priority Research Centre for Reproductive Science, University of Newcastle, Callaghan, NSW, Australia
- Mothers and Babies Research Centre, Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Adrian Mindel
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Jeffrey D. Klausner
- Division of Infectious Diseases and the Program in Global Health, Fielding School of Public Health, University of California Los Angeles Care Center, Los Angeles, CA, United States
| | - John N. Krieger
- Department of Urology, University of Washington School of Medicine, Seattle, WA, United States
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PEREIRA JD, LEMOS MSD. Preditores motivacionais de adesão à prevenção do câncer do colo do útero em estudantes universitárias. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2019. [DOI: 10.1590/1982-0275201936e170073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Este estudo analisou o papel das variáveis motivacionais na adesão à prevenção do câncer do colo do útero. Participaram da pesquisa 399 estudantes universitárias que responderam a um questionário em que avaliaram fatores de adesão à prevenção do câncer, incluindo variáveis sociodemográficas, nível de conhecimento sobre o câncer e variáveis motivacionais. Os resultados mostraram que as variáveis motivacionais explicam de 34% a 54% da variância (p < 0,001) da intenção de adesão aos comportamentos de prevenção (exames de Papanicolau, uso de preservativo e restrição do número de parceiros sexuais) e são também um preditor significativo do envolvimento efetivo nesses comportamentos (odds ratios: 0,33 – 5,83; p < 0,05). O estudo evidencia a importância de considerar quer as variáveis motivacionais facilitadoras (autoeficácia e construção da intenção de adesão), quer as debilitantes (custos emocionais) no planejamento e avaliação de intervenções de educação para a saúde, com vistas a maximizar a adesão à prevenção do câncer do colo do útero.
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Cervical cancer cell lines are sensitive to sub-erythemal UV exposure. Gene 2018; 688:44-53. [PMID: 30517878 DOI: 10.1016/j.gene.2018.11.079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 11/24/2018] [Indexed: 11/22/2022]
Abstract
High risk human papillomavirus (HPV) infections are the causative agent in virtually every cervical cancer as well as a host of other anogenital and oropharyngeal malignancies. These viruses must activate DNA repair pathways to facilitate their replication, while avoiding the cell cycle arrest and apoptosis that can accompany DNA damage. HPV oncoproteins facilitate each of these goals, but also reduce genome stability. Our data dissect the cytotoxic and cytoprotective characteristics of HPV oncogenes in cervical cancer cells. These data show that while the transformation of keratinocytes by HPV oncogene leaves these cells more sensitive to UV, the oncogenes also protect against UV-induced apoptosis. Cisplatin and UV resistant cervical cancer cell lines were generated and probed for their sensitivity to genotoxic agents. Cervical cancer cells can acquire resistance to one DNA crosslinking agent (UV or cisplatin) without gaining broad tolerance of crosslinked DNA. Further, cisplatin resistance may or may not result in sensitivity to PARP1 inhibition.
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Chabbert-Buffet N, Marret H, Agostini A, Cardinale C, Hamdaoui N, Hassoun D, Jonville-Bera AP, Lambert M, Linet T, Pienkowski C, Plu-Bureau G, Pragout D, Robin G, Rousset-Jablonski C, Scheffler M, Vidal F, Vigoureux S, Hédon B. [Contraception: CNGOF Guidelines for Clinical Practice (Short Version)]. ACTA ACUST UNITED AC 2018; 46:760-776. [PMID: 30416023 DOI: 10.1016/j.gofs.2018.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Indexed: 12/26/2022]
Abstract
The French College of Obstetrics and Gynecology (CNGOF) releases its first global recommendations for clinical practice in contraception, to provide physicians with an updated synthesis of available data as a basis for their practice. The French Health Authority (HAS) methodology was used. Twelve practical issues were selected by the organizing committee and the task force members. The available literature was screened until December 2017, and allowed the release of evidence-based, graded recommendations. This synthesis is issued from 12 developed texts, previously reviewed by experts and physicians from public and private practices, with an experience in the contraceptive field. Male and female sterilization, as well as the use of hormonal treatments without contraceptive label were excluded from the field of this analysis. Specific practical recommendations on the management of contraception prescription, patient information including efficacy, risks, and benefits of the different contraception methods, follow up, intrauterine contraception, emergency contraception, local and natural methods, contraception in teenagers and after 40, contraception in vascular high-risk situations, and in case of cancer risk are provided. The short/mid-term future of contraception mostly relies on improving the use of currently available methods. This includes reinforced information for users and increased access to contraception for women, whatever the social and clinical context. That is the goal of these recommendations.
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Affiliation(s)
- N Chabbert-Buffet
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpitaux universitaires Est parisien, hôpital Tenon, Assistance publique des hôpitaux de Paris (AP-HP), 4, rue de la Chine, 75020 Paris, France; UMRS_938, Inserm Sorbonne université, 75012 Paris, France.
| | - H Marret
- Service de chirurgie pelvienne gynécologique et oncologique, centre hospitalier universitaire de Bretonneau, pôle de gynécologie-obstétrique, 2, boulevard Tonnellé, 37044 Tours cedex 1, France
| | - A Agostini
- Service de gynécologie-obstétrique, hôpital de la Conception, boulevard Baille, 13005 Marseille, France
| | - C Cardinale
- Service de gynécologie-obstétrique, hôpital de la Conception, boulevard Baille, 13005 Marseille, France
| | - N Hamdaoui
- Service de gynécologie-obstétrique, hôpital de la Conception, boulevard Baille, 13005 Marseille, France
| | - D Hassoun
- 38, rue Turenne, 75003 Paris, France
| | - A P Jonville-Bera
- Centre régional de pharmacovigilance, centre Val-de-Loire, CHRU de Tours, 37044 Tours cedex, France
| | - M Lambert
- Service de gynécologie et de médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie Raba-Léon, 33076 Bordeaux cedex, France
| | - T Linet
- Service de gynécologie-obstétrique, centre hospitalier de Loire-Vendée-Océan, 85302 Challans, France
| | - C Pienkowski
- Unité d'endocrinologie et de gynécologie médicale, TSA 70034, centre de référence de pathologies gynécologiques rares (PGR Toulouse), hôpital des Enfants, CHU de Toulouse, 31000 Toulouse, France
| | - G Plu-Bureau
- Unité de gynécologie endocrinienne, hôpital Port-Royal, 53, avenue de l'Observatoire, 75679 Paris, France; Université Paris Descartes, 75005 Paris, France; Inserm UMR 1153, Obstetrical, perinatal and paediatric epidemiology research team (Épopé), Centre for epidemiology and statistics Sorbonne Paris Cité (CRESS), 75005 Paris, France
| | - D Pragout
- Unité d'orthogénie, service de gynécologie-obstétrique, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - G Robin
- Centre d'assistance médicale à la procréation et de préservation de la fertilité, centre hospitalier universitaire de Lille, hôpital Jeanne de Flandre, 59000 Lille, France; EA 4308, gamétogenèse et qualité du gamète, centre hospitalier universitaire de Lille, 59000 Lille, France
| | - C Rousset-Jablonski
- Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France; Centre hospitalier de Lyon Sud, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - M Scheffler
- Service de gynécologie, CHU, 10, rue du Dr-Heydenreich, 54000 Nancy, France
| | - F Vidal
- CHU de Purpan, hôpital Paule-de-Viguier, pôle femme-mère-couple, 330, avenue Grande-Bretagne, 31059 Toulouse, France
| | - S Vigoureux
- Service de gynécologie-obstétrique, hôpital Bicêtre, Assistance publique des Hôpitaux de Paris (AP-HP), 94276 Le Kremlin-Bicêtre, France; Faculté de médecine Paris-Sud, université Paris-Sud, 94276 Le Kremlin-Bicêtre, France; U1018, Inserm, reproduction and child development, Centre for research in epidemiology and population health (CESP), 94805 Villejuif, France
| | - B Hédon
- Département de gynécologie-obstétrique, faculté de médecine université de Montpellier (France), centre hospitalier universitaire Arnaud-de-Villeneuve, 34000 Montpellier, France
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Pienkowski C, Cartault A. [Contraception for adolescent : CNGOF Contraception guidelines]. ACTA ACUST UNITED AC 2018; 46:858-864. [PMID: 30392989 DOI: 10.1016/j.gofs.2018.10.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The goal is to establish dialogue and determine the needs and skill levels of adolescence. This concerns sexuality, the prevention of STIs, the informed choice of contraception to avoid an unplanned pregnancy. MéTHODES: A systematic review based on literature about contraception AND teenagers was performed using Pubmed, Cochrane, national and international recommendations. RESULTS The surveillance of the teenager contraception must integrate more specifically: global health with a stability of weight and corpulence, a sufficient calcium intake, the prevention of the sexually transmitted infections (STIs) and the vaccination against HPV. The 1st consultations with adolescent girls are an essential moment for dialogue in order to develop sexuality education. Main themes are: prevention of STIs with the use of condoms, detection of situations of precariousness or sexual abuse, and finally adherence to treatment to avoid unplanned pregnancy. Use of condoms associated with regular contraception is essential to assure a barrier against sexually transmitted infections (STIs) (NP1). To preserve the patient confidentiality, the patient is received alone (Grade B). She must be reassured about respect of anonymity and availability of free treatment. Clinical examination collects weight, height, BMI and blood pressure (Grade C). It is important to give them the choice of contraceptive method and provide objective information on the different contraceptive methods (NP2). If there are any contraindications, when the first prescription is a pill, it must be a 1st or 2nd generation pill with levonorgestrel. For some experts, it would be important to prescribe a pill at 30μg EE for better efficacy in case of forgetfulness in very young patients and for the good maintenance of bone mineralization (NP4). Information on long-acting reversible contraceptives, or LARCs, is essential. These contraceptive methods have proved their efficacy and their place in the first intention. (NP1). CONCLUSION Prescribing contraception to a teenage girl requires the adaptation of the best treatment to her needs to prevent an unwanted pregnancy. This requires good information on prevention of STIs and on different methods of contraception in a confidence climate.
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Affiliation(s)
- C Pienkowski
- Unité d'endocrinologie et de gynécologie médicale, hôpital des Enfants, TSA 70034, Centre de référence de pathologies gynécologiques rares (PGR Toulouse), CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
| | - A Cartault
- Unité d'endocrinologie et de gynécologie médicale, hôpital des Enfants, TSA 70034, Centre de référence de pathologies gynécologiques rares (PGR Toulouse), CHU de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France
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Omame A, Umana RA, Okuonghae D, Inyama SC. Mathematical analysis of a two-sex Human Papillomavirus (HPV) model. INT J BIOMATH 2018. [DOI: 10.1142/s1793524518500924] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A two-sex deterministic model for Human Papillomavirus (HPV) that assesses the impact of treatment and vaccination on its transmission dynamics is designed and rigorously analyzed. The model is shown to exhibit the phenomenon of backward bifurcation, caused by the imperfect vaccine as well as the re-infection of individuals who recover from a previous infection, when the associated reproduction number is less than unity. Analysis of the reproduction number reveals that the impact of treatment on effective control of the disease is conditional, and depends on the sign of a certain threshold unlike when preventive measures are implemented (i.e. condom use and vaccination of both males and females). Numerical simulations of the model showed that, based on the parameter values used therein, a vaccine (with 75% efficacy) for male population with about 40% condom compliance by females will result in a significant reduction in the disease burden in the population. Also, the numerical simulations of the model reveal that with 70% condom compliance by the male population, administering female vaccine (with 45% efficacy) is sufficient for effective control of the disease.
