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Human papillomavirus infection and the HPV vaccine: What are the facts? JAAPA 2008; 21:32-4, 37. [DOI: 10.1097/01720610-200810000-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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302
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Louie K, Didelot MN, Damay A, Nagot N, Mayaud P, Segondy M. Papillomavirus humains (HPV) et cancers associés : aspects épidémiologiques. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1773-035x(08)74275-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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303
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Muñoz N, Jacquard AC. Quelles données épidémiologiques sont nécessaires pour la mise en place de la vaccination contre le papillomavirus humain? Presse Med 2008; 37:1377-90. [DOI: 10.1016/j.lpm.2008.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Revised: 04/17/2008] [Accepted: 04/23/2008] [Indexed: 10/21/2022] Open
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304
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Lowy DR, Solomon D, Hildesheim A, Schiller JT, Schiffman M. Human papillomavirus infection and the primary and secondary prevention of cervical cancer. Cancer 2008; 113:1980-93. [PMID: 18798536 PMCID: PMC6263938 DOI: 10.1002/cncr.23704] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A wealth of evidence has led to the conclusion that virtually all cases of cervical cancer are attributable to persistent infection by a subset of human papillomavirus (HPV) types, especially HPV type 16 (HPV-16) and HPV-18. These HPV types also cause a proportion of other cancers, including vulvar, vaginal, anal, penile, and oropharyngeal cancers. Although cervical cancer screening, primarily with the Papanicolaou (Pap) smear, has reduced the incidence of this cancer in industrialized countries, cervical cancer remains the second most common cause of death from cancer in women worldwide, because the developing world has lacked the resources for widespread, high-quality screening. In addition to advances in Pap smear technology, the identification of HPV as the etiologic agent has produced 2 recent advances that may have a major impact on approaches to reduce the incidence of this disease. The first is the development of a preventive vaccine, the current versions of which appear to prevent close to 100% of persistent genital infection and disease caused by HPV-16 and HPV-18; future second-generation vaccines may be able to protect against oncogenic infections by a broader array of HPV types. The second is the incorporation of HPV testing into screening programs. In women aged >30 years, HPV testing can identify high-grade cervical intraepithelial neoplasia earlier than Pap smears with acceptable rates of specificity. These results, together with the high sensitivity of HPV testing, suggest that such testing could permit increased intervals for screening. An inexpensive HPV test in development, if successful, may be incorporated as part of an economically viable 'screen-and-treat' approach in the developing world. The manner in which vaccination and screening programs are integrated will need to be considered carefully so that they are efficient in reducing the overall incidence of cervical cancer.
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Affiliation(s)
- Douglas R Lowy
- Laboratory of Cellular Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
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305
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Geographical relationships between sociodemographic factors and incidence of cervical cancer in the Netherlands 1989–2003. Eur J Cancer Prev 2008; 17:453-9. [DOI: 10.1097/cej.0b013e3282f75ed0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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306
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Updated guidelines for papanicolaou tests, colposcopy, and human papillomavirus testing in adolescents. J Adolesc Health 2008; 43:S41-51. [PMID: 18809144 PMCID: PMC2938015 DOI: 10.1016/j.jadohealth.2008.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2008] [Revised: 04/01/2008] [Accepted: 04/02/2008] [Indexed: 11/21/2022]
Abstract
Worldwide, cervical cancer is a major health concern for women of all ages; however the epidemiology and biology of human papillomavirus (HPV) infection differs in female adolescents and adults. In the United States, 50% of adolescent and young women acquire HPV within 3 years after initiating sexual intercourse, resulting in relatively high prevalence rates. Most infections, however, are transient and clear within several months. Consequently HPV infections detected in adolescents are likely to reflect benign disease, whereas infections detected in older women are likely to reflect persistent infections and a higher risk of advanced cervical intraepithelial lesions that can lead to invasive cervical cancer. This article reviews the most recently published guidelines for the prevention of cervical cancer through screening and management of abnormal cervical cytologic and histologic findings, which have been updated to reflect the differences in HPV infections and cervical abnormalities in female adolescents and adults.
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307
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Abstract
External genital warts are a significant health problem particularly for young adults. This review summarizes the current literature on epidemiology, transmission, diagnosis, and treatment. Efficacy of all treatments is less than optimal, and multiple therapies may be necessary for complete resolution. Data on a new patient-applied therapy are presented. New vaccine therapy for prevention of infection should reduce the incidence of disease.
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308
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Trigg BG, Kerndt PR, Aynalem G. Sexually transmitted infections and pelvic inflammatory disease in women. Med Clin North Am 2008; 92:1083-113, x. [PMID: 18721654 DOI: 10.1016/j.mcna.2008.04.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Sexually transmitted infections (STIs) are an important public health challenge in the United States. Primary care clinicians can contribute to decreasing these largely preventable causes of morbidity and mortality by integrating routine screening, testing, counseling, treatment, and partner management of STIs into their practice. Newer tests for chlamydia and gonorrhea that can be performed on urine specimens allow screening without a pelvic examination. The most recent edition of the Centers for Disease Control and Prevention sexually transmitted disease treatment guidelines provides an evidence-based, reliable, and convenient set of recommendations for treating and caring for patients who have STIs.
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Affiliation(s)
- Bruce G Trigg
- Sexually Transmitted Disease Program, Regions 1 and 3, New Mexico Department of Health, 1111 Stanford Drive NE, Albuquerque, NM 87106, USA.
