Cervical, anal and oral hpv in an adolescent inner-city health clinic providing free vaccinations

Nicolas F. Schlecht, Robert D. Burk, Anne Nucci-Sack, Shankar Viswanathan, Ken Peake, Elizabeth Lorde-Rollins, Richard Porter, Lourdes Oriana Linares, Mary Rojas, Howard Strickler, Angela Diaz

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objectives: Published human papillomavirus (HPV) vaccine trials indicate efficacy is strongest for those naive to the vaccine-types. However, few high-risk young women have been followed and cervical HPV has been the predominant outcome measure. Methods: We collected cervical and anal swabs, as well as oral rinse specimens from 645 sexually active inner-city young females attending a large adolescent health-clinic in New York City that offers free care and HPV vaccination. Specimens were tested for HPV-DNA using a MY09/MY11-PCR system. Type-specific prevalence of HPV at each anatomic site was compared for individuals by vaccination dose using generalized estimating equation logistic regression models. Results: The majority of subjects reported being of non-Caucasian (92%) and/or Hispanic ethnicity (61%). Median age was 18 years (range:14-20). All had practiced vaginal sex, a third (33%) practiced anal sex, and most (77%) had also engaged in oral sex. At enrollment, 21% had not received the vaccine and 51% had received three doses. Prevalent HPV infection at enrollment was detected in 54% of cervical, 42% of anal and 20% of oral specimens, with vaccine types present in 7%, 6% and 1% of specimens, respectively. Comparing prevalence for vaccine types, the detection of HPV in the cervix of vaccinated compared to unvaccinated adolescents was significantly reduced: HPV6/11 (odds ratio [OR] = 0.19, 95%CI:0.06-0.75), HPV16 (OR = 0.31, 95%CI:0.11-0.88) and HPV18 (OR = 0.14, 95%CI:0.03-0.75). For anal HPV, the risk of detecting vaccine types HPV6/11 (OR = 0.27, 95%CI:0.10-0.72) and HPV18(OR = 0.12, 95%CI:0.01-1.16) were significantly reduced for vaccinated adolescents however, the risk for HPV16 was not significantly decreased (OR = 0.63, 95%CI:0.18-2.20). Conclusion: HPV Prevalence is extremely high in inner-city female adolescents. Administration of the HPV vaccine reduced the risk for cervical HPV; however continued follow-up is required to assess the protection for HPV at all sites in young women with high exposure.

Original languageEnglish (US)
Article numbere37419
JournalPLoS One
Volume7
Issue number5
DOIs
StatePublished - May 18 2012

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Papillomaviridae
Papillomavirus Vaccines
mouth
Vaccination
Vaccines
vaccination
Health
Odds Ratio
odds ratio
vaccines
Logistics
Sexual Behavior
Logistic Models
gender
DNA
Papillomavirus Infections
Hispanic Americans
Cervix Uteri
cervix
dosage

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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Cervical, anal and oral hpv in an adolescent inner-city health clinic providing free vaccinations. / Schlecht, Nicolas F.; Burk, Robert D.; Nucci-Sack, Anne; Viswanathan, Shankar; Peake, Ken; Lorde-Rollins, Elizabeth; Porter, Richard; Linares, Lourdes Oriana; Rojas, Mary; Strickler, Howard; Diaz, Angela.

In: PLoS One, Vol. 7, No. 5, e37419, 18.05.2012.