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Affiliation(s)
- A. Omame
- Department of Mathematics, Federal University of Technology, Owerri, Nigeria
| | - R. A. Umana
- Department of Mathematics, Federal University of Technology, Owerri, Nigeria
| | - D. Okuonghae
- Department of Mathematics, University of Benin, Benin City, Nigeria
| | - S. C. Inyama
- Department of Mathematics, Federal University of Technology, Owerri, Nigeria
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LeConte BA, Szaniszlo P, Fennewald SM, Lou DI, Qiu S, Chen NW, Lee JH, Resto VA. Differences in the viral genome between HPV-positive cervical and oropharyngeal cancer. PLoS One 2018; 13:e0203403. [PMID: 30161236 PMCID: PMC6117069 DOI: 10.1371/journal.pone.0203403] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/20/2018] [Indexed: 11/27/2022] Open
Abstract
Human papillomavirus (HPV)-driven oropharyngeal cancer incidence in the United States has steadily increased in the past decades and has now become the most frequently diagnosed HPV-associated cancer type, surpassing cervical cancer. Variations in the HPV genome correlate with tumorigenic risk, and the distribution of genetic variants is extensively studied in cervical cancer, but very little is known about new mutations or the distribution of HPV types and variants in oropharyngeal cancer. Here we present an archival tissue cohort study that compares genomic characteristics of HPV associated with cervical versus oropharyngeal tumors using DNA sequence analysis. We found HPV16 to be more prevalent in oropharyngeal samples than in cervical samples (91.2% versus 52.9%), while HPV18 (1.5% versus 18.2%) and HPV45 (0.7% versus 9.9%) were much less prevalent. Differences between cervix and oropharynx in HPV16 variants distribution were more subtle, but the combined European + Asian (EUR+AS) variant group was more prevalent (90.2% versus 71.4%), while the American Asian 1 + American Asian 2 (AA1+AA2) variant group was much less prevalent (4.4% versus 22.5%) in oropharyngeal cancers. HPV prevalence in oropharyngeal cancers showed an increasing trend from 60% in 2003 to 80% in 2016. We also identified over nine times more nonsynonymous mutations in the HPV E6 gene amplified from oropharyngeal samples, but for E7 the difference in mutation rates between the two anatomical locations was not significant. Overall, we showed that HPV genome in oropharyngeal cancer presents important differences when compared to cervical cancer and this may explain the distinct pathomechanisms and susceptibility to treatment of HPV-associated oropharyngeal cancer.
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Affiliation(s)
- Bailey A. LeConte
- Department of Otolaryngology, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States of America
| | - Peter Szaniszlo
- Department of Otolaryngology, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States of America
| | - Susan M. Fennewald
- Department of Otolaryngology, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States of America
| | - Dianne I. Lou
- Department of Otolaryngology, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States of America
| | - Suimin Qiu
- Department of Pathology, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States of America
| | - Nai-Wei Chen
- Department of Preventive Medicine & Community Health, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States of America
| | - John H. Lee
- Department of Adult Medical Affairs, Chan Soon-Shiong Institute of Molecular Medicine, Culver City, California, United States of America
| | - Vicente A. Resto
- Department of Otolaryngology, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States of America
- * E-mail:
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Ajayi AI, Akpan W. Determinants of condom use among parous women in North Central and South Western Nigeria: a cross-sectional survey. BMC Res Notes 2018; 11:467. [PMID: 30005715 PMCID: PMC6044001 DOI: 10.1186/s13104-018-3573-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 07/06/2018] [Indexed: 11/20/2022] Open
Abstract
Objectives There appears to be an increasing trend of condom use for pregnancy prevention among nulliparous and multiparous women in developing countries. Drawing from a cross-sectional survey involving 1227 women selected using a 3-stage cluster random sampling technique, the study examines the rates of condom use and its determinants among parous women in three states in North Central and South Western Nigeria. Results The rate of condom use among parous women was 13.8% and 23.2% among women using any form of contraceptives. After adjusting for confounding factors (religion and marital status, socioeconomic status and access to a health facility in the resident community), women aged 26–35 (AOR 2.7; CI 1.6–4.5), urban residence (AOR: 3.6; CI 2.2–5.8), no income (AOR: 2.7; CI 1.4–4.9), living in Ekiti State (AOR: 1.8; CI 1.2–2.8) and having a tertiary level of education (AOR: 4.5; CI 1.3–15.6) were the independent predictors of condom use. There is an increasing trend of condom use among parous women. Electronic supplementary material The online version of this article (10.1186/s13104-018-3573-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anthony I Ajayi
- Department of Sociology, University of Fort Hare, 50 Church Street, East London, 5200, South Africa.
| | - Wilson Akpan
- Department of Sociology, University of Fort Hare, 50 Church Street, East London, 5200, South Africa
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Harper CR, Steiner RJ, Lowry R, Hufstetler S, Dittus PJ. Variability in Condom Use Trends by Sexual Risk Behaviors: Findings from the 2003-2015 National Youth Risk Behavior Surveys. Sex Transm Dis 2018; 45:400-405. [PMID: 29465682 PMCID: PMC10926089 DOI: 10.1097/olq.0000000000000763] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to examine variability in condom use trends by sexual risk behavior among US high school students. METHODS Data were from the 2003-2015 national Youth Risk Behavior Surveys conducted biennially among a nationally representative sample of students in grades 9 to 12. We used logistic regression to examine variability in trends of condom use during last sexual intercourse among female and male students by 4 sexual risk behaviors: drank alcohol or used drugs before last sexual intercourse, first sexual intercourse before age 13 years, 4 or more sex partners during their life, and 2 or more sex partners during the past 3 months. RESULTS Between 2003 and 2015, significant declines in self-reported condom use were observed among black female (63.6% in 2003 to 46.7% in 2015) and white male students (69.0% in 2003 to 58.1% in 2015). Among female students, declines in self-reported condom use were significant only among those who drank or use drugs before last sexual intercourse, had 4 or more sex partners during their life, or had 2 or more sex partners during the past 3 months. There was a significant interaction between trends in condom use and first sexual intercourse before age 13 years, suggesting more pronounced declines among female students who initiated first sexual intercourse before age 13 years compared with their female peers. Trends did not vary by sexual risk behavior for male students. CONCLUSIONS Results suggest that declines in self-reported condom use have occurred among female students at greater risk for acquiring a sexually transmitted disease.
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Malagón T, Laurie C, Franco EL. Human papillomavirus vaccination and the role of herd effects in future cancer control planning: a review. Expert Rev Vaccines 2018; 17:395-409. [PMID: 29715059 DOI: 10.1080/14760584.2018.1471986] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Vaccine herd effects are the indirect protection that vaccinated persons provide to those who remain susceptible to infection, due to the reduced transmission of infections. Herd effects have been an important part of the discourse on how to best implement human papillomavirus (HPV) vaccines and prevent HPV-related diseases. AREAS COVERED In this paper, we review the theory of HPV vaccine herd effects derived from mathematical models, give an account of observed HPV vaccine herd effects worldwide, and examine the implications of vaccine herd effects for future cervical cancer screening efforts. EXPERT COMMENTARY HPV vaccine herd effects improve the cost-effectiveness of vaccinating preadolescent girls, but contribute to making gender-neutral vaccination less economically efficient. Vaccination coverage and sexual mixing patterns by age are strong determinants of herd effects. Many countries worldwide are starting to observe reductions in HPV-related outcomes likely attributable to herd effects, most notably declining anogenital warts in young men, and declining HPV-16/18 infection prevalence in young unvaccinated women. Policy makers making recommendations for cervical cancer screening will have to consider HPV vaccination coverage and herd effects, as these will affect the positive predictive value of screening and the risk of cervical cancer in unvaccinated women.
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Affiliation(s)
- Talía Malagón
- a Division of Cancer Epidemiology, Faculty of Medicine , McGill University , Montréal , Canada
| | - Cassandra Laurie
- a Division of Cancer Epidemiology, Faculty of Medicine , McGill University , Montréal , Canada
| | - Eduardo L Franco
- a Division of Cancer Epidemiology, Faculty of Medicine , McGill University , Montréal , Canada
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Lemley SM, Jarmolowicz DP, Parkhurst D, Celio MA. The Effects of Condom Availability on College Women's Sexual Discounting. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:551-563. [PMID: 28913688 DOI: 10.1007/s10508-017-1040-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 06/28/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
College students commonly engage in risky sexual behaviors, such as casual sexual encounters and inconsistent condom use. Discounting paradigms that examine how individuals devalue rewards due to their delay or uncertainty have been used to improve our understanding of behavioral problems, including sexual risk. The current study assessed relations between college women's sexual partners discounting and risky sexual behavior. In this study, college women (N = 42) completed two sexual partners delay discounting tasks that assessed how choices among hypothetical sexual partners changed across a parametric range of delays in two conditions: condom availability and condom unavailability. Participants also completed two sexual partners probability discounting tasks that assessed partner choices across a parametric range of probabilities in condom availability and unavailability conditions. Additionally, participants reported risky sexual behavior on the Sexual Risk Survey (SRS). Participants discounted delayed partners more steeply in the condom availability condition, but those differences were significant only for those women with three or fewer lifetime sexual partners. There were no consistent differences in discounting rate across condom availability conditions for probability discounting. Sexual partners discounting measures correlated with risky sexual behaviors as measured by the SRS, but a greater number of significant relations were observed with the condoms-unavailable delay discounting task. These findings suggest the importance of examining the interaction of inconsistent condom use and multiple partners in examinations of sexual decision-making.
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Affiliation(s)
- Shea M Lemley
- Department of Applied Behavioral Science, University of Kansas, 4041 Dole Developmental Center, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA.
| | - David P Jarmolowicz
- Department of Applied Behavioral Science and Problem Gambling Research and Education Support System, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA
| | - Daniel Parkhurst
- Department of Applied Behavioral Science, University of Kansas, 4050 Dole Developmental Center, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA
| | - Mark A Celio
- Department of Behavioral and Social Sciences, Brown University, Box G-121-5, 121 S. Main Street, Providence, RI, 02915, USA
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Superinfection Exclusion between Two High-Risk Human Papillomavirus Types during a Coinfection. J Virol 2018; 92:JVI.01993-17. [PMID: 29437958 DOI: 10.1128/jvi.01993-17] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 01/25/2018] [Indexed: 12/12/2022] Open
Abstract
Superinfection exclusion is a common phenomenon whereby a single cell is unable to be infected by two types of the same pathogen. Superinfection exclusion has been described for various viruses, including vaccinia virus, measles virus, hepatitis C virus, influenza A virus, and human immunodeficiency virus. Additionally, the mechanism of exclusion has been observed at various steps of the viral life cycle, including attachment, entry, viral genomic replication, transcription, and exocytosis. Human papillomavirus (HPV) is the causative agent of cervical cancer. Recent epidemiological studies indicate that up to 50% women who are HPV positive (HPV+) are infected with more than one HPV type. However, no mechanism of superinfection exclusion has ever been identified for HPV. Here, we show that superinfection exclusion exists during a HPV coinfection and that it occurs on the cell surface during the attachment/entry phase of the viral life cycle. Additionally, we are able to show that the minor capsid protein L2 plays a role in this exclusion. This study shows, for the first time, that superinfection exclusion occurs during HPV coinfections and describes a potential molecular mechanism through which it occurs.IMPORTANCE Superinfection exclusion is a phenomenon whereby one cell is unable to be infected by multiple related pathogens. This phenomenon has been described for many viruses and has been shown to occur at various points in the viral life cycle. HPV is the causative agent of cervical cancer and is involved in other anogenital and oropharyngeal cancers. Recent epidemiological research has shown that up to 50% of HPV-positive individuals harbor more than one type of HPV. We investigated the interaction between two high-risk HPV types, HPV16 and HPV18, during a coinfection. We present data showing that HPV16 is able to block or exclude HPV18 on the cell surface during a coinfection. This exclusion is due in part to differences in the HPV minor capsid protein L2. This report provides, for the first time, evidence of superinfection exclusion for HPV and leads to a better understanding of the complex interactions between multiple HPV types during coinfections.