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309
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Holmes WR, Maher L, Rosenthal SL. Attitudes of men in an Australian male tolerance study towards microbicide use. Sex Health 2008; 5:273-8. [PMID: 18771643 PMCID: PMC3777800 DOI: 10.1071/sh07093] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2007] [Accepted: 05/15/2008] [Indexed: 04/14/2024]
Abstract
BACKGROUND Vaginal microbicides are in development to provide new options for the prevention of sexually transmissible infections. Although promoted as a female-initiated product, men may influence the decision to use a microbicide and the way that it is used, so it is important to explore their views. METHODS Men (n = 36) enrolled in a 7-day, phase 1 clinical safety trial of SPL7013 Gel were interviewed pre- and post-use of the gel. The trial did not include use of the gel during sex. Interviews were digitally-recorded and transcribed verbatim, and analysed using a framework approach. RESULTS The men (mean age 37 years) were interested in the idea of vaginal microbicides, had little knowledge about them, and varied beliefs about how they work. They tended to assess microbicide use in relation to condoms and lubricants. Many would want a microbicide to be as effective as condoms. Participants did not anticipate difficulties discussing use with their partners. Many thought that a microbicide would be less intrusive than condoms; some anticipated that the lubricating properties might enhance sexual pleasure. Some anticipated using a microbicide with a condom or with a lubricant, and a few raised questions about the timing of use and use during different types of sexual activity. CONCLUSIONS No major barriers to microbicide use were found in this sample of Australian men, who anticipated being willing to use them if they are shown to be safe and effective. Our findings should help to inform the design of further studies as well as future information materials and anticipatory guidance.
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Affiliation(s)
- Wendy R Holmes
- Centre for International Health, Macfarlane Burnet Institute for Medical Research and Public Health, 23?87 Commercial Road, Melbourne, Vic. 3004, Australia.
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310
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Abstract
PURPOSE OF REVIEW To provide an update of research findings and recommendations regarding immunizations. RECENT FINDINGS New research has examined the efficacy of the 2007-2008 influenza vaccine, the transmission and incidence of human papillomavirus, the increased prevalence of pneumococcal serotypes not included in the 7-valent pneumococcal conjugate vaccine, the emergence of a drug-resistant strain of Streptococcus pneumoniae, febrile seizure rates following measles-mumps-rubella-varicella vaccination, and the 2006 mumps outbreak in the American Midwest. The Food and Drug Administration has approved the expansion of live attenuated influenza virus vaccine and quadrivalent meningococcal conjugate vaccine for use in children no younger than 2 years of age. The Advisory Committee on Immunization Practices now recommends immunization with quadrivalent meningococcal conjugate vaccine for all previously unvaccinated 11-18-year-old children and has revised its recommendations for Streptococcus pneumoniae catch-up vaccinations. The Advisory Committee on Immunization Practices no longer expresses a preference for the use of the combination measles-mumps-rubella-varicella vaccine over separate measles-mumps-rubella and varicella administration. Because of a notable recall of Haemophilus influenzae type B vaccines by Merck & Co Inc, Whitehouse Station, New Jersey, USA, the Advisory Committee on Immunization Practices recommends that pediatric providers conserve available Haemophilus influenzae type B vaccines by delaying the administration of the booster dose of the vaccine in healthy children. SUMMARY New vaccine recommendations continue to be made, and research continues on infectious diseases, vaccine safety, and vaccine efficacy.
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311
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Grinsztejn B, Veloso VG, Levi JE, Velasque L, Luz PM, Friedman RK, Andrade AC, Moreira RI, Russomano F, Pilotto JH, Bastos FI, Palefsky J. Factors associated with increased prevalence of human papillomavirus infection in a cohort of HIV-infected Brazilian women. Int J Infect Dis 2008; 13:72-80. [PMID: 18632296 DOI: 10.1016/j.ijid.2008.03.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2007] [Revised: 03/19/2008] [Accepted: 03/31/2008] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES Human papillomavirus (HPV) infection is a major risk factor for cervical disease. Using baseline data from the HIV-infected cohort of Evandro Chagas Clinical Research Institute at Fiocruz, Rio de Janeiro, Brazil, factors associated with an increased prevalence of HPV were assessed. METHODS Samples from 634 HIV-infected women were tested for the presence of HPV infection using hybrid capture II and polymerase chain reaction. Prevalence ratios (PR) were estimated using Poisson regression analysis with robust variance. RESULTS The overall prevalence of HPV infection was 48%, of which 94% were infected with a high-risk HPV. In multivariate analysis, factors independently associated with infection with high-risk HPV type were: younger age (<30 years of age; PR 1.5, 95% confidence interval (CI) 1.1-2.1), current or prior drug use (PR 1.3, 95% CI 1.0-1.6), self-reported history of HPV infection (PR 1.2, 95% CI 0.96-1.6), condom use in the last sexual intercourse (PR 1.3, 95% CI 1.1-1.7), and nadir CD4+ T-cell count <100cells/mm(3) (PR 1.6, 95% CI 1.2-2.1). CONCLUSIONS The estimated prevalence of high-risk HPV-infection among HIV-infected women from Rio de Janeiro, Brazil, was high. Close monitoring of HPV-related effects is warranted in all HIV-infected women, in particular those of younger age and advanced immunosuppression.
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Affiliation(s)
- Beatriz Grinsztejn
- Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
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312
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de Irala J, Urdiain IG, López Del Burgo C. Analysis of content about sexuality and human reproduction in school textbooks in Spain. Public Health 2008; 122:1093-103. [PMID: 18614191 DOI: 10.1016/j.puhe.2008.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Revised: 08/27/2007] [Accepted: 01/07/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The spread of sexually transmitted infections (STIs) inadolescents and teenage pregnancy rates are increasing. A decrease in the average age of youth's first sexual experience has also been noted. Sexual education programmes in schools have an important role to play in addressing these issues. The objective of this study was to analyse the content of textbooks in the areas of sexuality and human reproduction in order to evaluate the extent to which these textbooks promote healthy reproductive lifestyles, as well as avoidance of risk behaviour among adolescent students. STUDY DESIGN Descriptive study of the content of school textbooks. METHODS The study sample consisted of 12 textbooks (approximately 80% of all the textbooks used in Spanish secondary schools) which were edited in 2002. Content analysis evaluated the extent to which these books demonstrated reliable scientific information about: (a) condom effectiveness; (b) consequences, prevention and treatment of STIs; (c) family planning methods; (d) assisted reproductive technologies; and (e) the promotion of healthy reproductive lifestyles. RESULTS All textbooks presented inaccurate information in the areas studied. One hundred and fifty one quotes were identified that facilitated incomplete perception of sexuality or risky behaviour. On average, 12.6 incorrect messages were identified in each textbook. CONCLUSIONS The textbooks examined are neither appropriate nor sufficiently comprehensive for adolescent education on issues of sexuality. Results suggest a need for alternative textbooks based on better scientific evidence. It is essential that textbooks empower adolescents to make healthy decisions through the promotion of useful life skills that provide a more integrated concept of sexuality. There is a need for approaches to sexual education to integrate values commonly held by parents of the youth that use such texts.
