Protecting Women Against Human Papillomavirus: Benefits, Barriers, and Evidence-Based Strategies to Increase Vaccine Uptake

Abstract

Human papillomavirus (HPV) infection significantly impacts women, as it can cause cancers and precancers of the cervix, vulva, vagina, oropharynx, and anus. However, many of these cancers can be prevented by HPV vaccination. Despite evidence of vaccine effectiveness and safety, vaccination rates remain low. Evidence-based strategies should be utilized to reduce barriers and increase vaccination rates. Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Approximately 85% of sexually active women and 91% of sexually active men will be infected with HPV in their lifetime [1]. Approximately half of new infections occur among individuals aged 15-24 years [2]. Though genital skin contact is the primary mode of transmission, the infection does not require sexual penetration [3]. The most common symptom of HPV infection is genital warts, although many infected people are asymptomatic, and the virus often resolves on its own. Physicians diagnosed over 400,000 cases of genital warts in 2013 [4]. However, the most serious consequence of HPV infection is cancer.HPV infection is known to cause cervical, vulvar, and vaginal cancer in women and penile cancer in men. It is also an attributable cause of anal and oropharyngeal cancer in both men and women. Between 1993 and 2005, HPV was linked to 90.6% of all cervical cancer cases, 70.1% of oropharyngeal cancers, and 91.1% of anal cancers in the United States [5].HPV-related cancers disproportionately affect women in the United States. There are 17,600 women affected by HPVrelated cancers annually; of those, approximately 11,000 are cervical cancer diagnoses [5]. In comparison, 9,300 men are affected by HPV-attributable cancer each year [5]. Women also have a higher prevalence of anal cancer than men (2,600 cases versus 1,400 cases annually). However, men have a higher prevalence of oropharyngeal cancer than women (7,200 cases versus 1,800 cases annually) [5]. Among women, the incidence of cervical cancer disproportionately affects African Americans and Latinas, who are more likely to be diagnosed with cervical cancer and have higher cervical cancer mortality rates than whites (see Table 1). Delayed diagnosis is a major contributor to this disparity [6]. White women have higher rates of HPV-associated anal and vulvar cancer than black and Latina women [6].The first HPV vaccine available in the United States, the quadrivalent HPV vaccine (4vHPV), was licensed in 2006 for females aged 9-26 years, although administration was routinely recommended at ages 11-12 years (prior to the onset of sexual activity for most adolescents) [7]. 4vHPV was approved for males permissively in 2009 for genital wart prevention and was recommended routinely for males in 2011, at which time 4vHPV was licensed by the US Food and Drug Administration for the prevention of anal cancer in both males and females [8]. The bivalent HPV vaccine (2vHPV) for cervical cancer prevention and the nonavalent HPV vaccine (9vHPV) were introduced in 2009 and 2014, respectivel...

Increasing Women’s Knowledge about HPV Using BERT Text Summarization: An Online Randomized Study

“…HPV is the most common sexually transmitted infection that causes cervical cancer. It contributes to 17,600 known cases of cervical cancer in women annually [46,47]. While HPV vaccination, early detection, and treatment of this virus can help women prevent its longterm and life-threatening effects, few women have the necessary knowledge and awareness to do so.…”

Adolescent human papillomavirus vaccination in the United States: Opportunities for integrating pharmacies into the immunization neighborhood

“…1 Another important parental barrier that has been well-documented is the fear that HPV vaccination may condone or lead to more promiscuous sexual behaviors in sons and daughters. 29 Though these thought processes present a significant challenge to immunizing clinicians, it should be noted and communicated to parents that there have been several studies which found no link between HPV vaccination and an increase in or risky sexual behavior, [30][31][32][33] and no evidence has been found to date which establishes any correlation. 34 Although parental barriers have been extremely well documented in the literature, the methodology of most studies designed to reveal these barriers still leave questions and gaps in the full picture of poor vaccine uptake.…”

HPV vaccine promotion: Snapshot of two health departments during the COVID‐19 pandemic

“…The quadrivalent HPV (4vHPV) vaccine was licensed and became available in the United States in 2006 for females, in 2009 for males to prevent genital warts, and in 2011, recommended routinely for males (Coyne‐Beasley & Hochwalt, 2016; Petrosky et al., 2015). In 2009, the bivalent HPV vaccine (2vHPV) became available for cervical cancer prevention (FDA, 2009) and in 2014, the nonavalent HPV vaccine (9vHPV) was introduced (Petrosky et al., 2015).…”

“…In 2009, the bivalent HPV vaccine (2vHPV) became available for cervical cancer prevention (FDA, 2009) and in 2014, the nonavalent HPV vaccine (9vHPV) was introduced (Petrosky et al., 2015). The goal of 4vHPV is to protect against genital warts and cervical cancer, and both 4vHPV and 9vHPV protect against vaginal, vulvar, and anal cancer (Coyne‐Beasley & Hochwalt, 2016). It is recommended that a series of two shots should be administered to those 9–14 years of age and a series of three shots should be administered to those 15–26 years of age (ACOG, 2017).…”