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65
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Teixeira MF, Sabidó M, Leturiondo AL, de Oliveira Ferreira C, Torres KL, Benzaken AS. High risk human papillomavirus prevalence and genotype distribution among women infected with HIV in Manaus, Amazonas. Virol J 2018; 15:36. [PMID: 29454382 PMCID: PMC5816532 DOI: 10.1186/s12985-018-0942-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 02/01/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV)-positive women have a high prevalence of human papillomavirus (HPV), and are infected with a broader range of HPV types than HIV-negative women. We aimed to determine the prevalence of cervical cytologic abnormalities, high-risk (HR)-HPV prevalence, type distribution according to the severity of cervical lesions and CD4 cell count and identify factors associated with HR-HPV infection among women living with HIV in Manaus, Amazonas. METHODS We enrolled 325 women living with HIV that attended an infectious diseases referral hospital. Each woman underwent a gynecological exam, cervical cytology, HR-HPV detection by Polymerase chain Reaction (PCR) using the BD Onclarity™ HPV Assay, colposcopy and biopsy, when necessary. We assessed the associations between potential risk factors and HR-HPV infection. RESULTS Overall, 299 (92.0%) women had a PCR result. The prevalence of HR-HPV- infection was 31.1%. The most prevalent HR-HPV types were: 56/59/66 (32.2%), 35/39/68 (28.0%), 52 (21.5%), 16 (19.4%), and 45 (12.9%). Among the women with HR-HPV infection (n = 93), 43.0% had multiple infections. Women with HPV infection showed higher prevalence of cervical abnormalities than that HPV-negative (LSIL: 22.6% vs. 1.5%; HSIL: 10.8% vs. 0.0%). The prevalence of HR-HPV among women with cytological abnormalities was 87.5% for LSIL and 100.0% for HSIL. Women with CD4 < 200 cell/mm3 showed the highest HR-HPV prevalence (59.3%) although this trend was not statistically significant (p-value = 0.62). The mean CD4 cell count decreased with increasing severity of cervical lesions (p-value = 0.001). The multivariable analysis showed that increasing age was associated with a decreased risk of HR-HPV infection with an adjusted prevalence odds ratio of 0.9 (95.0% CI: 0.9-1.0, p-value: 0.03) for each additional year. The only factor statistically significant associated with HR-HPV infection was CD4 cell count. CONCLUSIONS HR-HPV and abnormal cytology prevalence are high among women in the Amazonas. The low CD4 cell count was an important determinant of HPV infection and abnormal cytological findings. HPV quadrivalent vaccination used in Brazil might not offer protection for an important fraction of HPV-related disease burden in women living with HIV. This is partly explained by the high presence of non targeted vaccine HR-HPVs, such as the HPV genotype groups 56/59/66, 35/39/68 and individually HPV-52 and HPV-45, some of which contribute to high-grade lesion.
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Affiliation(s)
- Monique Figueiredo Teixeira
- Universidade Federal do Amazonas (UFAM), 6200, Coroado I, General Rodrigo Octávio Ave, Manaus, Amazon, 69080-900, Brazil.
| | - Meritxell Sabidó
- TransLab. Departament de Ciències Mèdiques, Facultat de Medicina, Girona, Catalunya, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Kátia Luz Torres
- Fundação Centro de Controle de Oncologia do Amazonas (FCecon), Manaus, Amazonas, Brazil
| | - Adele Schwartz Benzaken
- Fundação Alfredo da Matta (FUAM), Manaus, Amazonas, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil.,Departamento de IST, Aids, e Hepatites Virais, Ministério da Saúde, Brasília, DF, Brazil
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66
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Grandahl M, Chun Paek S, Grisurapong S, Sherer P, Tydén T, Lundberg P. Parents' knowledge, beliefs, and acceptance of the HPV vaccination in relation to their socio-demographics and religious beliefs: A cross-sectional study in Thailand. PLoS One 2018; 13:e0193054. [PMID: 29447271 PMCID: PMC5814087 DOI: 10.1371/journal.pone.0193054] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 02/02/2018] [Indexed: 11/18/2022] Open
Abstract
Thailand has one of the world's highest prevalence of cervical cancer, mainly caused by the human papillomavirus (HPV). HPV infections can successfully be prevented by vaccination, which is available at a cost but not yet implemented in the national vaccination program. Parents play a critical role in deciding whether to vaccinate their child against HPV. Thus, the aim was to examine the association between parents' knowledge, beliefs, and acceptance of the HPV vaccination for their daughters, considering their socio-demographics and religious beliefs. A cross-sectional design was used among three schools in Thailand: Nakorn Phatom province (suburban) and Bangkok (urban). Parents of 9-12-year-old daughters completed the questionnaires, guided by the Health Belief Model. In total, 359 parents completed the questionnaires; of those, 301 were included in the final analyses. The ordinary least squares (OLS) regression analysis showed that background knowledge of HPV and the HPV vaccine was positively related to knowledge of HPV and cervical cancer. For beliefs, knowledge was positively associated with susceptibility (i.e., parents' perceived risk of an HPV infection/ related disease), severity, and benefit. However, knowledge was not significantly related to barriers. For acceptance, higher susceptibility and benefit were related to higher acceptance, and greater knowledge was associated with higher acceptance. Thus, we found associations between parents' knowledge, beliefs, and acceptance of the HPV vaccination for their daughters, considering their socio-demographics and religious beliefs. Parents, who reported religion as important, as opposed to those who did not, were more favorable toward the HPV vaccination. Four out of ten mothers had never undergone a cervical cancer screening, but most had accepted previous childhood vaccinations for their daughters. The overall acceptance of the vaccine was high, and we believe our results are promising for future implementation of the HPV vaccination in the national childhood vaccination program in Thailand.
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Affiliation(s)
- Maria Grandahl
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Seung Chun Paek
- Department of Society and Health, Mahidol University, Salaya Campus, Bangkok, Thailand
| | - Siriwan Grisurapong
- Department of Society and Health, Mahidol University, Salaya Campus, Bangkok, Thailand
| | - Penchan Sherer
- Department of Society and Health, Mahidol University, Salaya Campus, Bangkok, Thailand
| | - Tanja Tydén
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Pranee Lundberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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67
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Dave S, Afshar K, Braga LH, Anderson P. Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (abridged version). Can Urol Assoc J 2018; 12:18-28. [PMID: 29381455 PMCID: PMC5937397 DOI: 10.5489/cuaj.5034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Sumit Dave
- Department of Surgery (Urology), Western University, London, ON; Canada
| | - Kourosh Afshar
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC; Canada
| | - Luis H. Braga
- Department of Surgery (Urology), McMaster University, Hamilton, ON; Canada
| | - Peter Anderson
- Department of Urology, Dalhousie University, Halifax, NS; Canada
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68
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Dave S, Afshar K, Braga LH, Anderson P. Canadian Urological Association guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants (full version). Can Urol Assoc J 2018; 12:E76-E99. [PMID: 29381458 PMCID: PMC5937400 DOI: 10.5489/cuaj.5033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Sumit Dave
- Department of Surgery (Urology), Western University, London, ON; Canada
| | - Kourosh Afshar
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC; Canada
| | - Luis H. Braga
- Department of Surgery (Urology), McMaster University, Hamilton, ON; Canada
| | - Peter Anderson
- Department of Urology, Dalhousie University, Halifax, NS; Canada
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69
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Biryukov J, Myers JC, McLaughlin-Drubin ME, Griffin HM, Milici J, Doorbar J, Meyers C. Mutations in HPV18 E1^E4 Impact Virus Capsid Assembly, Infectivity Competence, and Maturation. Viruses 2017; 9:v9120385. [PMID: 29257050 PMCID: PMC5744159 DOI: 10.3390/v9120385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 12/14/2017] [Accepted: 12/15/2017] [Indexed: 01/24/2023] Open
Abstract
The most highly expressed protein during the productive phase of the human papillomavirus (HPV) life cycle is E1^E4. Its full role during infection remains to be established. HPV E1^E4 is expressed during both the early and late stages of the virus life cycle and contributes to viral genome amplification. In an attempt to further outline the functions of E1^E4, and determine whether it plays a role in viral capsid assembly and viral infectivity, we examined wild-type E1^E4 as well as four E1^E4 truncation mutants. Our study revealed that HPV18 genomes containing the shortest truncated form of E1^E4, the 17/18 mutant, produced viral titers that were similar to wild-type virus and significantly higher compared to virions containing the three longer E1^E4 mutants. Additionally, the infectivity of virus containing the shortest E1^E4 mutation was equivalent to wild-type and significantly higher than the other three mutants. In contrast, infectivity was completely abrogated for virus containing the longer E1^E4 mutants, regardless of virion maturity. Taken together, our results indicate for the first time that HPV18 E1^E4 impacts capsid assembly and viral infectivity as well as virus maturation.
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Affiliation(s)
- Jennifer Biryukov
- Department of Microbiology and Immunology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA; (J.B.); (J.C.M.); (M.E.M.-D.); (J.M.)
| | - Jocelyn C. Myers
- Department of Microbiology and Immunology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA; (J.B.); (J.C.M.); (M.E.M.-D.); (J.M.)
| | - Margaret E. McLaughlin-Drubin
- Department of Microbiology and Immunology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA; (J.B.); (J.C.M.); (M.E.M.-D.); (J.M.)
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA 02215, USA
| | - Heather M. Griffin
- Department of Pathology, University of Cambridge, Cambridge CB2 1QP, UK; (H.M.G.); (J.D.)
| | - Janice Milici
- Department of Microbiology and Immunology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA; (J.B.); (J.C.M.); (M.E.M.-D.); (J.M.)
| | - John Doorbar
- Department of Pathology, University of Cambridge, Cambridge CB2 1QP, UK; (H.M.G.); (J.D.)
| | - Craig Meyers
- Department of Microbiology and Immunology, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA; (J.B.); (J.C.M.); (M.E.M.-D.); (J.M.)
- Correspondence: ; Tel.: +1-717-531-6240
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70
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Zhao J, Virani S, Sriplung H. Spatiotemporal mapping of cervical cancer incidence highlights need for targeted prevention in Songkhla province, Thailand. Health Policy Plan 2017; 32:430-436. [PMID: 27935803 DOI: 10.1093/heapol/czw145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 11/13/2022] Open
Abstract
Background The national cervical cancer screening program in Thailand has been successful in reducing overall burden from this disease. However, evaluation on spatial and temporal scales is needed to assess the efficacy of this program in smaller regions. Here, we geographically assess incidence in a province with a uniquely heterogeneous distribution of lifestyle factors associated with religiosity. Methods Cervical cancer cases were extracted from the provincial cancer registry from 1989 to 2013. Age-adjusted incidence rates were calculated using population statistics from the census bureau and adjusted to the Segi world standard population. Bayesian hierarchical modelling was employed to spatiotemporally map cervical cancer incidence trends in Songkhla province in 5-year period. Results Overall, the incidence of cervical cancer decreased in Songkhla province. The three districts with a Muslim population of greater than 70% had consistently lower cervical cancer rates from 1989 to 2013 compared with the rest of the predominantly Buddhist districts. Hotspots of incidence were identified in Sadao, Hat Yai and the juncture of Mueang Songkhla and Singhanakhon in each 5-year period. Conclusions Distinct cervical cancer incidence trends by religion over time indicate differences in sexual habits, lifestyle and religion-associated culture between Muslims and Buddhists, and suggest divergent risk factor profiles for these groups. The high incidence rates in Sadao and Hat Yai is likely explained by the main road to Malaysia, which runs across these two areas and has frequent commercial sex trade. Female sex workers should be targeted as a vulnerable population for screening efforts to address this continuing burden of cervical cancer.
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Affiliation(s)
- Jun Zhao
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.,Hubei University of Medicine, Hubei, China
| | - Shama Virani
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.,Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Hutcha Sriplung
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Mitkevich VA, Burnysheva KM, Petrushanko IY, Adzhubei AA, Schulga AA, Chumakov PM, Makarov AA. Binase treatment increases interferon sensitivity and apoptosis in SiHa cervical carcinoma cells by downregulating E6 and E7 human papilloma virus oncoproteins. Oncotarget 2017; 8:72666-72675. [PMID: 29069817 PMCID: PMC5641160 DOI: 10.18632/oncotarget.20199] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 07/25/2017] [Indexed: 11/25/2022] Open
Abstract
In this study, we determined whether binase, a ribonuclease from Bacillus pumilus, increases interferon sensitivity and apoptosis in SiHa cervical cancer cells infected with high-risk human papilloma virus (HPV) strain 16. Binase treatment increased SiHa cell apoptosis in a time- and concentration-dependent manner, as determined by flow cytometry, WST tests and real time xCelligence cell index analysis. Binase-treated SiHa cells showed reduced expression of E6 and E7 viral oncoproteins and increased expression of their intracellular targets, p53 and pRb. Combined treatment with binase and IFNα2b enhanced the interferon sensitivity of HPV-positive SiHa cells. By contrast, combined treatment with binase and IFNα2b in HPV-negative C33A cervical cancer cells, which do no expess E6 and E7, elicited no changes in interferon sensitivity or p53 and pRb expression. These findings suggest binase enhances interferon sensitivity and apoptosis in HPV-positive SiHa cervical cancer cells by suppressing E6 and E7 viral protein expression.
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Affiliation(s)
- Vladimir A. Mitkevich
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Ksenia M. Burnysheva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Irina Yu Petrushanko
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Alexei A. Adzhubei
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Alexey A. Schulga
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, 117871 Moscow, Russia
| | - Peter M. Chumakov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Alexander A. Makarov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
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72
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Stewart J, Calderon M, Hathaway A, Winer RL, Zunt J. Human papillomavirus infection among male clients of female sex workers soliciting sex in brothels in Peru. Int J STD AIDS 2017; 29:178-184. [PMID: 28747145 DOI: 10.1177/0956462417721563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevalence of high-risk human papillomavirus (HR-HPV) has been reported to be three times higher in female sex workers (FSWs) in Callao, Peru than in the general population of women in Peru. Prevalence of HR-HPV among male clients has not yet been reported. A total of 150 men soliciting intercourse in sex work venues submitted questionnaires, samples for sexually transmitted infection (STI) testing, and self-collected penile samples prior to and following intercourse for HPV genotyping. We identified variables associated with pre-coital HR-HPV, and compared HR-HPV detection pre- and post-coitus. Prior to intercourse, HR-HPV prevalence was 41.9%. Married clients were less likely than unmarried clients to have HR-HPV detected ( p = 0.03). While post-coital HR-HPV prevalence was higher (47.6%), the difference was not statistically significant. However, there was a significant increase in the mean number of HR-HPV DNA strains detected before (0.75) and after (0.94) intercourse ( p = 0.02). No cases of gonorrhoea or syphilis and six (4.1%) cases of chlamydial infection were detected. Despite low prevalence of other STIs, male clients had a high HR-HPV prevalence. The increase in detection of HR-HPV following intercourse demonstrates a potential for transmission of HR-HPV despite high self-reported condom use.
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Affiliation(s)
- Jenell Stewart
- 1 Department of Medicine, 7284 University of Washington , Seattle, WA, USA
| | | | - Alison Hathaway
- 3 16230 Yale University School of Nursing , Hartford, CT, USA
| | - Rachel L Winer
- 4 Department of Epidemiology, 7284 University of Washington , Seattle, WA, USA
| | - Joseph Zunt
- 1 Department of Medicine, 7284 University of Washington , Seattle, WA, USA.,4 Department of Epidemiology, 7284 University of Washington , Seattle, WA, USA.,5 Department of Neurology, 7284 University of Washington , Seattle, WA, USA.,6 Global Health, 7284 University of Washington , Seattle, WA, USA
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73
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Dalgo Aguilar P, Loján González C, Córdova Rodríguez A, Acurio Páez K, Arévalo AP, Bobokova J. Prevalence of High-Risk Genotypes of Human Papillomavirus: Women Diagnosed with Premalignant and Malignant Pap Smear Tests in Southern Ecuador. Infect Dis Obstet Gynecol 2017; 2017:8572065. [PMID: 28717342 PMCID: PMC5498899 DOI: 10.1155/2017/8572065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/23/2017] [Indexed: 01/18/2023] Open
Abstract
Human papillomavirus (HPV) is the primary infectious agent for the development of cervical cancer, although the presence of the virus alone is insufficient for viral development and proliferation; this can be attributed to the increase in potential oncogenic risk, along with other risk factors. In the present investigation, the prevalence of high-risk HPV was determined from samples of premalignant or malignant cervical cytology in women from the southern region of Ecuador. The kit we used was able to detect genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59. In addition, 64.5% of the analyzed samples were positive for HPV, with genotypes 16 and 18 being the most prevalent (16 was detected in 148 samples and 18 in 108). Genotypes 58 and 51 were the third most frequent simple and multiple infections, respectively. The data are very similar to those obtained worldwide, suggesting that the strategy of sex education, and the use of vaccines as primary prevention agents, could significantly decrease the incidence and mortality rate of cervical cancer in the southern region of Ecuador.
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Affiliation(s)
- Paola Dalgo Aguilar
- Departamento de Ciencias de la Salud, Sección Genética Humana, Microbiología y Bioquímica Clínica, Universidad Técnica Particular de Loja, Loja, Ecuador
| | - Cisne Loján González
- Sociedad de Lucha Contra el Cáncer, Hospital SOLCA Núcleo de Loja, Loja, Ecuador
| | - Ana Córdova Rodríguez
- Departamento de Ciencias de la Salud, Sección Genética Humana, Microbiología y Bioquímica Clínica, Universidad Técnica Particular de Loja, Loja, Ecuador
| | | | - Ana Paulina Arévalo
- Departamento de Ciencias de la Salud, Sección Genética Humana, Microbiología y Bioquímica Clínica, Universidad Técnica Particular de Loja, Loja, Ecuador
| | - Jana Bobokova
- Departamento de Ciencias de la Salud, Sección Genética Humana, Microbiología y Bioquímica Clínica, Universidad Técnica Particular de Loja, Loja, Ecuador
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Condom Availability in Schools: A Practical Approach to the Prevention of Sexually Transmitted Infection/HIV and Unintended Pregnancy. J Adolesc Health 2017; 60:754-757. [PMID: 28532649 DOI: 10.1016/j.jadohealth.2017.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 03/28/2017] [Indexed: 11/29/2022]
Abstract
Adolescents and young adults are highly impacted by sexually transmitted infections (STIs) and unplanned pregnancy in the United States and globally. Consistent and correct use of male latex condoms is associated with protection against both STIs and pregnancy. Providing adolescents and young adults with access to free condoms in schools may increase the use of condoms by improving condom availability, eliminating cost, and decreasing embarrassment associated with purchasing condoms. Studies demonstrate that condom availability in schools is associated with the increased use of condoms and improved overall sexual health. The Society for Adolescent Health and Medicine encourages schools to make condoms available to students as part of efforts to decrease rates of STIs and unplanned pregnancy in adolescents and young adults. The Society for Adolescent Health and Medicine also encourages health care providers to advocate for and support the availability of condoms in local schools.
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Trub L, Starks TJ. Insecure attachments: Attachment, emotional regulation, sexting and condomless sex among women in relationships. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2017.01.052] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jamshidi Makiani M, Minaeian S, Moghaddam SA, Moosavi SA, Moeini Z, Zamani V, Karbalaei Sabbagh M, Forghani H. Relative frequency of human papillomavirus genotypes and related sociodemographic characteristics in women referred to a general hospital in Tehran, 2014- 2015: A cross-sectional study. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.5.305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Lopez CS, Krauskopf E, Villota CE, Burzio LO, Villegas JE. Cervical cancer, human papillomavirus and vaccines: assessment of the information retrieved from general knowledge websites in Chile. Public Health 2017; 148:19-24. [PMID: 28404529 DOI: 10.1016/j.puhe.2017.02.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 02/01/2017] [Accepted: 02/24/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Cervical cancer is the most common gynaecologic malignancy worldwide and is the sixth cause of cancer death in Chile. Human papillomavirus (HPV) is responsible for most cervical cancers. Individuals seeking basic information about HPV frequently turn to health information websites. We hypothesized that some of their data may be inaccurate. STUDY DESIGN Comparative analysis of information. METHODS We analyze the content of highly accessed websites such as the Spanish version of Wikipedia and Yahoo Answers through the application of a questionnaire, as well as a website managed by the Chilean Ministry of Health (Minsal). The accuracy of each answer was confirmed by comparison with information retrieved from articles published by indexed journals. RESULTS The information provided by the Spanish version of Wikipedia was accurate; nevertheless a few omissions were detected. The quality of the information provided by the Spanish version of Yahoo Answers was inaccurate and confusing. The Minsal website lacked important information on several topics about HPV even though it is managed and endorsed by the government. CONCLUSIONS We suggest periodical content reviews to increase the completeness, transparency and correctness of the website.
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Affiliation(s)
- C S Lopez
- Fundación Ciencia & Vida - Andes Biotechnologies SpA, Av. Zañartu 1482, Ñuñoa, Santiago, Chile
| | - E Krauskopf
- Fundación Ciencia & Vida - Andes Biotechnologies SpA, Av. Zañartu 1482, Ñuñoa, Santiago, Chile; Facultad de Ciencias Biológicas, Universidad Andrés Bello, Republica 217, Santiago, Chile
| | - C E Villota
- Fundación Ciencia & Vida - Andes Biotechnologies SpA, Av. Zañartu 1482, Ñuñoa, Santiago, Chile; Departamento de Ciencias Químicas y Biológicas, Facultad de Salud, Universidad Bernardo O Higgins, General Gana 1780, Santiago, Chile
| | - L O Burzio
- Fundación Ciencia & Vida - Andes Biotechnologies SpA, Av. Zañartu 1482, Ñuñoa, Santiago, Chile; Facultad de Ciencias Biológicas, Universidad Andrés Bello, Republica 217, Santiago, Chile
| | - J E Villegas
- Fundación Ciencia & Vida - Andes Biotechnologies SpA, Av. Zañartu 1482, Ñuñoa, Santiago, Chile; Facultad de Ciencias Biológicas, Universidad Andrés Bello, Republica 217, Santiago, Chile.