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Affiliation(s)
- J de Irala
- Preventive Medicine and Public Health, School of Medicine, University of Navarra, Irunlarrea 1, 31080 Pamplona, Navarra, Spain.
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313
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Penile cancer: epidemiology, pathogenesis and prevention. World J Urol 2008; 27:141-50. [DOI: 10.1007/s00345-008-0302-z] [Citation(s) in RCA: 237] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Accepted: 06/09/2008] [Indexed: 11/25/2022] Open
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314
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Giorgi C, Di Bonito P, Grasso F, Mochi S, Accardi L, Donà MG, Branca M, Costa S, Mariani L, Agarossi A, Ciotti M, Syrjänen K. Clinical and epidemiological correlates of antibody response to human papillomaviruses (HPVs) as measured by a novel ELISA based on denatured recombinant HPV16 late (L) and early (E) antigens. Infect Agent Cancer 2008; 3:9. [PMID: 18582363 PMCID: PMC2474580 DOI: 10.1186/1750-9378-3-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2007] [Accepted: 06/26/2008] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND At present, seroreactivity is not a valuable parameter for diagnosis of Human Papillomavirus (HPV) infection but, it is potentially valuable as marker of viral exposure in elucidating the natural history of this infection. More data are needed to asses the clinical relevance of serological response to HPV. OBJECTIVES The objective was to assess the clinical and epidemiological correlates of HPV-seroreactivity in a cohort of HIV-negative and HIV-positive women. METHODS Seroreactivity of 96 women, evaluated in an ELISA test based on denatured HPV16 late (L) and early (E) antigens, was correlated with their clinical and epidemiological data previously collected for a multi-centre Italian study, HPV-PathogenISS study. RESULTS No significant correlation was found between HPV DNA detection and seroreactivity. Women, current smokers showed significantly less seroreactivity to L antigens as compared with the non-smokers. HIV-positive women showed significantly less (66.7%) antibody response as compared with HIV-negative women (89.3%), with particularly impaired response to L antigens. Women, HIV-positive and current smokers, showed by far the lowest seroprevalence (33.3%) as compared to 75.9% among all other women (OR = 0.158; 95%CI 0.036-0.695, p = 0.014; Fisher's exact test). Importantly, this association did not loose its significance when controlled for confounding from age (continuous variable) in multivariate analysis or using Mantel-Haenszel test for age-groups. CONCLUSION It is tempting to speculate that HIV-positive current smokers comprise a special high-risk group, with highly impaired immunological response that could prevent eradication of persistent HPV infections and thus contribute to development of CIN3/CC.
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Affiliation(s)
- Colomba Giorgi
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Paola Di Bonito
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Felicia Grasso
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Stefania Mochi
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Luisa Accardi
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Maria Gabriella Donà
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità, Roma, Italy
| | - Margherita Branca
- Unità Citoistopatologia, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanità, Roma, Italy
| | - Silvano Costa
- Dipartimento di Ginecologia e Ostetricia, Ospedale S. Orsola Malpighi, Bologna, Italy
| | - Luciano Mariani
- Clinica Ostetrica e Ginecologica, IFO, Istituto Regina Elena, Roma, Italy
| | - Alberto Agarossi
- Istituto Scienze Biomediche, Ospedale Luigi Sacco, Milano, Italy
| | - Marco Ciotti
- Laboratory of Clinical Microbiology and Virology, Policlinico of Tor Vergata University, Rome, Italy
| | - Kari Syrjänen
- Department of Oncology and Radiotherapy, Turku University Hospital, FIN-20521 Turku, Finland
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315
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316
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Diaz ML. Human Papilloma Virus – Prevention and Treatment. Obstet Gynecol Clin North Am 2008; 35:199-217, vii-viii. [DOI: 10.1016/j.ogc.2008.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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317
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Abstract
Human papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States. Modeling estimates suggest that more than 80% of sexually active women will have acquired genital HPV by age 50 years. Although most infections are transient and asymptomatic, persistent infection with high-risk types of HPV can lead to precancerous lesions and progress to cancer. In June 2006, the US Food and Drug Administration licensed the first vaccine to prevent cervical cancers and other diseases in women. This quadrivalent vaccine protects against HPV-6, HPV-11, HPV-16, and HPV-18, which are responsible for 70% of cervical cancers and 90% of genital warts. Several studies have been published examining the vaccine's efficacy, duration, immunogenicity, and safety. Questions and controversy remain regarding mandatory vaccination, need for booster doses, and cost-effectiveness.
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Affiliation(s)
- Christine M Huang
- Department of Internal Medicine, UCLA School of Medicine, VA Greater Los Angeles Healthcare System, West Los Angeles, California. 11301 Wilshire Blvd (PACC), Los Angeles, CA 90073, USA
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318
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Castle PE. Human papillomavirus (HPV) genotype 84 infection of the male genitalia: further evidence for HPV tissue tropism? J Infect Dis 2008; 197:776-8. [PMID: 18419356 DOI: 10.1086/527398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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319
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Abstract
The addition of the human papillomavirus vaccination and the 2006 national guidelines for the management of abnormal cervical cytology have led to significant changes in the management of cervical disease among adolescents. This article reviews recommendations for prevention, screening, diagnosis, and management of cervical disease.
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320
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Vanslyke JG, Baum J, Plaza V, Otero M, Wheeler C, Helitzer DL. HPV and cervical cancer testing and prevention: knowledge, beliefs, and attitudes among Hispanic women. QUALITATIVE HEALTH RESEARCH 2008; 18:584-596. [PMID: 18337618 DOI: 10.1177/1049732308315734] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Cervical cancer is a preventable disease resulting from infection with high-risk types of sexually transmitted human papillomaviruses (HPVs). Public knowledge of HPVs and their link to cervical cancer is limited. Participation in cervical cancer prevention programs, including Pap and HPV screening and HPV vaccine acceptance, is crucial for limiting the incidence of cervical cancer. Hispanic women suffer the highest cervical cancer incidence rates in the United States. In this study, we conducted community-based focus groups with Hispanic women to explore knowledge and attitudes relating to cervical cancer, HPV, HPV testing, and HPV vaccination. Study findings suggest a need to increase public health literacy in relation to HPV, the link between HPV and cervical cancer, and HPV primary and secondary prevention options. Health care providers should be prepared to share information with patients that supports and promotes informed decision making about HPV testing and vaccines and their complementary roles in cervical cancer screening and prevention.