Research output: Contribution to journalArticle

Schlecht, NF, Burk, RD, Nucci-Sack, A, Viswanathan, S, Peake, K, Lorde-Rollins, E, Porter, R, Linares, LO, Rojas, M, Strickler, H & Diaz, A 2012, 'Cervical, anal and oral hpv in an adolescent inner-city health clinic providing free vaccinations', PLoS One, vol. 7, no. 5, e37419. https://doi.org/10.1371/journal.pone.0037419
Schlecht, Nicolas F. ; Burk, Robert D. ; Nucci-Sack, Anne ; Viswanathan, Shankar ; Peake, Ken ; Lorde-Rollins, Elizabeth ; Porter, Richard ; Linares, Lourdes Oriana ; Rojas, Mary ; Strickler, Howard ; Diaz, Angela. / Cervical, anal and oral hpv in an adolescent inner-city health clinic providing free vaccinations. In: PLoS One. 2012 ; Vol. 7, No. 5.
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abstract = "Objectives: Published human papillomavirus (HPV) vaccine trials indicate efficacy is strongest for those naive to the vaccine-types. However, few high-risk young women have been followed and cervical HPV has been the predominant outcome measure. Methods: We collected cervical and anal swabs, as well as oral rinse specimens from 645 sexually active inner-city young females attending a large adolescent health-clinic in New York City that offers free care and HPV vaccination. Specimens were tested for HPV-DNA using a MY09/MY11-PCR system. Type-specific prevalence of HPV at each anatomic site was compared for individuals by vaccination dose using generalized estimating equation logistic regression models. Results: The majority of subjects reported being of non-Caucasian (92{\%}) and/or Hispanic ethnicity (61{\%}). Median age was 18 years (range:14-20). All had practiced vaginal sex, a third (33{\%}) practiced anal sex, and most (77{\%}) had also engaged in oral sex. At enrollment, 21{\%} had not received the vaccine and 51{\%} had received three doses. Prevalent HPV infection at enrollment was detected in 54{\%} of cervical, 42{\%} of anal and 20{\%} of oral specimens, with vaccine types present in 7{\%}, 6{\%} and 1{\%} of specimens, respectively. Comparing prevalence for vaccine types, the detection of HPV in the cervix of vaccinated compared to unvaccinated adolescents was significantly reduced: HPV6/11 (odds ratio [OR] = 0.19, 95{\%}CI:0.06-0.75), HPV16 (OR = 0.31, 95{\%}CI:0.11-0.88) and HPV18 (OR = 0.14, 95{\%}CI:0.03-0.75). For anal HPV, the risk of detecting vaccine types HPV6/11 (OR = 0.27, 95{\%}CI:0.10-0.72) and HPV18(OR = 0.12, 95{\%}CI:0.01-1.16) were significantly reduced for vaccinated adolescents however, the risk for HPV16 was not significantly decreased (OR = 0.63, 95{\%}CI:0.18-2.20). Conclusion: HPV Prevalence is extremely high in inner-city female adolescents. Administration of the HPV vaccine reduced the risk for cervical HPV; however continued follow-up is required to assess the protection for HPV at all sites in young women with high exposure.",
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AU - Viswanathan, Shankar

AU - Peake, Ken

AU - Lorde-Rollins, Elizabeth

AU - Porter, Richard

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AU - Rojas, Mary

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AU - Diaz, Angela

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N2 - Objectives: Published human papillomavirus (HPV) vaccine trials indicate efficacy is strongest for those naive to the vaccine-types. However, few high-risk young women have been followed and cervical HPV has been the predominant outcome measure. Methods: We collected cervical and anal swabs, as well as oral rinse specimens from 645 sexually active inner-city young females attending a large adolescent health-clinic in New York City that offers free care and HPV vaccination. Specimens were tested for HPV-DNA using a MY09/MY11-PCR system. Type-specific prevalence of HPV at each anatomic site was compared for individuals by vaccination dose using generalized estimating equation logistic regression models. Results: The majority of subjects reported being of non-Caucasian (92%) and/or Hispanic ethnicity (61%). Median age was 18 years (range:14-20). All had practiced vaginal sex, a third (33%) practiced anal sex, and most (77%) had also engaged in oral sex. At enrollment, 21% had not received the vaccine and 51% had received three doses. Prevalent HPV infection at enrollment was detected in 54% of cervical, 42% of anal and 20% of oral specimens, with vaccine types present in 7%, 6% and 1% of specimens, respectively. Comparing prevalence for vaccine types, the detection of HPV in the cervix of vaccinated compared to unvaccinated adolescents was significantly reduced: HPV6/11 (odds ratio [OR] = 0.19, 95%CI:0.06-0.75), HPV16 (OR = 0.31, 95%CI:0.11-0.88) and HPV18 (OR = 0.14, 95%CI:0.03-0.75). For anal HPV, the risk of detecting vaccine types HPV6/11 (OR = 0.27, 95%CI:0.10-0.72) and HPV18(OR = 0.12, 95%CI:0.01-1.16) were significantly reduced for vaccinated adolescents however, the risk for HPV16 was not significantly decreased (OR = 0.63, 95%CI:0.18-2.20). Conclusion: HPV Prevalence is extremely high in inner-city female adolescents. Administration of the HPV vaccine reduced the risk for cervical HPV; however continued follow-up is required to assess the protection for HPV at all sites in young women with high exposure.

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