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Dahiya N, Bachani D, Acharya AS, Sharma DN, Gupta S, Haresh KP. Socio-Demographic, Reproductive and Clinical Profile of Women Diagnosed with Advanced Cervical Cancer in a Tertiary Care Institute of Delhi. J Obstet Gynaecol India 2017; 67:53-60. [PMID: 28242969 PMCID: PMC5306097 DOI: 10.1007/s13224-016-0907-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/12/2016] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Cervical cancer is one of the leading cancers among Indian women with estimated 123,000 new cases and 67,477 deaths in 2012. Cervical cancer is a multi-etiological disease. Factors such as low socioeconomic status, tobacco use, sexual and reproductive factors, HIV and other sexually transmitted diseases and long-term oral contraceptive use have been suggested as determinants. Assessment of socio-demographic profile and reproductive history gives a better picture of the determinants of cervical carcinoma in low-resource settings. METHODS This hospital-based cross-sectional study was undertaken at a tertiary healthcare institute at New Delhi, India. Sixty-seven newly diagnosed women with advanced cervical cancer (stage 2B-4B), who were undertaking radio- and/or chemotherapy, were included to assess their socio-demographic, reproductive and clinical profile. RESULTS The mean age of women at the time of detection of cervical cancer was 52.28 ± 11.29 years (range 30-75 years). More than 60 % of patients were illiterate and belonged to middle socioeconomic status. Thirty-nine percentage of the study subjects had their first sexual experience before 15 years of age. Nearly 54 % women had 5 or more pregnancies. Nearly 73 % of women had all deliveries at home. Majority (69 %) of women had symptoms suggestive of reproductive tract infection. Among them, unusual discharge from vagina (73.13 %) followed by bleeding after menopause (55.10 %) and pain in abdomen (44.77 %) were the most common presenting complaints. Pallor was present in nearly two-third (63.93 %) study subjects. More than half (56.72 %) study subjects had moderate anemia, and 7.46 % had severe anemia before treatment. Mean hemoglobin level of the study subjects was 10.35 ± 1.72 gm% before treatment and 9.69 ± 1.29 gm% after treatment. This difference was statistically significant. Around 97 % of the study subjects had squamous cell carcinoma of the cervix. Majority (53.73 %) of the study subjects were in stage 3B of cervical cancer. Combination of radiotherapy and chemotherapy was the most common (77.67 %) modality of treatment. CONCLUSIONS AND RECOMMENDATIONS Illiteracy, low socioeconomic status, early sexual debut, high fertility, home delivery, reproductive tract infections, use of insanitary clothes during menstruation and anemia were observed in majority of women with advanced cancer cervix. Presence of these factors indicates possible risk of cervical cancer and should be kept in mind when women seek health services. Early diagnosis through high risk or opportunistic screening and timely management of cervical cancer needs to be ensured for better outcomes.
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Affiliation(s)
- Neha Dahiya
- Department of Community Medicine, Lady Hardinge Medical College & Associated Hospitals, New Delhi, 110001 India
| | - Damodar Bachani
- Department of Community Medicine, Lady Hardinge Medical College & Associated Hospitals, New Delhi, 110001 India
| | - Anita S. Acharya
- Department of Community Medicine, Lady Hardinge Medical College & Associated Hospitals, New Delhi, 110001 India
| | - D. N. Sharma
- Department of Radiation Oncology, IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Subhash Gupta
- Department of Radiation Oncology, IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - K. P. Haresh
- Department of Radiation Oncology, IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Apalla Z, Nashan D, Weller RB, Castellsagué X. Skin Cancer: Epidemiology, Disease Burden, Pathophysiology, Diagnosis, and Therapeutic Approaches. Dermatol Ther (Heidelb) 2017; 7:5-19. [PMID: 28150105 PMCID: PMC5289116 DOI: 10.1007/s13555-016-0165-y] [Citation(s) in RCA: 214] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Indexed: 12/26/2022] Open
Abstract
Skin cancer, including both melanoma and non-melanoma, is the most common type of malignancy in the Caucasian population. Firstly, we review the evidence for the observed increase in the incidence of skin cancer over recent decades, and investigate whether this is a true increase or an artefact of greater screening and over-diagnosis. Prevention strategies are also discussed. Secondly, we discuss the complexities and challenges encountered when diagnosing and developing treatment strategies for skin cancer. Key case studies are presented that highlight the practic challenges of choosing the most appropriate treatment for patients with skin cancer. Thirdly, we consider the potential risks and benefits of increased sun exposure. However, this is discussed in terms of the possibility that the avoidance of sun exposure in order to reduce the risk of skin cancer may be less important than the reduction in all-cause mortality as a result of the potential benefits of increased exposure to the sun. Finally, we consider common questions on human papillomavirus infection.
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Affiliation(s)
- Zoe Apalla
- First Department of Dermatology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Dorothée Nashan
- Teaching Hospital of the University of Münster, Münster, Germany
| | | | - Xavier Castellsagué
- Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Catalonia, Spain
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Sahasrabuddhe VV, Vermund SH. Human Papillomavirus Infections. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00063-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Wahid B, Ali A, Idrees M, Rafique S. Immunotherapeutic strategies for sexually transmitted viral infections: HIV, HSV and HPV. Cell Immunol 2016; 310:1-13. [PMID: 27514252 PMCID: PMC7124316 DOI: 10.1016/j.cellimm.2016.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/22/2016] [Accepted: 08/02/2016] [Indexed: 12/24/2022]
Abstract
More than 1 million sexually transmitted infections (STIs) are acquired each day globally. Etiotropic drugs cannot effectively control infectious diseases therefore, there is a dire need to explore alternative strategies especially those based on the regulation of immune system. The review discusses all rational approaches to develop better understanding towards immunotherapeutic strategies based on modulation of immune system in an attempt to curb the elevating risk of infectious diseases such as HIV, HPV and HSV because of their high prevalence. Development of monoclonal antibodies, vaccines and several other immune based treatments are promising alternative strategies that are offering new opportunities to eradicate pathogens.
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Affiliation(s)
- Braira Wahid
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Amjad Ali
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
| | - Muhammad Idrees
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan; Vice Chancellor Hazara University Mansehra, Pakistan.
| | - Shazia Rafique
- Centre for Applied Molecular Biology, 87-West Canal Bank Road, Thokar Niaz Baig, University of the Punjab, Lahore, Pakistan.
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Carlos S, Lopez-Del Burgo C, Burgueño E, Martinez-Gonzalez MA, Osorio A, Ndarabu A, Passabosc C, de Irala J. Male condom use, multiple sexual partners and HIV: a prospective case-control study in Kinshasa (DRC). AIDS Care 2016; 29:772-781. [PMID: 27852108 DOI: 10.1080/09540121.2016.1258450] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In the Democratic Republic of Congo no previous studies have assessed the factors associated with different patterns of condom use and with multiple sexual partners, and the association between condom use simultaneously taking into account multiple sexual partnerships, and HIV infection. We carried out a prospective case-control study. From December 2010 until June 2012, 1630 participants aged 15-49 getting HIV Voluntary Counseling and Testing in a hospital in Kinshasa were selected. Cases were new HIV diagnosis and controls were HIV-negative participants detected along the study period. We recruited 274 cases and 1340 controls that were interviewed about HIV-related knowledge, attitudes and behaviours. Among cases there was a high prevalence of multiple lifetime and concurrent sexual partnerships (89.8% and 20.4%, respectively) and most cases never used condoms with only 1.5% using them consistently. Condom use and multiple partnerships were associated with male, single and high-educated participants. An association was found between multiple lifetime partners and 'any condom use' (OR = 2.99; 95%CI: 2.14-4.19) but not with consistent use. Both having two or more multiple concurrent sexual partners or not using condoms were variables similarly and highly associated to HIV risk. The association found between having two or more concurrent sexual partners and HIV was slightly higher (OR = 3.58, 95%CI:2.31-5.56) than the association found between never condom use and HIV (OR = 3.38, 95%CI:1.15-9.93). We found a high prevalence of multiple lifetime sexual partners and an extremely high prevalence of inconsistent condom use, both strongly associated with HIV seropositivity. Local programmes would benefit from comprehensive interventions targeting all behavioural and sociocultural determinants.
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Affiliation(s)
- Silvia Carlos
- a Preventive Medicine and Public Health Department , University of Navarra , Pamplona , Spain.,b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain.,c Institute for Culture and Society (ICS), Education of Affectivity and Human Sexuality , University of Navarra , Pamplona Spain
| | - Cristina Lopez-Del Burgo
- a Preventive Medicine and Public Health Department , University of Navarra , Pamplona , Spain.,b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain.,c Institute for Culture and Society (ICS), Education of Affectivity and Human Sexuality , University of Navarra , Pamplona Spain
| | - Eduardo Burgueño
- d CEFA-Monkole , Kinshasa , Democratic Republic of the Congo.,e Department of Family Medicine and Primary Health Care , UPC - Protestant University in Congo, Kinshasa , Democratic Republic of the Congo
| | - Miguel Angel Martinez-Gonzalez
- a Preventive Medicine and Public Health Department , University of Navarra , Pamplona , Spain.,b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain.,f CIBER Fisiopatología de la Obesidad y Nutrición (CIBER obn), Spanish Government (ISCIII) , Madrid , Spain
| | - Alfonso Osorio
- b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain.,c Institute for Culture and Society (ICS), Education of Affectivity and Human Sexuality , University of Navarra , Pamplona Spain.,g School of Education and Psychology , University of Navarra , Pamplona , Spain
| | - Adolphe Ndarabu
- h Monkole Hospital , Kinshasa, Democratic Republic of the Congo
| | - Clément Passabosc
- i Department of Ophthalmology , Hospital de la Santa Creu i Sant Pau , Barcelona , Spain
| | - Jokin de Irala
- a Preventive Medicine and Public Health Department , University of Navarra , Pamplona , Spain.,b IdiSNA, Navarra Institute for Health Research , Pamplona , Spain.,c Institute for Culture and Society (ICS), Education of Affectivity and Human Sexuality , University of Navarra , Pamplona Spain
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Abstract
Objectives The main objective of this study was to review the evidence relating to the level of awareness of human papillomavirus (HPV) in the general population and the implications for the potential introduction of HPV vaccination and HPV testing as part of screening. Methods PubMed search performed on terms: ‘HPV education’, ‘HPV awareness’ ‘Genital Warts Awareness’ Results Public awareness of HPV is generally very low, particularly with respect to its relation to abnormal smears and cervical cancer although knowledge levels vary to some extent according to sociodemographic characteristics. There is also much confusion around which types cause warts and the types that can cause cancer. The sexually transmissible nature of the infection is of major concern and confusion to women. Conclusions Due to the lack of current awareness of HPV, significant education initiatives will be necessary should HPV vaccination and/or HPV testing be introduced. Organized edification of healthcare workers and the media, who constitute the two most preferred sources of information, will be crucial.