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MESH Headings
- Adolescent
- Adult
- Condoms/statistics & numerical data
- DNA, Viral/analysis
- Female
- Focus Groups
- Health Knowledge, Attitudes, Practice
- Hispanic or Latino
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18
- Humans
- Middle Aged
- Papillomavirus Infections/complications
- Papillomavirus Infections/ethnology
- Papillomavirus Infections/prevention & control
- Papillomavirus Vaccines/therapeutic use
- Sexual Behavior
- Sexually Transmitted Diseases, Viral/complications
- Sexually Transmitted Diseases, Viral/ethnology
- Sexually Transmitted Diseases, Viral/prevention & control
- Socioeconomic Factors
- Uterine Cervical Neoplasms/etiology
- Uterine Cervical Neoplasms/prevention & control
- Vaginal Smears/statistics & numerical data
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321
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Miksis S. A Review of the Evidence Comparing the Human Papillomavirus Vaccine Versus Condoms in the Prevention of Human Papillomavirus Infections. J Obstet Gynecol Neonatal Nurs 2008; 37:329-37. [DOI: 10.1111/j.1552-6909.2008.00236.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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322
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Hernandez BY, Vu Nguyen T. Cervical human papillomavirus infection among female sex workers in southern Vietnam. Infect Agent Cancer 2008; 3:7. [PMID: 18433504 PMCID: PMC2405771 DOI: 10.1186/1750-9378-3-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2008] [Accepted: 04/23/2008] [Indexed: 11/30/2022] Open
Abstract
Background Cervical cancer is the most frequently diagnosed malignancy among women in southern Vietnam where its incidence is one of the highest observed worldwide. Results Cervical HPV DNA infection was measured in a cross-sectional sample of 282 female sex workers (FSW) in Soc Trang province in southern Vietnam. HPV DNA was detected in 85% of FSW and prevalence did not vary by age. Thirty-five HPV genotypes were detected; HPV 52 was the most common type. Half of HPV-positive women were infected with oncogenic types and 37% were infected with multiple genotypes. The prevalence of oncogenic HPV infection was lower among FSW with more formal education (adj. prevalence ratio = 0.63, 95% CI 0.42–0.93), those servicing 25 or more clients per month (adj. PR = 0.66 95% CI 0.48–0.92), and those engaging in withdrawal prior to ejaculation (adj. PR = 0.68, 95% CI 0.53–0.87). Oncogenic HPV prevalence was higher among FSW with regular male partners who had other female partners (adj. PR = 1.75, 95% CI 1.34–2.28) and FSW who were HIV+ (adj. PR = 1.42, 95% CI 1.08–1.88). Conclusion Our results demonstrate that although cervical HPV infection is extremely common among FSW in southern Vietnam, prevalence varies by education level, sexual activity, habits of regular partners, and HIV status.
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Affiliation(s)
- Brenda Y Hernandez
- Cancer Research Center of Hawaii, University of Hawaii, Honolulu, Hawaii, USA.
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323
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Llamazares M, Smith RJ. Evaluating human papillomavirus vaccination programs in Canada: should provincial healthcare pay for voluntary adult vaccination? BMC Public Health 2008; 8:114. [PMID: 18402671 PMCID: PMC2373297 DOI: 10.1186/1471-2458-8-114] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2007] [Accepted: 04/10/2008] [Indexed: 11/20/2022] Open
Abstract
Background Recently, provincial health programs in Canada and elsewhere have begun rolling out vaccination against human papillomavirus for girls aged 9–13. While vaccination is voluntary, the cost of vaccination is waived, to encourage parents to have their daughters vaccinated. Adult women who are eligible for the vaccine may still receive it, but at a cost of approximately CAN$400. Given the high efficacy and immunogenicity of the vaccine, the possibility of eradicating targeted types of the virus may be feasible, assuming the vaccination programs are undertaken strategically. Methods We develop a mathematical model to describe the epidemiology of vaccination against human papillomavirus, accounting for a widespread childhood vaccination program that may be supplemented by voluntary adult vaccination. A stability analysis is performed to determine the stability of the disease-free equilibrium. The critical vaccine efficacy and immunogenicity thresholds are derived, and the minimum level of adult vaccination required for eradication of targeted types is determined. Results We demonstrate that eradication of targeted types is indeed feasible, although the burden of coverage for a childhood-only vaccination program may be high. However, if a small, but non-negligible, proportion of eligible adults can be vaccinated, then the possibility of eradication of targeted types becomes much more favourable. We provide a threshold for eradication in general communities and illustrate the results with numerical simulations. We also investigate the effects of suboptimal efficacy and immunogenicity and show that there is a critical efficacy below which eradication of targeted types is not possible. If eradication is possible, then there is a critical immunogenicity such that even 100% childhood vaccination will not eradicate the targeted types of the virus and must be supplemented with voluntary adult vaccination. However, the level of adult vaccination coverage required is modest and may be achieved simply by removing the cost burden to vaccination. Conclusion We recommend that provincial healthcare programs should pay for voluntary adult vaccination for women aged 14–26. However, it should be noted that our model results are preliminary, in that we have made a number of simplifying assumptions, including a lack of age-dependency in sexual partner rates, a lack of sexual activity outside of the vaccine age-range among females and a uniform age of sexual debut; thus, further work is desired to enhance the external generalisability of our results.
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Affiliation(s)
- Marco Llamazares
- Department of Mathematics, The University of Ottawa, Ottawa, Canada.
