The purpose of this study was to examine the attitudes about hypothetical human papillomavirus (HPV) vaccines in two groups of women in clinical settings. Twenty adolescent women attending an urban community adolescent health clinic and 20 adult women attending a city health department sexually transmitted disease (STD) clinic were recruited to participate in individual interviews. Adolescents were 14-18 years of age (mean 15.6), 75% nonHispanic white, and 75% sexually experienced. Adults were 20-50 years of age (mean 33.6), 95% African American, and all were sexually experienced. As part of the interview, participants ranked nine hypothetical HPV vaccines in order of acceptability. Each vaccine was uniquely defined as a function of cost ($150, $50, or free), efficacy (50% or 90%), disease targeted (genital warts, cervical cancer, or both), and physician recommendation (not mentioned by a physician or specifically recommended). Rankings by adolescents and adults were highly concordant (Spearman rho = 0.9). Efficacy, physician's recommendation, and cost influenced rankings most strongly. Ranking decisions were often based on complex decision making, in which all characteristics were considered simultaneously. These findings suggest that certain features of an HPV vaccine might significantly affect vaccine acceptability. Vaccine efficacy, physician endorsement, and cost were particularly salient issues.
Pacific Islanders face many health disparities, including higher rates of cardiovascular disease, cancer, obesity, and diabetes compared to other racial and ethnic groups. Specifically, the Marshallese population suffers disproportionately from type 2 diabetes, with rates 400% higher than the general US population. As part of an ongoing community-based participatory research (CBPR) partnership, 148 participants were recruited for a study examining genetic variants to better understand diabetes. Participants provided a saliva specimen in an Oragene® DNA self-collection kit. Each participant provided approximately 2 mL volume of saliva and was asked qualitative questions about their experience. The study yielded a recruitment rate of 95.5%. Among the 148 persons who participated, 143 (96.6%) agreed to be contacted for future studies; 142 (95.9%) agreed to have their samples used for future IRB-approved studies; and 144 (97.3%) gave permission for the researchers to link information from this study to other studies in which they had participated. Qualitative responses showed that the majority of participants were willing to participate because of their desire to contribute to the health of their community and to understand the genetic influence related to diabetes. This study demonstrates willingness to participate in genetic research among Marshallese living in Arkansas. Willingness was likely enhanced because the feasibility study was part of a larger CBPR effort. This study is important to community stakeholders who have voiced a desire to collaboratively conduct genetic research related to diabetes, perinatal outcomes, and cancer.
Given the high prevalence of HPV infection among young women with mostly single-type infection, and the fact that type-specific HPV screening is not recommended prior to the administration of the quadrivalent HPV vaccine, our data suggest the importance of widespread,rather than targeted, immunisation.
To investigate potential links between environmental exposure to petrochemical plant emissions and lung cancer, a population-based case-control study (LMRICS) was conducted in eleven Louisiana parishes bordering the Mississippi River. Cases and age, gender, and race-matched controls were interviewed regarding potential risk factors. Residential history was geocoded to provide indices of long-term proximity to industrial sites. Cases were more likely to have lived near a petrochemical site. Models adjusted for other risk factors, however, showed small or no association with lung cancer (odds ratio for residence within a half-mile of a site = 1.10, 95% confidence interval 0.58–2.08). While associations were strongest for exposures exceeding 15 years, none approached statistical significance and there was no clear dose-response across exposure duration, distance categories, or when sites were grouped according to carcinogenicity rating of chemical releases. Residential proximity to petrochemical plants along the lower Mississippi thus showed no significant association with lung cancer.
Background and aims
Infection with high‐risk (HR) genotypes of the human papillomavirus (HPV) is necessary for and causative of almost all cervical cancers and their precursor condition, cervical intraepithelial neoplasia. These conditions have been sharply reduced by cervical cytology screening, and a further decrease is expected because of the recent introduction of prophylactic HPV vaccinations. While significant attention has been given to gynecologic HPV disease, men can be affected by HPV‐related cancers of the anus, penis, and oropharynx. This literature review aims to address disparities in HPV‐related disease in men, and certain HR male subpopulations, compared with women.
Discussion
Overall, immunocompetent men are far less likely than women to develop anogenital HPV‐related cancers, despite harboring HR HPV infections at anogenital sites. On the other hand, men who have sex with men and men living with human immunodeficiency virus infection are at considerably higher risk of HPV‐related disease. Historic rates of prophylactic HPV vaccination in males have trailed those of females due to numerous multilevel factors, although, in recent years, this sex gap in vaccination coverage has been closing. In the absence of routine HPV screening in males, therapeutic vaccinations have emerged as a potential treatment modality for preinvasive neoplasia and are in various phases of clinical testing.
Conclusion
Successful reductions in HPV disease morbidity at the population level must acknowledge and target HPV infections in men.
Noninvasive sampling of genital skin to identify individuals with subclinical HPV infection remains a challenge. Future studies should involve the use of more abrasive sampling devices (such as cytobrushes), perhaps combined with some type of soap to dislodge more epithelial cells.
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