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Affiliation(s)
- K S Cuschieri
- Specialist Virology Centre, Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.
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Reich M, Licitra L, Vermorken J, Bernier J, Parmar S, Golusinski W, Castellsagué X, Leemans C. Best practice guidelines in the psychosocial management of HPV-related head and neck cancer: recommendations from the European Head and Neck Cancer Society's Make Sense Campaign. Ann Oncol 2016; 27:1848-54. [DOI: 10.1093/annonc/mdw272] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 07/14/2016] [Indexed: 12/31/2022] Open
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Abstract
Human papilloma virus (HPV) infection is the most common sexually transmitted infection in the United States. Some infections will result in anogenital warts and anogenital or oropharyngeal cancers. Preventing HPV infection is a public health priority to reduce cancer and HPV-associated complications. Prevention through vaccination is the most cost-effective and lifesaving intervention to decrease the burden of HPV-related cancers and other HPV-associated diseases. It is critical for pediatricians to make a strong recommendation for early and timely vaccination and completion of the 3-dose series. The goal of early vaccination is to immunize before first exposure to HPV virus.
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Hussain AN, Alkhenizan A, McWalter P, Qazi N, Alshmassi A, Farooqi S, Abdulkarim A. Attitudes and perceptions towards HPV vaccination among young women in Saudi Arabia. J Family Community Med 2016; 23:145-50. [PMID: 27625580 PMCID: PMC5009883 DOI: 10.4103/2230-8229.189107] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Rising incidence of human papillomavirus (HPV) infection and cervical cancer can be reduced by effective vaccination. Saudi Food and Drug Administration approved prophylactic HPV vaccine in 2010 for females of 11–26 years. Objectives: To determine the awareness of HPV infection, its health sequel and the attitude and barriers to the acceptance of HPV vaccine by young women in Saudi Arabia. Dynamics influencing the decision of patients and parents regarding vaccination were assessed to foster effective and strategically focused interventions. Materials and Methods: All patients of Family Medicine department, King Faisal Specialist Hospital and Research Center, Riyadh were invited to participate in this study from January 2012 to June 2014. A culturally sensitive and specially designed questionnaire was administered using an interview-based model to assess the knowledge, perception, and associated sociodemographic factors of HPV. Results: A total of 325 patients participated as per the inclusion criteria: 87.4% were Saudis, 53.5% had university or higher education and 65.2% were adolescents (age 11-19 years). The questionnaire was answered by participants (50.8%) or guardians (49.2%). About 34.5% of the population was aware of HPV infection, and 27.4% were aware of its relation with cervical cancer. However, awareness of the HPV vaccine, perception of its prevention of cervical cancer and other HPV-related disease was relatively low (32.3%), Saudis (29.9%) versus non-Saudis (48.8%) (P = 0.016). More guardians (41.2%) were aware of the HPV vaccine and its impact than participants (27.9%) (P = 0.01). Higher educational background (43.1%) increased the knowledge of HPV compared to less than high school education (24.5%) (odds ratio: 2.33; 95% confidence interval: 1.44–3.76). Nearly 64.3% of participants agreed, and 35.7% refused to receive the HPV vaccine. Conclusion: Knowledge and perception of HPV infection as an sexually transmitted infections and its vaccine was significantly low in this cohort of patients. Higher age and educational levels directly correlated with increased knowledge of HPV infection and its complications. It is recommended that awareness should be raised, and access to HPV vaccination increased to help reduce the health care burden of HPV sequelae in the Kingdom.
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Affiliation(s)
- Aneela N Hussain
- Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Abdullah Alkhenizan
- Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Patricia McWalter
- Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Nusrat Qazi
- Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Amal Alshmassi
- Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Samina Farooqi
- Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed Abdulkarim
- Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
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In vitro inhibition of human papillomavirus following use of a carrageenan-containing vaginal gel. Gynecol Oncol 2016; 143:313-318. [PMID: 27625046 DOI: 10.1016/j.ygyno.2016.09.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 08/30/2016] [Accepted: 09/03/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To assess in vitro efficacy of Divine 9, a carrageenan-based vaginal lubricant that is being studied as a microbicide to inhibit HPV16 pseudovirus (PsV) infection. METHODS Sexually active US women between 19 and 35years without prior HPV vaccination or cervical intraepithelial neoplasia were instructed to use Divine 9 vaginally with an applicator either before sex only or before and after intercourse. Women who applied a single dose of gel returned for cervicovaginal lavage (CVL) collection 1, 4 or 8-12h after intercourse versus those who applied gel before and after intercourse returned 1, 4 or 8-12h after the second gel dose. Carrageenan concentrations were assessed using an ELISA assay and the inhibitory activity was assessed using a PsV-based neutralization assay against HPV16 infection. Carrageenan concentrations and the percentage of PsV16 inhibition were compared using the Wilcoxon rank sum test. RESULTS Thirteen women were enrolled and thirty specimens from different time-points were assessed. 87% of CVL samples had detectable carrageenans with levels decreasing over time from intercourse. 93% of CVL samples had detectable PsV16 inhibition with median inhibition of 97.5%. PsV16 inhibition decreased over time, but remained high, with median inhibition of 98.1%, 97.4% and 83.4% at 1, 4 and 8-12h, respectively. Higher carrageenan concentrations were associated with higher levels of PsV16 inhibition (rho=0.69). CONCLUSIONS This is the first report of a human study investigating in vitro HPV inhibition of a carrageenan-based vaginal lubricant with CVL collected after sexual intercourse. We demonstrate excellent efficacy in preventing PsV16 infection.
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Samson KK, Haynatzki G, Soliman AS, Valerianova Z. Temporal changes in the cervical cancer burden in Bulgaria: Implications for eastern european countries going through transition. Cancer Epidemiol 2016; 44:154-160. [PMID: 27597149 DOI: 10.1016/j.canep.2016.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 07/20/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION In most developed countries, incidence of cervical cancer declined likely due to well-established cervical cancer screening programs. However, such decline has not been identified in Eastern Europe, where such programs are not well established. METHODS This study utilized data of the Bulgarian Cancer Registry for the period 1993-2013. Age-standardized incidence and mortality trends were analyzed using Joinpoint regression. Maps were created to illustrate spatial distributions of rates. RESULTS The northern region of Bulgaria showed a larger cervical cancer burden than the southern region and rural women tended to be diagnosed at older ages (p<0.0001) and later stages (p<0.0001) than urban women. The distribution of disease stages changed over the 21 years, with most common stages of diagnosis being stage II in 1993 (39.2%) to stage I in 2013 (44.7%; p<0.0001). While age-standardized mortality slightly increased over the 21 years (from 4.8 to 5.2 per 100,000; p=0.009), age-standardized incidence increased from 14.0 to 21.4 per 100,000 up until 2006 (p<0.001), after which it plateaued. CONCLUSIONS The lack of a similar plateau in mortality may be because the second most prevalent stage of diagnosis in recent years was stage III, indicating diagnosis at advanced symptomatic stages. Cervical cancer incidence is expected to continue to decrease if screening programs are strengthened and human papillomavirus vaccines are widely utilized. As Bulgaria has shared cervical cancer trends with other Eastern European countries in the past, it may be beneficial to develop future prevention interventions based on a regional, rather than a country-specific level.
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Affiliation(s)
- Kaeli K Samson
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Gleb Haynatzki
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Amr S Soliman
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Zdravka Valerianova
- Bulgarian National Cancer Registry, National Oncological Hospital, Sofia, Bulgaria.
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Wang LY, OuYang L, Tong F, Zhang XJ, Li XD, Wang CC, Li X, Sun L, Sun YH. The effect of contraceptive methods on reproductive tract infections risk: a cross-sectional study having a sample of 52,481 women. Arch Gynecol Obstet 2016; 294:1249-1256. [PMID: 27538571 DOI: 10.1007/s00404-016-4172-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 08/08/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between specific contraceptives use and reproductive tract infections (RTIs). STUDY DESIGN Participants consisted of 52,481 rural married women of reproductive age identified from a cross-sectional study in Anhui Province of China. The questionnaire, gynecological examination, and laboratory inspection were used to collect data. The subgroup analysis was performed to estimate the effect of the specific contraceptives on the specific RTIs. RESULTS A total of 49,970 (95.2 %) women used contraceptive methods and 31,390 (59.8 %) women had at least one RTI. Overall, use of intrauterine device (IUD), condom, female sterilisation, rhythm method, and oral contraceptive (OC) were associated with RTIs. In the subgroup analysis, IUD use was a risk factor for endocervicitis, bacterial vaginosis (BV), and trichomoniasis; condom, rhythm method, and OC were associated with endocervicitis; female sterilisation was associated with endocervicitis and trichomoniasis. Moreover, male sterilisation was associated with endocervicitis; withdrawal was a protective factor for endocervicitis and a risk factor for trichomoniasis; subdermal implant was associated with candidiasis and pelvic inflammatory disease (PID). CONCLUSIONS All the contraceptive methods may lead to the RTIs. A properly assessment for contraceptive methods use is needed for female reproductive health.
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Affiliation(s)
- Li-Ya Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Le OuYang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Fei Tong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China.
| | - Xiu-De Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Cheng-Cheng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Xiang Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Liang Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
| | - Ye-Huan Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, People's Republic of China
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90
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Fu TCJ, Carter JJ, Hughes JP, Feng Q, Hawes SE, Schwartz SM, Xi LF, Lasof T, Stern JE, Galloway DA, Koutsky LA, Winer RL. Re-detection vs. new acquisition of high-risk human papillomavirus in mid-adult women. Int J Cancer 2016; 139:2201-12. [PMID: 27448488 DOI: 10.1002/ijc.30283] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/29/2016] [Accepted: 07/11/2016] [Indexed: 01/24/2023]
Abstract
To understand high-risk (hr) human papillomavirus (HPV) epidemiology in mid-adulthood, we assessed whether associations between incident detection of hrHPV DNA and recent sexual behavior differed according to whether or not there was serologic evidence of prior infection. From 2011 to 2012, we enrolled 409 women aged 30-50 years into a 6-month longitudinal study. We collected health and sexual behavior histories, enrollment sera for HPV antibody testing, and monthly self-collected vaginal swabs for HPV DNA genotyping. Generalized estimating equations logistic regression identified risk factors for type-specific incident hrHPV DNA, stratified by type-specific hrHPV serostatus at enrollment. Population attributable risks of hrHPV due to prior and recent exposure were estimated. When type-specific hrHPV serology was negative, recent sexual risk behavior was positively associated with incident hrHPV DNA (odds ratio in women reporting ≥3 recent sexual risk behaviors [e.g., new or multiple partners] vs. no recent sexual activity = 9.8, 95% CI: 2.4-40.6). No associations with recent sexual behavior were observed with positive type-specific hrHPV serology. Thirty percent of incident hrHPV DNA detection was attributable to prior infection (with positive serology) and 40% was attributable to recent sexual risk behavior (with negative serology). The proportion of incident hrHPV DNA detection attributable to recent sexual risk behavior decreased with increasing age. Among women with serologic evidence of prior infection, re-detection of the same hrHPV type is likely due to reactivation or intermittent detection of persistent infection. Without serologic evidence of prior infection, new detection is likely due to new acquisition or to intermittent detection of persisting infection.