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324
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Kohler PK, Manhart LE, Lafferty WE. Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. J Adolesc Health 2008; 42:344-51. [PMID: 18346659 DOI: 10.1016/j.jadohealth.2007.08.026] [Citation(s) in RCA: 200] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Revised: 08/16/2007] [Accepted: 08/29/2007] [Indexed: 11/26/2022]
Abstract
PURPOSE The role that sex education plays in the initiation of sexual activity and risk of teen pregnancy and sexually transmitted disease (STD) is controversial in the United States. Despite several systematic reviews, few epidemiologic evaluations of the effectiveness of these programs on a population level have been conducted. METHODS Among never-married heterosexual adolescents, aged 15-19 years, who participated in Cycle 6 (2002) of the National Survey of Family Growth and reported on formal sex education received before their first sexual intercourse (n = 1719), we compared the sexual health risks of adolescents who received abstinence-only and comprehensive sex education to those of adolescents who received no formal sex education. Weighted multivariate logistic regression generated population-based estimates. RESULTS Adolescents who received comprehensive sex education were significantly less likely to report teen pregnancy (OR(adj) = .4, 95% CI = .22- .69, p = .001) than those who received no formal sex education, whereas there was no significant effect of abstinence-only education (OR(adj) = .7, 95% CI = .38-1.45, p = .38). Abstinence-only education did not reduce the likelihood of engaging in vaginal intercourse (OR(adj) = .8, 95% CI = .51-1.31, p = .40), but comprehensive sex education was marginally associated with a lower likelihood of reporting having engaged in vaginal intercourse (OR(adj) = .7, 95% CI = .49-1.02, p = .06). Neither abstinence-only nor comprehensive sex education significantly reduced the likelihood of reported STD diagnoses (OR(adj) = 1.7, 95% CI = .57-34.76, p = .36 and OR(adj) = 1.8, 95% CI = .67-5.00, p = .24 respectively). CONCLUSIONS Teaching about contraception was not associated with increased risk of adolescent sexual activity or STD. Adolescents who received comprehensive sex education had a lower risk of pregnancy than adolescents who received abstinence-only or no sex education.
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Affiliation(s)
- Pamela K Kohler
- Department of Health Services, University of Washington, Seattle, Washington 98195-7660, USA
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325
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326
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Abstract
The 1994 International Conference on Population and Development held in Cairo recognized the centrality of reproductive health to human rights and development. Progress on the Cairo agenda has slowed for numerous reasons, however. The United States, once an enthusiastic promoter of this agenda and still the world's leading reproductive health donor, has revised its reproductive health policies radically since the 2000 presidential election of George W. Bush. This study examines how policies have been reconfigured in five key reproductive health areas, sparking controversy both in the United States and internationally. These categories are the content of sex education, access to emergency contraception and to abortion services, condom effectiveness, and HIV/AIDS prevention. The analysis presented here elucidates how ideological considerations have superseded public health and ethical concerns and reflects on health and ethical consequences.
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Affiliation(s)
- Andrzej Kulczycki
- Department of Maternal and Child Health, University of Alabama at Birmingham, 320 Ryals School of Public Health, 1665 University Boulevard, Birmingham, AL 35294-0022, USA.
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327
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Hoory T, Monie A, Gravitt P, Wu TC. Molecular Epidemiology of Human Papillomavirus. J Formos Med Assoc 2008; 107:198-217. [PMID: 18400605 DOI: 10.1016/s0929-6646(08)60138-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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328
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Winer RL, Feng Q, Hughes JP, O'Reilly S, Kiviat NB, Koutsky LA. Risk of female human papillomavirus acquisition associated with first male sex partner. J Infect Dis 2008; 197:279-82. [PMID: 18179386 DOI: 10.1086/524875] [Citation(s) in RCA: 175] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
To quantify the risk of human papillomavirus (HPV) acquisition associated with a first male sex partner and to identify associated risk factors, we analyzed data from women who were enrolled before or within 3 months of first intercourse with a male partner and were censored at the report of a second partner. The 1-year cumulative incidence of first HPV infection was 28.5% (95% confidence interval, 20.6%-38.6%) and increased to almost 50% by 3 years. The risk was increased when the first male partner was sexually experienced. Our results indicate a high risk of HPV infection in young women who have had just 1 male sex partner.
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Affiliation(s)
- Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, WA 98103, USA.
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329
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Abstract
Consistent condom use can reduce the spread of HIV, and Markus Steiner and Willard Cates believe condoms are the answer to other sexually transmitted infections. But Stephen Genuis argues that a more comprehensive approach is needed
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Affiliation(s)
- Markus J Steiner
- Family Health International, Research Triangle Park, NC 27709, USA
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330
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Cutts FT, Franceschi S, Goldie S, Castellsague X, de Sanjose S, Garnett G, Edmunds WJ, Claeys P, Goldenthal KL, Harper DM, Markowitz L. Human papillomavirus and HPV vaccines: a review. Bull World Health Organ 2008; 85:719-26. [PMID: 18026629 DOI: 10.2471/blt.06.038414] [Citation(s) in RCA: 211] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2006] [Accepted: 03/02/2007] [Indexed: 11/27/2022] Open
Abstract
Cervical cancer, the most common cancer affecting women in developing countries, is caused by persistent infection with "high-risk" genotypes of human papillomaviruses (HPV). The most common oncogenic HPV genotypes are 16 and 18, causing approximately 70% of all cervical cancers. Types 6 and 11 do not contribute to the incidence of high-grade dysplasias (precancerous lesions) or cervical cancer, but do cause laryngeal papillomas and most genital warts. HPV is highly transmissible, with peak incidence soon after the onset of sexual activity. A quadrivalent (types 6, 11, 16 and 18) HPV vaccine has recently been licensed in several countries following the determination that it has an acceptable benefit/risk profile. In large phase III trials, the vaccine prevented 100% of moderate and severe precancerous cervical lesions associated with types 16 or 18 among women with no previous infection with these types. A bivalent (types 16 and 18) vaccine has also undergone extensive evaluation and been licensed in at least one country. Both vaccines are prepared from non-infectious, DNA-free virus-like particles produced by recombinant technology and combined with an adjuvant. With three doses administered, they induce high levels of serum antibodies in virtually all vaccinated individuals. In women who have no evidence of past or current infection with the HPV genotypes in the vaccine, both vaccines show > 90% protection against persistent HPV infection for up to 5 years after vaccination, which is the longest reported follow-up so far. Vaccinating at an age before females are exposed to HPV would have the greatest impact. Since HPV vaccines do not eliminate the risk of cervical cancer, cervical screening will still be required to minimize cancer incidence. Tiered pricing for HPV vaccines, innovative financing mechanisms and multidisciplinary partnerships will be essential in order for the vaccines to reach populations in greatest need.
