Evaluating Cervical Cancer Trends among HIV-Positive Florida Women 2001-2012: Implications for HPV Vaccine Policy

Introduction:  One in four people are infected with at least one type of human papillomavirus (HPV) – the leading cause of cervical cancers.  Two vaccines have been shown to be effective against infection by the most prevalent cancer causing HPV types.  However, lack of HPV vaccine use can increase the rate of HPV infection and cervical cancers among HIV-infected women.  The purpose of this study is to explore cervical cancer rates in HIV infected women and recommend ways to accelerate vaccine uptake in underserved populations.

Methods: Using data collected by the Florida Department of Health between 2001 – 2012, researchers examined changes in cervical cancer rates among women with HIV compared to rates in the general population. Underserved areas of HIV-positive individuals and women with both HIV and cervical cancer were evaluated using geospatial analysis. 

Results: Results show 26% of HIV-infected women under age 29 had cervical cancer compared to 6% of women of either status.  Of HIV-infected women with cervical cancer, 70% were black compared to 60% white and 10% Hispanic.  Also, most HIV-infected women were diagnosed at inpatient hospitals (43%) compared to HIV clinics (16%) and most were uninsured (85%). 

Conclusion:  Our research shows clear disparities among women based on HIV-status, race and insurance type. Recommendations include maximizing the availability of HPV vaccine, reducing missed clinical opportunities to vaccinate against HPV and targeting areas of greatest underuse.  By increasing vaccine uptake among women with HIV, fewer will be affected by HPV-related cervical cancer.

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Learning Areas:

Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Assess needs related to cervical cancer prevention among HIV infected populations Identify under used facilities in preventative health delivery for cervical cancer in HIV populations Recommend policy-level interventions for cervical cancer prevention in underserved populations

Keyword(s): Women and HIV/AIDS, Health Promotion and Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have participated in several outreach initiatives regarding continuation of care for individuals with HIV. I am a candidate for Spring 2014 graduation with a master of public health degree, health policy & management track. I've worked closely with specialists in HIV/AIDS and public health research for this project. My scientific interests are biomedical HIV prevention interventions and HIV policy development. I am also an advocate for provider education, especially for HIV/AIDS and co-morbidities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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