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Affiliation(s)
| | | | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, WA, 98195
| | | | - Stephen E Hawes
- Department of Epidemiology, University of Washington, Seattle, WA, 98195
| | - Stephen M Schwartz
- Department of Epidemiology, University of Washington, Seattle, WA, 98195.,Fred Hutchinson Cancer Research Center, Seattle, WA, 98109
| | - Long Fu Xi
- Department of Pathology, University of Washington, Seattle, WA, 98195
| | - Taylor Lasof
- University of California San Diego, La Jolla, CA, 92093
| | - Joshua E Stern
- Department of Global Health, University of Washington, Seattle, WA, 98195
| | - Denise A Galloway
- Fred Hutchinson Cancer Research Center, Seattle, WA, 98109.,Department of Microbiology, University of Washington, Seattle, WA, 98195
| | - Laura A Koutsky
- Department of Epidemiology, University of Washington, Seattle, WA, 98195
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, WA, 98195.
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91
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Nigenda G, Gonzalez-Robledo MC, Gonzalez-Robledo LM, Bejarano-Arias RM. Breast cancer policy in Latin America: account of achievements and challenges in five countries. Global Health 2016; 12:39. [PMID: 27405471 PMCID: PMC4942957 DOI: 10.1186/s12992-016-0177-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 06/23/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The recent increase of breast cancer mortality has put on alert to most countries in the region. However it has taken some time before breast cancer could be considered as a relevant problem. Only in recent years breast cancer has been considered a priority in some Latin American countries and resources have been mobilized to confront the problem at the institutional level. The article analyzes the efforts made in five Latin American countries (Argentina, Brazil, Colombia, Mexico and Venezuela) in the last 15 years to design and implement policies to address the growing incidence of breast cancer. METHODS Data was collected between July and December 2010 from both primary and secondary sources. Semi-structured interviews were conducted with key informants from governmental and non-governmental organizations. Secondary data was obtained from publications in journals, government reports and official statistics in each country. Analysis combines information from both types of sources. RESULTS Countries have followed different paths and are in different stages of policy implementation. In all cases early detection is a key strategy. Through the design of programs and guidelines, the allocation of financial resources to treat patients, as well as a formally structured information system, Brazil and Mexico have been able to set up comprehensive national policies. Argentina, Colombia and Venezuela have made important advancements but not yet capable of coordinating comprehensive national policies. CONCLUSION Breast cancer is being considered a priority in all five countries but there are different stages in the rolling out of comprehensive national policies due to differences in their capacity to allocate resources, implement operational strategies and encourage the participation of relevant stakeholders.
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Affiliation(s)
- Gustavo Nigenda
- />School of Medicine, Morelos State Autonomous University, Calle Leñeros esquina Iztaccíhuatl s/n Col. Volcanes, Cuernavaca, Morelos CP 62350 Mexico
| | - Maria Cecilia Gonzalez-Robledo
- />Centre for Health Systems Research, National Institute of Public Health, Av. Universidad 655, Santa María A, Cuernavaca, Morelos CP 62100 Mexico
| | - Luz Maria Gonzalez-Robledo
- />School of Medicine, Morelos State Autonomous University, Calle Leñeros esquina Iztaccíhuatl s/n Col. Volcanes, Cuernavaca, Morelos CP 62350 Mexico
| | - Rosa Maria Bejarano-Arias
- />Health Science and Medicine School, Valley of Mexico University, Calzada de Tlalpan No. 3016 y 3058 Ex Hacienda Coapa, CP 04910 Coyoac, Mexico
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92
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Harden ME, Munger K. Human papillomavirus molecular biology. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2016; 772:3-12. [PMID: 28528688 DOI: 10.1016/j.mrrev.2016.07.002] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/13/2016] [Accepted: 07/04/2016] [Indexed: 12/19/2022]
Abstract
Human papillomaviruses are small DNA viruses with a tropism for squamous epithelia. A unique aspect of human papillomavirus molecular biology involves dependence on the differentiation status of the host epithelial cell to complete the viral lifecycle. A small group of these viruses are the etiologic agents of several types of human cancers, including oral and anogenital tract carcinomas. This review focuses on the basic molecular biology of human papillomaviruses.
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Affiliation(s)
- Mallory E Harden
- Program in Virology, Division of Medical Sciences, Harvard Medical School, Boston, MA, 02115, USA; Department of Developmental, Molecular and Chemical Biology, Tufts University School of Medicine, Boston, MA, 02111, USA
| | - Karl Munger
- Department of Developmental, Molecular and Chemical Biology, Tufts University School of Medicine, Boston, MA, 02111, USA.
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93
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Febronio MV, Pereira RMR, Bonfa E, Takiuti AD, Pereyra EAG, Silva CAA. Inflammatory cervicovaginal cytology is associated with disease activity in juvenile systemic lupus erythematosus. Lupus 2016; 16:430-5. [PMID: 17664234 DOI: 10.1177/0961203307079298] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
To evaluate cervicovaginal cytology in adolescents with juvenile systemic lupus erythematosus (JSLE) and to compare them to controls. Fifty-two female adolescents with JSLE (ACR criteria) were compared to 52 age-matched healthy controls. All Pap smears were evaluated by the same cytopathologist blinded to gynecology examination (Bethesda 2001). The mean age of JSLE patients and controls were similar (16.17 ± 1.94 versus 16.13 ± 2.16 years, P = 0.92). The cervicovaginal cytology was found to be similar in both groups, although sexual intercourses in the last month were less frequent in JSLE than controls (23% versus 59.6%, P = 0.0003). Only one patient (2%) with JSLE versus two controls (4%) had cervical dysplasia (LGSIL) and human papilomavirus ( P = 1.0). Candida spp vaginitis was observed in seven JSLE (14%) versus none in controls ( P = 0.012) and was associated with immunosuppressive drugs ( P = 0.01) and high dose of prednisone ( P = 0.002). Of interest, inflammatory cervicovaginal cytology was observed in 21 (60%) of patients with SLEDAI ≥ 4 and only four (23%) of those with SLEDAI < 4 ( P = 0.001). Likewise, a higher frequency of inflammatory changes was also observed in virgin JSLE (57% versus 8%, P = 0.005). Our findings supports the notion that female genital tract may be a potential target organ in SLE since cervical inflammation is associated to disease activity independently of sexual activity. Lupus (2007) 16, 430—435.
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Affiliation(s)
- M V Febronio
- Rheumatology Division, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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94
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Sutherland ME. An intersectional approach for understanding the vulnerabilities of English-speaking heterosexual Caribbean youth to HIV/AIDS and sexually transmitted infections: Prevention and intervention strategies. Health Psychol Open 2016; 3:2055102916679349. [PMID: 28070411 PMCID: PMC5193298 DOI: 10.1177/2055102916679349] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Caribbean youth comprise about 30 percent of the English-speaking Caribbean population, and about 81,000 Caribbean and Latin American youth are HIV infected. AIDS is the leading cause of death for 15- to 24-year-old English-speaking Caribbean youth. This article relies on intersectionality theory in the assessment of the macro-level, or structural variables, and micro-level, or individual level, variables that influence the risk-taking sexual behaviors of heterosexual English-speaking Caribbean youth and increase their vulnerability to HIV/sexually transmitted infections. This article offers macro- and micro-level prevention/intervention strategies for reducing the prevalence of sexually transmitted infections in English-speaking Caribbean youth, including the promotion of condom use, voluntary male circumcision, and HIV testing and counseling. Suggestions are offered for future research investigations to explore the contributing factors to youth's vulnerability to sexually transmitted infections and to empirically verify the relationship between and among variables that account for desired outcomes, including decreases in risky sexual behaviors.
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95
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Nguyen NP, Nguyen LM, Thomas S, Hong-Ly B, Chi A, Vos P, Karlsson U, Vinh-Hung V. Oral sex and oropharyngeal cancer: The role of the primary care physicians. Medicine (Baltimore) 2016; 95:e4228. [PMID: 27428229 PMCID: PMC4956823 DOI: 10.1097/md.0000000000004228] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 04/29/2016] [Accepted: 06/20/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND We aimed to study the prevalence of oral sex and its possible association with human papillomavirus (HPV) 16 infection in the development of oropharyngeal cancer in the US population for possible prevention. METHODS We conduct a systemic review on the prevalence of oral sex among Americans among different age groups, the prevalence of HPV 16 infection reported in oropharyngeal cancer, and correlation between oral sex and oropharyngeal cancer. RESULTS Oral sex is prevalent among adolescents and sexually active adults. Sixty percent of oropharyngeal cancer reported in the United States is associated with HPV 16 infections. Individuals who practiced oral sex with multiple partners are at risk for developing oropharyngeal cancer and need to be informed about practicing safe sex or getting vaccination. CONCLUSION Family physicians will play a key role in prevention and educating the public about the risk of oral sex.
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Affiliation(s)
- Nam P. Nguyen
- Department of Radiation Oncology, Howard University, Washington, DC
| | | | - Sroka Thomas
- Department of Radiation Oncology, Darmouth College of Medicine, New Lebanon, NH
| | - Bevan Hong-Ly
- Department of Radiation Oncology, University of Miami, Miami, FL
| | - Alexander Chi
- Department of Radiation Oncology, University of West Virginia, Morgantown, WV
| | - Paul Vos
- Department of Biostatistics, East Carolina University, Greenville, NC
| | - Ulf Karlsson
- Department of Radiation Oncology, Marshfield Clinic, Marshfield, WI
| | - Vincent Vinh-Hung
- Department of Radiation Oncology, University of Martinique, Martinique, France
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96
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Abstract
BACKGROUND Although risk factors for HPV infections in young women are well defined, the risk associated with meeting male sex partners via the Internet is unclear. METHODS We analyzed cross-sectional data from 282 women aged 18 to 24 years who reported using Internet dating Web sites in the past year. Women were mailed vaginal self-sampling kits for polymerase chain reaction-based HPV genotyping (including 19 oncogenic types) and sexual behavior and health history questionnaires. Generalized linear models were used to evaluate risk factors for prevalent oncogenic HPV infections. RESULTS Thirty-five percent of women reported having met a male sex partner via the Internet in the past 6 months, and 42% reported a history of HPV vaccination. The prevalence of oncogenic HPV infection was 37%, and 9% of women tested positive for HPV-16 or HPV-18. Having met a male sex partner via the Internet in the past 6 months was not significantly associated with oncogenic HPV infection. In multivariate analyses, variables associated with an increased likelihood of oncogenic HPV infection included male partners in the past 6 months who were reported to have at least 1 concurrent partnership (adjusted prevalence ratio [aPR], 1.51; 95% confidence interval [CI], 1.11-2.06) and not always using condoms with male partners in the past 6 months (aPR, 1.86; 95% CI, 1.05-3.30). Self-reporting a history of receiving at least 1 dose of HPV vaccine was inversely associated with testing positive for HPV-16 or HPV-18 (aPR, 0.39; 95% CI, 0.16-0.97). CONCLUSIONS Although measures of recent sexual behavior were associated with prevalent oncogenic HPV infection, male partners met online were not associated with an increased likelihood of infection in this cohort of young women.