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Affiliation(s)
- F T Cutts
- Initiative for Vaccine Research, WHO, Geneva, Switzerland.
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331
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Mindel A, Sawleshwarkar S. Condoms for sexually transmissible infection prevention: politics versus science. Sex Health 2008; 5:1-8. [DOI: 10.1071/sh07054] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Accepted: 11/09/2007] [Indexed: 11/23/2022]
Abstract
The present review assesses the protection that condoms offer against sexually transmissible infections (STI) and the impact that social, political and religious opinion in the USA has had in the past 8 years on promoting condoms for safer sex. Condoms offer protection against most STI. However, the degree of protection depends on correct and consistent use, the type of sexual activity and the biological characteristics of different infections. Cross-sectional and case-control studies and other observational data provide the majority of evidence for STI prevention. Condoms provide a high level of protection against those infections that are transmitted mainly via infected secretions, including HIV, gonorrhoea, chlamydia and trichomoniasis. Protection against those infections transmitted via skin and mucous membrane contact, including Herpes simplex virus infection and human papilloma virus, appears to be less. The Bush administration, driven by conservative political, social and religious elements in the USA, has mounted a concerted campaign to undermine the role of the condom in health-promotion activities in the USA and overseas by undervaluing and misrepresenting scientific data, and through a sustained and well-funded promotion of abstinence-only education. However, this has lead to considerable controversy and disillusionment with abstinence-only education, both at home and abroad, and there is now incontrovertible evidence that abstinence-only programs are ineffectual.
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332
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Jennifer M, Sturpe DA, Khanna N. Human papillomavirus vaccine and cervical cancer prevention: Practice and policy implications for pharmacists. J Am Pharm Assoc (2003) 2008. [DOI: 10.1331/japha.2008.07032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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333
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Crosby R, Warner L. Pending research issues in male condom use promotion. Sex Health 2008; 5:317-9. [DOI: 10.1071/sh08080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Accepted: 10/30/2008] [Indexed: 11/23/2022]
Abstract
Sufficient evidence has accumulated to warrant the expansion of condom use research in several additional directions. Possible risk compensation pertaining to human papillomavirus vaccination and vaginal microbicides is one example. A second area of needed research involves the question of when couples can be advised to safely discontinue condom use given that ‘lifelong’ condom use is not a realistic goal for most people. A third example is intensified research designed to identify more effective means of mass marketing condoms and their use as a health-protective behaviour. As the AIDS and sexually transmissible infection pandemics persist, intensified condom promotion research is an ethical imperative.
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334
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Auslander BA, Perfect MM, Breitkopf DM, Succop PA, Rosenthal SL. Microbicides: Information, Beliefs, and Preferences for Insertion. J Womens Health (Larchmt) 2007; 16:1458-67. [DOI: 10.1089/jwh.2006.0190] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Beth A. Auslander
- Department of Pediatrics, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Michelle M. Perfect
- Department of Pediatrics, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Daniel M. Breitkopf
- Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Paul A. Succop
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Susan L. Rosenthal
- Department of Pediatrics, University of Texas Medical Branch at Galveston, Galveston, Texas
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335
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Abstract
This article reviews the current data on human papillomavirus as the cause of most cervical cancer cases, data on the recently approved human papillomavirus vaccines, and updated information concerning the Bethesda System for interpretation of Papanicolaou test results. Current recommendations for surgical treatment, concurrent chemotherapy, and radiation therapy and recent advances in systemic therapy for advanced or metastatic cervical cancer are reviewed.
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Affiliation(s)
- Harry J Long
- Division of Medical Oncology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
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336
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Affiliation(s)
- Peter Sasieni
- Centre for Epidemiology, Mathematics & Statistics, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London EC1M 6BQ, UK.
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337
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Prevention strategies against the human papillomavirus: The effectiveness of vaccination. Gynecol Oncol 2007; 107:S19-23. [DOI: 10.1016/j.ygyno.2007.07.068] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Accepted: 07/24/2007] [Indexed: 11/20/2022]
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338
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Rhodes SD, Hergenrather KC, Yee LJ, Wilkin AM, Clarke TL, Wooldredge R, Brown M, Davis AB. Condom acquisition and preferences within a sample of sexually active gay and bisexual men in the southern United States. AIDS Patient Care STDS 2007; 21:861-70. [PMID: 18240895 DOI: 10.1089/apc.2007.0027] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Health departments, community-based organizations (CBOs), and AIDS service organizations (ASOs) in the United States and abroad distribute large quantities of free condoms to sexually active individuals; however, little is known about where individuals who use condoms actually acquire them. This community-based participatory research (CBPR) study was designed to identify factors associated with the use of free condoms during most recent anal intercourse among self-identifying gay and bisexual men who reported condom use. Data were collected using targeted intercept interviewing during North Carolina Pride Festival events in Fall 2006, using the North Carolina Condom Acquisition and Preferences Assessment (NC-CAPA). Of the 606 participants who completed the assessment, 285 met the inclusion criteria. Mean age of participants was 33 (+/-10.8) years. The sample was predominantly white (80%), 50% reported being single or not dating anyone special, and 38% reported the use of free condoms during most recent anal intercourse. In multivariable analysis, participants who reported using free condoms during most recent anal sex were more likely to report increased age; dating someone special or being partnered; and having multiple male sexual partners in the past 3 months. These participants were less likely to report ever having had a sexually transmitted disease. Despite being in the third decade of the HIV epidemic, little is known about condom acquisition among, and condom preferences of, gay and bisexual men who use condoms. Although more research is needed, our findings illustrate the importance of free condom distribution.
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Affiliation(s)
- Scott D. Rhodes
- Section on Society and Health, Department of Social Sciences and Health Policy, Division of Public Health Sciences, Maya Angelou Research Center on Minority Health, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | - Kenneth C. Hergenrather
- Department of Counseling/Human Organizational Studies, The George Washington University, Washington, D.C
| | - Leland J. Yee
- Department of Epidemiology, Graduate School of Public Health and Division of Infectious Diseases, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Aimee M. Wilkin
- Section on Infectious Diseases, and Infectious Diseases Specialty Clinic, Department of Internal Medicine, Wake Forest University School of Medicine, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | | | | | - Monica Brown
- HIV/STD Program, Forsyth County Department of Public Health, Winston-Salem, North Carolina
| | - A. Bernard Davis
- North Carolina Department of Health and Human Service HIV/STD Branch, Raleigh, North Carolina
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339
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Peipert JF, Lapane KL, Allsworth JE, Redding CA, Blume JL, Lozowski F, Stein MD. Women at risk for sexually transmitted diseases: correlates of intercourse without barrier contraception. Am J Obstet Gynecol 2007; 197:474.e1-8. [PMID: 17714677 PMCID: PMC2175265 DOI: 10.1016/j.ajog.2007.03.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2006] [Revised: 12/06/2006] [Accepted: 03/12/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the correlates of vaginal intercourse without barrier contraception (unprotected intercourse). STUDY DESIGN Baseline data from a randomized trial were analyzed to evaluate factors that are associated with intercourse without barrier method use among women < 35 years old. Logistic regression models provided estimates of the association of demographic, reproductive, and sexual history variables with unprotected intercourse. RESULTS Intercourse without barrier contraception was common; 65% of participants had > or = 2 episodes of intercourse without barrier contraception use in the past month. Factors that were associated with increased odds of unprotected intercourse included the number of coital episodes, a male partner's unwillingness to use condoms (adjusted odds ratio, 4.1; 95% CI, 2.3-6.9), and, among women < 20 years old, low condom use self-efficacy score (adjusted odds ratio, 1.6; 95% CI, 1.0-2.9). CONCLUSION Risk factors for unprotected intercourse included coital frequency and the male partner's unwillingness to use condoms. Self-efficacy for condom use was especially important for women < 20 years old.
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Affiliation(s)
- Jeffrey F Peipert
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
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340
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Abstract
The sports medicine physician may face challenging issues regarding infectious diseases when dealing with teams or highly competitive athletes who have difficulties taking time off to recover. One must treat the individual sick athlete and take the necessary precautions to contain the spread of communicable disease to the surrounding team, staff, relatives, and other contacts. This article reviews preventive strategies for infectious disease in athletes, including immunization recommendations and prophylaxis guidelines, improvements in personal hygiene and prevention of spread of infectious organisms by direct contact, insect-borne disease precautions, and prevention of sexually transmitted diseases. A special emphasis on immunizations focuses on pertussis, influenza, and meningococcal prophylaxis.
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341
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Kim S, De La Rosa M, Trepka MJ, Kelley M. Condom use among unmarried students in a Hispanic-serving university. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2007; 19:448-461. [PMID: 17967114 DOI: 10.1521/aeap.2007.19.5.448] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This study compares the prevalence of risky sexual behavior between unmarried Hispanic and non-Hispanic students in southern Florida and assesses the role of substance use in risky sexual behavior. Among 815 unmarried respondents, approximately 35% had two or more sexual partners within the past 12 months. Compared with non-Hispanic White students, Hispanic students were less likely to engage in unprotected sex under the influence of alcohol (25% vs. 16%) but also less likely to have been tested for HIV infection (55% vs. 43%). The percentage of students using a condom during their last sexual encounter was 8% (oral), 35% (anal), and 50% (vaginal). For both Hispanic and non-Hispanic students, condom use was low regardless of smoking, heavy alcohol consumption, and marijuana use. From the problem behavior theory perspective, condom use and substance use may have different behavioral origins. These findings can help target and guide the development of prevention programs in university settings.
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Affiliation(s)
- Sunny Kim
- Department of Epidemiology and Biostatistics, School of Public Health, Florida International University, Miami, FL 33199, USA.
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342
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Short MB, Succop PA, Ugueto AM, Rosenthal SL. Predictors of using a microbicide-like product among adolescent girls. J Adolesc Health 2007; 41:357-62. [PMID: 17875461 PMCID: PMC2040129 DOI: 10.1016/j.jadohealth.2007.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Revised: 05/02/2007] [Accepted: 05/02/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE This study examined demographic, sexual history and weekly contextual variables, and perceptions about microbicides as predictors of microbicide-like product use. METHODS Adolescent girls (N = 208; 14-21 years) participated in a 6-month study in which they completed three face-to-face interviews and 24-weekly phone call interviews. Participants were given microbicide-like products (vaginal lubricants) and encouraged to use them with condoms when they had intercourse. RESULTS Of the girls, 75% had had a sexual opportunity to use the product. Using multi-variable logistic regression, the following variables independently predicted ever using the product: length of sexual experience, number of lifetime vaginal partners, and the Comparison to Condoms subscale on the Perceptions of Microbicides Scale. Using a mixed model repeated measure linear regression, the following variables independently predicted frequency of use: week of the study, age, condom frequency prior to the study, and three subscales on the Perceptions of Microbicide Scale: namely, the Comparison to Condoms subscale, the Negative Effects subscale, and the Pleasure subscale. CONCLUSION Most girls used the product, including those who were not protecting themselves with condoms. Girls' initial perceptions regarding the product predicted initial use and frequency of use. Further research should evaluate the best methods for supporting the use of these products by young or sexually less experienced girls.
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Affiliation(s)
- Mary B Short
- Department of Psychology, University of Houston-Clear Lake, Houston, Texas 77058, USA.
