Australia has provided free quadrivalent HPV vaccine to 12- to 18-year-old girls through a school-based program since April 2007 and to women age 26 and younger through general medical practices since July 2007. To determine if the program has had a population impact on presentations of genital warts, the researchers undertook a retrospective study comparing the proportion of new clients with genital warts attending Melbourne Sexual Health Center from January 2004 to December 2008.
During the study period, the center saw 36,055 new clients and 3,826 were diagnosed with genital warts (10.6 percent; 95 percent confidence interval [CI] 10.3 to 10.9). The proportion of women younger than 28 diagnosed with warts fell by 25.1 percent (95 percent CI 30.5 percent to 19.3 percent) per quarter in 2008. Comparing this decline to a negligible increase of 1.8 percent (95 percent CI 0.2 percent to 3.4 percent) per quarter from the start of 2004 to the end of 2007, also in women under 28, generates strong evidence of a difference in these two trends (p less than 0.001).
“There was no evidence of a difference in trend for the quarterly proportions before and after the end of 2007 for any other subgroup, and on only one occasion was there strong evidence of a trend different to zero, for heterosexual men in 2008 in whom the average quarterly change was a decrease of 5 percent (95 percent CI 0.5 percent to 9.4 percent; p=0.031).
“The data suggest that a rapid and marked reduction in the incidence of genital warts among vaccinated women may be achievable through an HPV vaccination program targeting women, and supports some benefit being conferred to heterosexual men,” the authors concluded.
[Article source: http://sti.bmj.com/]
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UNITED STATES: Association of Sexual Abuse with Incident High-Risk Human Papillomavirus Infection Among Young African-American Women
“Noticeably absent from the known risk factors for HPV is history of sexual abuse,” wrote the study researchers, who sought to examine the association between incident high-risk HPV infection and sexual abuse in young adult black women.
A longitudinal study was performed as part of a larger HIV/STD randomized controlled behavioral trial that randomly recruited eligible participants from October 2002 through March 2006. At baseline and 12-month follow-up, 665 females ages 18-29 completed a survey assessing known HPV risk factors and sexual abuse history. Specimens were assayed for high-risk HPV. Incident infection was defined as laboratory confirmed high-risk HPV infection at follow-up after testing negative at baseline.
Among participants, high-risk HPV prevalence was 38.9 percent. Sexual abuse occurring during the 12-month follow-up and the acquisition of high-risk HPV types were examined via age-stratified multiple regression analyses, and known HPV risk factors were entered as covariates. Those ages 18-24 with a history of sexual abuse in the past year, compared with participants without a history, were 4.5 times more likely to test positive for an incident high-risk HPV infection (p<0.007). However, this relationship was not significant for the overall sample or for women ages 25-29.
“This is one of the first analyses demonstrating exposure to sexual abuse as a predictor of high-risk HPV,” concluded the researchers. “HPV vaccination recommendations for black women 18 to 24 years of age with a history of sexual abuse warrant special consideration.”
[Article source: http://www.stdjournal.com]
UNITED STATES: African-American Women Leaders Urge Obama to Target Black Women in National AIDS Strategy
African-American women in leadership positions in business, academia, media, and other fields gathered last month at a conference in Washington to discuss how the National AIDS Strategy (NAS) could best address the specific needs of black women. HIV/AIDS is the leading cause of death for African-American women ages 25-34, but these women are “rarely focused on as a group,” said the coalition, which was organized by the National Black Leadership Commission on AIDS (NBLCA).
African Americans “remain notably absent from public policy and resource-allocation decisions affecting communities of African descent nationwide,” said C. Virginia Fields, NBLCA’s president and CEO.
The women made NAS policy recommendations that fell under three broad themes: reducing HIV incidence, expanding access to care, and reducing HIV-related health disparities. Their suggestions were:
*Create a surveillance system that includes social determinants relating to HIV incidence.
*Integrate efforts addressing domestic violence, substance abuse and mental health.
*Create a clear marketing plan so African-American women see themselves in the HIV/AIDS epidemic.
*Develop and support public campaigns that encourage women’s participation in service programs.
*Provide mobile health care services for underserved communities.
*Encourage “cross-fertilization” among federal offices that address the same populations, and encourage those programs to solicit input from African-American women.
*Conform resource allocation to the epidemic’s realities, including by offering HIV testing in non-traditional settings.
*Develop programs to address issues including stigma, addiction and gender identity.
[Article source: http://www.stlamerican.com]
AUSTRALIA: Tripling in Chlamydia Rate Prompts Demand for National Testing
A tripling of the annual number of Australians diagnosed with chlamydia has health officials calling for a national screening program. In 2009, more than 61,000 people were diagnosed with the STD, compared with 17,000 in 2000.
“The fact that there has been no public outcry about this is absolutely astounding,” said Anthony Smith, deputy director of the Australian Research Center in Sex, Health and Society.
In 1987, a hard-hitting health promotion campaign in Australia represented HIV as the grim reaper, mowing down people as they stood like pins in a bowling alley. The graphic commercial was credited with boosting awareness of STDs and increasing condom use.
“We have a whole generation now who never saw the grim reaper,” Smith said, offering an explanation for what he considers complacency around the issue.
“If it hadn’t been for HIV, which resulted in a massive increase in the use of condoms among young heterosexuals, we would have had this epidemic a decade ago, so it is not as if this wasn’t expected,” Smith said.
Other public health officials suggested that the increase in reported cases of chlamydia signals the effectiveness of Australia’s health promotion efforts.
“Reports of infections always rise during safe-sex promotions, an indication that more people are getting the message and are being tested, and perhaps those they have had sex with are also getting tested,” said Chris Bourne, senior staff specialist at the Sydney Sexual Health Center.
[Article source: http://www.smh.com.au]