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97
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Menon SS, Rossi R, Harebottle R, Mabeya H, Vanden Broeck D. Distribution of human papillomaviruses and bacterial vaginosis in HIV positive women with abnormal cytology in Mombasa, Kenya. Infect Agent Cancer 2016; 11:17. [PMID: 27053945 PMCID: PMC4822250 DOI: 10.1186/s13027-016-0061-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 03/03/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND HPV is the major etiological factor in the causal pathway for cervical cancer, which is the leading cancer among women in sub-Saharan Africa. HIV is associated with a higher prevalence and a broader range of high-risk HPV genotypes. Studies have shown a positive association between Bacterial vaginosis (BV) and HPV and HIV. Also, in African women, BV was found to be significantly associated with vaginal inflammation. The high prevalence of BV, HIV and HPV infections in the African continent makes elucidation of the interactions with one another of utmost public health interest. The aims of the current study are to examine the frequency of HPV genotypes and BV as well as their respective risk factors within an HIV infected population with abnormal cytology in the resource-constrained setting of Mombasa, Kenya and, secondly, highlight issues to consider for triple co-infection clinical management. METHOD Cross-sectional analysis with a sample drawn from an ongoing cohort study. All consenting, non-pregnant HIV infected women, between 18 and 50 years of age, without a history of cervical cancer or hysterectomy, between November 2005 and April 2006 were screened for HR HPV DNA in Mombasa, Kenya. 1 out of 4 HIV positive women fulfilled the criteria by having SIL (24.9 %). 600 HIV infected women were tested to reach a cohort of 74 HIV women with abnormal cytology. To assess which factors were associated with HR HPV, crude statistical analysis was performed through logistic regression. RESULTS Bacterial vaginosis (BV) was found in 46 women out of 74 (62.2 %). Cervicitis was diagnosed in 15 % of women (n = 11), of which 8 had BV. The most prevalent HPV genotypes were HPV 16 (33.8), HPV 53 (24.3) and HPV 18 (17.6 %), while 65 % of the participants had multiple genotype infection. Statistically significant associations between CD4 counts <200 cells/μl and multiple HPV prevalence, adjusted for age were also noted (OR = 3.7; 95 CI: 1.2-12.1; p = 0.03) and HPV53 (OR = 4.4, 95 % CI: 1.4-13.6; p = 0.01). A statistically significant association was found between CD4 count ≥ 350 μl and HPV 16 adjusted for age (OR = 2.9; 95 % CI: 1.0- 8.3; p = 0.05). A borderline statistically significant association was observed between BV and HPV58 (crude OR = 4.1, 95 % CI: 0.8-21.0; p = 0.07). CONCLUSION The most prevalent HPV genotypes observed were HPV 16, HPV 53, and HPV 18, which have a combined prevalence of 76 %. Our results show that a triage based on CD4 count should start at CD4 count ≥ 350 μl as our study suggests that HPV 16 are more prevalent when women are moderately immunosuppressed. Given the high prevalence of HPV 53 in a HIV infected population with abnormal cytology, its cervical carcinoma genesis potential as a stand-alone genotype and as well as its synergism with multiple infections should be investigated. The new WHO guideline in resource-poor settings to rescreen women for HPV within ten years may be more effective if BV and cervicitis management become a major component for HIV-HPV management.
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Affiliation(s)
- Sonia Simone Menon
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium
| | - Rodolfo Rossi
- Ambior Research group, Belgium (LSHTM Alumni), Ghent, Belgium
| | | | - Hillary Mabeya
- Moi University/Gynocare Fistula Centre, Eldoret, Uasin Gishu Kenya
| | - Davy Vanden Broeck
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 P3, 9000 Ghent, Belgium ; Faculty of Medicine and Health Sciences, AMBIOR (Applied Molecular Biology Research Group), Laboratory of Cell Biology & Histology, University of Antwerpen, Antwerpen, Belgium
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98
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Houlihan CF, Baisley K, Bravo IG, Kapiga S, de Sanjosé S, Changalucha J, Ross DA, Hayes RJ, Watson-Jones D. Rapid acquisition of HPV around the time of sexual debut in adolescent girls in Tanzania. Int J Epidemiol 2016; 45:762-73. [PMID: 26944311 PMCID: PMC5005945 DOI: 10.1093/ije/dyv367] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND No reports exist on genotype-specific human papillomavirus (HPV) acquisition in girls after first sex in sub-Saharan Africa, despite high HPV prevalence and cervical cancer incidence. METHODS We followed 503 HP-unvaccinated girls aged 15-16 years in Mwanza, Tanzania, 3-monthly for 18 months with interviews and self-administered vaginal swabs. Swabs were tested for 13 higHRisk and 24 low-risk HPV genotypes. Incidence, clearance and duration of overall HPV and genotype-specific infections were calculated and associated factors evaluated. RESULTS A total of 106 participants reported first sex prior to enrolment (N = 29) or during follow-up (N = 77). One was HIV-positive at the final visit. The remaining 105 girls contributed 323 adequate specimens. Incidence of any new HPV genotype was 225/100 person-years (pys), and incidence of vaccine types HPV-6, -11, -16 and -18 were 12, 2, 2 and 7/100 pys, respectively. Reporting sex in the past 3 months and knowing the most recent sexual partner for a longer period before sex were associated with HPV acquisition. Median time from reported sexual debut to first HPVinfection was 5 months, and infection duration was 6 months. CONCLUSION This is the first description of HPV acquisition after first sex in sub-Saharan Africa where the incidence of cervical cancer is amongst the highest in the world. HPV incidence was very high after first sex, including some vaccine genotypes, and infection duration was short. This very high HPV incidence may help explain high cervical cancer rates, and supports recommendations that the HPV vaccine should be given to girls before first sex.
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Affiliation(s)
- Catherine F Houlihan
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK Mwanza Intervention Trials Unit, Mwanza, Tanzania
| | - Kathy Baisley
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Ignacio G Bravo
- Unit of Infections and Cancer, Institut Català d'Oncologia, Barcelona, Spain
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit, Mwanza, Tanzania MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Silvia de Sanjosé
- Unit of Infections and Cancer, Institut Català d'Oncologia, Barcelona, Spain CIBER ESP, Barcelona, Spain
| | | | - David A Ross
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Richard J Hayes
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Deborah Watson-Jones
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK Mwanza Intervention Trials Unit, Mwanza, Tanzania
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99
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Grandahl M, Rosenblad A, Stenhammar C, Tydén T, Westerling R, Larsson M, Oscarsson M, Andrae B, Dalianis T, Nevéus T. School-based intervention for the prevention of HPV among adolescents: a cluster randomised controlled study. BMJ Open 2016; 6:e009875. [PMID: 26817639 PMCID: PMC4735203 DOI: 10.1136/bmjopen-2015-009875] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To improve primary prevention of human papillomavirus (HPV) infection by promoting vaccination and increased condom use among upper secondary school students. DESIGN Cluster randomised controlled trial. SETTING 18 upper secondary schools in Sweden. PARTICIPANTS Schools were first randomised to the intervention or the control group, after which individual classes were randomised so as to be included or not. Of the 832 students aged 16 years invited to participate during the regular individual health interview with the school nurse, 751 (90.2%) agreed to participate and 741 (89.1%) students completed the study. INTERVENTIONS The intervention was based on the Health Belief Model (HBM). According to HBM, a person's health behaviour can be explained by individual beliefs regarding health actions. School nurses delivered 30 min face-to-face structured information about HPV, including cancer risks and HPV prevention, by propagating condom use and HPV vaccination. Students in the intervention and the control groups completed questionnaires at baseline and after 3 months. MAIN OUTCOME MEASURES Intention to use condom with a new partner and beliefs about primary prevention of HPV, and also specifically vaccination status and increased condom use. RESULTS All statistical analyses were performed at the individual level. The intervention had a significant effect on the intention to use condom (p=0.004). There was also a significant effect on HBM total score (p=0.003), with a 2.559 points higher score for the intervention group compared to the controls. The influence on the HBM parameters susceptibility and severity was also significant (p<0.001 for both variables). The intervention also influenced behaviour: girls in the intervention group chose to have themselves vaccinated to a significantly higher degree than the controls (p=0.02). No harms were reported. CONCLUSIONS The school-based intervention had favourable effects on the beliefs about primary prevention of HPV, and increased the HPV vaccination rates in a diverse population of adolescents. TRIAL REGISTRATION NUMBER NCT02280967; Results.
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Affiliation(s)
- Maria Grandahl
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Andreas Rosenblad
- Centre for Clinical Research Västerås, Uppsala University, Västerås, Sweden
| | - Christina Stenhammar
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Tanja Tydén
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ragnar Westerling
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Margareta Larsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marie Oscarsson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Bengt Andrae
- Centre for Research and Development, Uppsala University/Region of Gävleborg, Gävle, Sweden
| | - Tina Dalianis
- Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Tryggve Nevéus
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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100
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Rosario M, Li F, Wypij D, Roberts AL, Corliss HL, Charlton BM, Frazier AL, Austin SB. Disparities by Sexual Orientation in Frequent Engagement in Cancer-Related Risk Behaviors: A 12-Year Follow-Up. Am J Public Health 2016; 106:698-706. [PMID: 26794176 DOI: 10.2105/ajph.2015.302977] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES We examined sexual-orientation disparities in frequent engagement in cancer-related risk indicators of tobacco, alcohol, diet and physical activity, ultraviolet radiation, and sexually transmitted infections (STIs). METHODS We used longitudinal data from the national Growing Up Today Study (1999-2010). Of the analytic sample (n = 9958), 1.8% were lesbian or gay (LG), 1.6% bisexual (BI), 12.1% mostly heterosexual (MH), and 84.5% completely heterosexual (CH). RESULTS More sexual minorities (LGs, BIs, and MHs) than CHs frequently engaged in multiple cancer-related risk behaviors (33%, 29%, 28%, and 19%, respectively). Sexual-minority young women, especially BI and MH, more frequently engaged over time in substance use and diet and physical activity risk than CH women. More young gay than CH men frequently engaged over time in vomiting for weight control (odds ratio [OR] = 3.2; 95% confidence interval [CI] = 1.1, 9.4), being physically inactive (OR = 1.7; 95% CI = 1.2, 2.4), and using tanning booths (OR = 4.7; 95% CI = 3.0, 7.4), and had a higher prevalence of ever having an STI (OR = 3.5; 95% CI = 2.0, 6.4). Individual analyses were generally comparable to the group-level analyses. CONCLUSIONS Young sexual minorities are at risk for cancer through frequent exposure to cancer-related risk behaviors over time. Long-term, longitudinal studies and surveillance data are essential and warranted to track frequent engagement in the risk behaviors and cancer-related morbidity and mortality.
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Affiliation(s)
- Margaret Rosario
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Fei Li
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - David Wypij
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Andrea L Roberts
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Heather L Corliss
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - Brittany M Charlton
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - A Lindsay Frazier
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
| | - S Bryn Austin
- Margaret Rosario is with Department of Psychology, City University of New York-City College and Graduate Center, New York, NY. Fei Li and David Wypij are with Department of Biostatistics, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. David Wypij, Brittany M. Charlton, A. Lindsay Frazier, and S. Bryn Austin are with Department of Pediatrics, Harvard Medical School (HMS), Boston. David Wypij is also with Department of Cardiology, Boston's Children's Hospital, Boston. Andrea L. Roberts is with Department of Social and Behavioral Sciences, HSPH. Heather L. Corliss is with Division of Health Promotion and Behavioral Science at San Diego State University, San Diego, CA. Brittany M. Charlton and S. Bryn Austin are also with Division of Adolescent and Young Adult Medicine, Boston Children's Hospital. A. Lindsay Frazier is also with Dana-Farber Cancer Institute, Boston, and Department of Epidemiology, HSPH. A. Lindsay Frazier and S. Bryn Austin are also with Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, HMS
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