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343
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Grimshaw-Mulcahy LJ. Now I Know My STDs Part I: Viral STDs: Human Papilloma Virus, Genital Herpes, and Molluscum Contagiosum. J Nurse Pract 2007. [DOI: 10.1016/j.nurpra.2007.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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344
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Abstract
Cervical cancer is the second most common cancer in women worldwide, and knowledge regarding its cause and pathogenesis is expanding rapidly. Persistent infection with one of about 15 genotypes of carcinogenic human papillomavirus (HPV) causes almost all cases. There are four major steps in cervical cancer development: infection of metaplastic epithelium at the cervical transformation zone, viral persistence, progression of persistently infected epithelium to cervical precancer, and invasion through the basement membrane of the epithelium. Infection is extremely common in young women in their first decade of sexual activity. Persistent infections and precancer are established, typically within 5-10 years, from less than 10% of new infections. Invasive cancer arises over many years, even decades, in a minority of women with precancer, with a peak or plateau in risk at about 35-55 years of age. Each genotype of HPV acts as an independent infection, with differing carcinogenic risks linked to evolutionary species. Our understanding has led to improved prevention and clinical management strategies, including improved screening tests and vaccines. The new HPV-oriented model of cervical carcinogenesis should gradually replace older morphological models based only on cytology and histology. If applied wisely, HPV-related technology can minimise the incidence of cervical cancer, and the morbidity and mortality it causes, even in low-resource settings.
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Affiliation(s)
- Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
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345
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Ferenczy A, Franco EL. Prophylactic human papillomavirus vaccines: potential for sea change. Expert Rev Vaccines 2007; 6:511-25. [PMID: 17669006 DOI: 10.1586/14760584.6.4.511] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Persistent human papillomavirus (HPV) infection is the central cause in the development of anogenital warts, precancers and cancers of uterine cervix, and a major factor in the genesis of other malignancies of the lower anogenital and upper aerodigestive tracts. The burden of disease carries very high medical, financial and psychosocial costs. The role of prophylactic HPV vaccines in reducing the burden of disease is discussed in light of the results of multiple randomized, controlled trials conducted worldwide in thousands of young females. The review discusses some of the issues that are still unknown, with respect to long-term vaccine performance, challenges to be overcome to achieve universal, mass prophylactic HPV vaccination, as well as the potential impact of the vaccines on primary screening for, and management of, HPV-related anogenital infection and disease.
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Affiliation(s)
- Alex Ferenczy
- McGill University and The Sir Mortimer B. Davis - Jewish General Hospital, Montreal, Quebec, Canada.
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346
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347
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Jin F, Prestage GP, Kippax SC, Pell CM, Donovan B, Templeton DJ, Kaldor JM, Grulich AE. Risk factors for genital and anal warts in a prospective cohort of HIV-negative homosexual men: the HIM study. Sex Transm Dis 2007; 34:488-93. [PMID: 17108849 DOI: 10.1097/01.olq.0000245960.52668.e5] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to determine the prevalence, incidence, and risk factors for genital and anal warts in HIV-negative homosexual men in Sydney. STUDY DESIGN The authors conducted a prospective cohort study. Participants were asked whether they had had genital and anal warts at each interview. Details of lifetime sexual contacts and sexual behaviors in the last 6 months were collected. RESULTS Among 1,427 men recruited, 8.9% and 19.6% reported a history of genital and anal warts at baseline, respectively. Incidence rates for genital and anal warts were 0.94 and 1.92 per 100 person-years, respectively. In multivariate analysis, both incident genital and anal warts were associated with younger age. In addition, incident genital warts was associated with insertive fingering (P trend = 0.018), whereas incident anal warts was associated with insertive fingering (P trend = 0.007) and insertive fisting (P trend = 0.039). CONCLUSIONS Anal warts were twice as common as genital warts. Fingering and other manual sexual practices may be an important transmission route for both.
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Affiliation(s)
- Fengyi Jin
- National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Darlinghurst, New South Wales, Australia.
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348
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Boot HJ, Wallenburg I, de Melker HE, Mangen MJM, Gerritsen AAM, van der Maas NA, Berkhof J, Meijer CJLM, Kimman TG. Assessing the introduction of universal human papillomavirus vaccination for preadolescent girls in The Netherlands. Vaccine 2007; 25:6245-56. [PMID: 17630049 DOI: 10.1016/j.vaccine.2007.05.061] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Revised: 05/14/2007] [Accepted: 05/30/2007] [Indexed: 10/23/2022]
Abstract
A persistent infection with human papillomavirus (HPV) is a prerequisite for the development of cervical cancer. Clinical trials with HPV-vaccines have been very successful in preventing persistent HPV16/18 infections, the two most oncogenic HPV-genotypes. We assessed the introduction of universal HPV-vaccination for preadolescent girls in the Dutch National Immunization Programme. Long-term vaccine efficacy, the need and extent of a catch-up programme for young women, and the impact of vaccination on the cervical cancer screening programme are major unresolved issues. Preliminary conservative estimates (80% vaccine efficacy and no effects on the screening programme, transmission rate, non-cervical cancer incidence, and cross protection) predict an acceptable cost-effectiveness ratio for universal vaccination of preadolescent girls.
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Affiliation(s)
- Hein J Boot
- Laboratory for Infectious Diseases and Perinatal Screening, RIVM, Bilthoven, The Netherlands.
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349
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Abstract
Sexual health is defined in terms of well-being, but is challenged by the social, cultural and economic realities faced by women and men with HIV. A sexual rights approach puts women and men with HIV in charge of their sexual health. Accurate, accessible information to make informed choices and safe, pleasurable sexual relationships possible is best delivered through peer education and health professionals trained in empathetic approaches to sensitive issues. Young people with HIV especially need appropriate sex education and support for dealing with sexuality and self-identity with HIV. Women and men with HIV need condoms, appropriate services for sexually transmitted infections, sexual dysfunction and management of cervical and anogenital cancers. Interventions based on positive prevention, that combine protection of personal health with avoiding HIV/STI transmission to partners, are recommended. HIV counselling following a positive test has increased condom use and decreased coercive sex and outside sexual contacts among discordant couples. HIV treatment and care have reduced stigma and increased uptake of HIV testing and disclosure of positive status to partners. High adherence to antiretroviral therapy and safer sexual behaviour must go hand-in-hand. Sexual health services have worked with peer educators and volunteer groups to reach those at higher risk, such as sex workers. Technological advances in diagnosis of STIs, microbicide development and screening and vaccination for human papillomavirus must be available in developing countries and for those with the highest need globally.
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350
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Condoms. REPRODUCTIVE HEALTH MATTERS 2007. [DOI: 10.1016/s0968-8080(07)29291-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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