An overview of implementing an evidence based program to increase HPV vaccination in HIV community clinics

Jessica Wells, James L Klosky, Yuan Liu, Theresa Wicklin Gillespie, Jessica Wells, James L Klosky, Yuan Liu, Theresa Wicklin Gillespie

Abstract

Background: HPV-related anal cancer occurs in excess rates among people living with HIV (PLWH) and has been increasing in incidence. The HPV vaccine is an effective and safe approach to prevent and reduce the risk of HPV-related disease. Yet, HPV vaccine programs tailored and implemented in the HIV population are lagging for this high-risk group.

Methods: A pre-post intervention study design will be used to tailor, refine, and implement the 4 Pillars™ Practice Transformation Program to increase HPV vaccination among PLWH. Guided by the RE-AIM framework, the CHAMPS study will provide training and motivation to HIV providers and clinic staff to recommend and administer the HPV vaccination within three HIV clinics in Georgia. We plan to enroll 365 HIV participants to receive HPV education, resources, and reminders for HPV vaccination. Sociodemographic, HPV knowledge, and vaccine hesitancy will be assessed as mediators and moderators for HPV vaccination. The primary outcome will be measured as an increase in uptake rate in initiation of the HPV vaccine and vaccine completion (secondary outcome) compared to historical baseline vaccination rate (control).

Discussion: The proposed study is a novel approach to address a serious and preventable public health problem by using an efficacious, evidence-based intervention on a new target population. The findings are anticipated to have a significant impact in the field of improving cancer outcomes in a high-risk and aging HIV population.

Trial registration: NCT05065840; October 4, 2021.

Keywords: HIV; HPV vaccination; Implementation.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Schematic overview of the CHAMPS study
Fig. 2
Fig. 2
Summary of study assessments and time of collection

References

    1. Khandwala P, Singhal S, Desai D, Parsi M, Potdar R. HIV-Associated Anal Cancer. Cureus. 2021;13(5):e14834.
    1. Silverberg MJ, Lau B, Justice AC, Engels E, Gill MJ, Goedert JJ, et al. Risk of anal cancer in HIV-infected and HIV-uninfected individuals in North America. Clin Infect Dis. 2012;54(7):1026–1034. doi: 10.1093/cid/cir1012.
    1. De Vuyst H, Clifford GM, Nascimento MC, Madeleine MM, Franceschi S. Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta analysis. Int J Cancer. 2009;124(7):1626–1636. doi: 10.1002/ijc.24116.
    1. Shrestha S, Sudenga SL, Smith JS, Bachmann LH, Wilson CM, Kempf MC. The impact of highly active antiretroviral therapy on prevalence and incidence of cervical human papillomavirus infections in HIV-positive adolescents. BMC Infect Dis. 2010;10(1):295. doi: 10.1186/1471-2334-10-295.
    1. Giuliano AR, Palefsky JM, Goldstone S, Moreira ED, Jr, Penny ME, Aranda C, et al. Efficacy of quadrivalent HPV vaccine against HPV infection and disease in males. N Engl J Med. 2011;364(5):401–411. doi: 10.1056/NEJMoa0909537.
    1. Palefsky JM, Gillison ML, Strickler HD. HPV vaccines in immunocompromised women and men. Vaccine. 2006;24:S140–S1S6. doi: 10.1016/j.vaccine.2006.05.120.
    1. Kahn JA, Xu J, Kapogiannis BG, Rudy B, Gonin R, Liu N, et al. Immunogenicity and safety of the human papillomavirus 6, 11, 16, 18 vaccine in HIV-infected young women. Clin Infect Dis. 2013;57(5):735–744. doi: 10.1093/cid/cit319.
    1. Wilkin T, Lee JY, Lensing SY, Stier EA, Goldstone SE, Berry JM, et al. Safety and immunogenicity of the quadrivalent human papillomavirus vaccine in HIV-1-infected men. J Infect Dis. 2010;202(8):1246–1253. doi: 10.1086/656320.
    1. Palefsky JM, Giuliano AR, Goldstone S, Moreira ED, Jr, Aranda C, Jessen H, et al. HPV vaccine against anal HPV infection and anal intraepithelial neoplasia. N Engl J Med. 2011;365(17):1576–1585. doi: 10.1056/NEJMoa1010971.
    1. Meites E, Markowitz LE, Paz-Bailey G, Oster AM, Group NS HPV vaccine coverage among men who have sex with men–national HIV behavioral surveillance system, United States, 2011. Vaccine. 2014;32(48):6356–6359. doi: 10.1016/j.vaccine.2014.09.033.
    1. Cummings T, Kasting ML, Rosenberger JG, Rosenthal SL, Zimet GD, Stupiansky NW. Catching up or missing out? Human papillomavirus vaccine acceptability among 18- to 26-year-old men who have sex with men in a US National Sample. Sex Transm Dis. 2015;42(11):601–606. doi: 10.1097/OLQ.0000000000000358.
    1. Nadarzynski T, Smith H, Richardson D, Pollard A, Llewellyn C. Perceptions of HPV and attitudes towards HPV vaccination amongst men who have sex with men: a qualitative analysis. Br J Health Psychol. 2017;22(2):345–361. doi: 10.1111/bjhp.12233.
    1. Reiter PL, Brewer NT, McRee A-L, Gilbert P, Smith JS. Acceptability of HPV vaccine among a national sample of gay and bisexual men. Sex Transm Dis. 2010;37(3):197. doi: 10.1097/OLQ.0b013e3181bf542c.
    1. FDA approves expanded use of Gardasil 9 to include individuals 27 through 45 years old [press release]. 2018.
    1. Markowitz LE, Dunne EF, Saraiya M, Chesson HW, Curtis CR, Gee J, et al. Human papillomavirus vaccination: recommendations of the advisory committee on immunization practices (ACIP) MMWR Recomm Rep. 2014;63(5):1–30.
    1. Abdool Karim SS, Passmore JS, Baxter C. The microbiome and HIV prevention strategies in women. Curr Opin HIV AIDS. 2018;13(1):81–87. doi: 10.1097/COH.0000000000000431.
    1. Nowalk MP, Moehling KK, Zhang S, Raviotta JM, Zimmerman RK, Lin CJ. Using the 4 pillars™ to increase vaccination among high-risk adults: who benefits? Am J Manag Care. 2017;23(11):651.
    1. Zimmerman RK, Brown AE, Pavlik VN, Moehling KK, Raviotta JM, Lin CJ, et al. Using the 4 pillars practice transformation program to increase pneumococcal immunizations for older adults: a cluster-randomized trial. J Am Geriatr Soc. 2017;65(1):114–122. doi: 10.1111/jgs.14451.
    1. Zimmerman RK, Moehling KK, Lin CJ, Zhang S, Raviotta JM, Reis EC, et al. Improving adolescent HPV vaccination in a randomized controlled cluster trial using the 4 pillars™ practice transformation program. Vaccine. 2017;35(1):109–117. doi: 10.1016/j.vaccine.2016.11.018.
    1. Zimmerman RK, Raviotta JM, Nowalk MP, Moehling KK, Reis EC, Humiston SG, et al. Using the 4 pillars™ practice transformation program to increase adolescent human papillomavirus, meningococcal, tetanus-diphtheria-pertussis and influenza vaccination. Vaccine. 2017;35(45):6180–6186. doi: 10.1016/j.vaccine.2017.09.039.
    1. Apaydin KZ, Fontenot HB, Shtasel D, Dale SK, Borba CP, Lathan CS, et al. Facilitators of and barriers to HPV vaccination among sexual and gender minority patients at a Boston community health center. Vaccine. 2018;36(26):3868–3875. doi: 10.1016/j.vaccine.2018.02.043.
    1. Gorbach PM, Cook R, Gratzer B, Collins T, Parrish A, Moore J, et al. Human papillomavirus vaccination among young men who have sex with men and transgender women in 2 US cities, 2012–2014. Sex Transm Dis. 2017;44(7):436. doi: 10.1097/OLQ.0000000000000626.
    1. Klosky JL, Hudson MM, Chen Y, Connelly JA, Wasilewski-Masker K, Sun C-L, et al. Human papillomavirus vaccination rates in young cancer survivors. J Clin Oncol. 2017;35(31):3582. doi: 10.1200/JCO.2017.74.1843.
    1. Reiter PL, Katz ML, Bauermeister JA, Shoben AB, Paskett ED, McRee A-L. Recruiting young gay and bisexual men for a human papillomavirus vaccination intervention through social media: the effects of advertisement content. JMIR Public Health Surveill. 2017;3(2):e33. doi: 10.2196/publichealth.7545.
    1. Subasinghe AK, Nguyen M, Wark JD, Tabrizi SN, Garland SM. Targeted Facebook advertising is a novel and effective method of recruiting participants into a human papillomavirus vaccine effectiveness study. JMIR Res Protocols. 2016;5(3):e154. doi: 10.2196/resprot.5679.
    1. Wells JS, Flowers L, Paul S, Nguyen ML, Sharma A, Holstad M. Knowledge of anal cancer, anal cancer screening, and hpv in hiv-positive and high-risk hiv-negative women. J Cancer Educ. 2020;35(3):606–615. doi: 10.1007/s13187-019-01503-8.
    1. York JM, Klosky JL, Chen Y, Connelly JA, Wasilewski-Masker K, Giuliano AR, et al. Patient-level factors associated with lack of health care provider recommendation for the human papillomavirus vaccine among young Cancer survivors. J Clin Oncol. 2020;38(25):2892–2901. doi: 10.1200/JCO.19.02026.
    1. Rand CM, Vincelli P, Goldstein NP, Blumkin A, Szilagyi PG. Effects of phone and text message reminders on completion of the human papillomavirus vaccine series. J Adolesc Health. 2017;60(1):113–119. doi: 10.1016/j.jadohealth.2016.09.011.
    1. Hox JJ, Moerbeek M. Van de Schoot R. multilevel analysis: techniques and applications. Routledge; 2017.
    1. Georgia Department of Health. HIV surveillance summary, Georgia 2018. In: Section HAE, editor. 2020.
    1. Panel PsC. HPV vaccination for cancer prevention: progress, opportunities, and a renewed call to action. A report to the president of the United States from the chair of the President’s Cancer Panel 2018.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner