HPV: The Most Common Sexually Transmitted Infection - Research Paper

Introduction

Human Papillomavirus Infection, known as HPV, is the most common sexually transmitted infection. According to the Centers for Disease Control Statistics (2017), HPV is so common that nearly all sexually active men and women get the virus at some point in their lives. Some people do not develop any symptoms from HPV, but a person can still get the disease through sexual contact. There are types of HPV that can include genital warts, warts on the skin, and cancers, CDC (2017). There are vaccines to stop HPV from developing, and prevent it from turning into cervical cancer, stated by the CDC (2017).

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

HPV Significance to Public Health

There are currently 79 million Americans diagnosed with the HPV infection, Centers for Disease Control and Prevention (2017). As reported by Duke Medicine (2013), most people do not know that they have the infection. HPV infection causes nearly all cases of cervical cancer, but the disease will begin as precancerous cervical abnormalities. Condoms can prevent HPV to an extent, but you can still get the virus through participating in oral sex, vaginal sex, and anal sex with someone who has the virus. A person may not know that they are infected with HPV, and they are likely to spread the virus with other people. Also, a person can have sex with a person who is infected with HPV, and they will never know it because it takes years for the symptoms to show, ("HPV Fact Sheet," 2017). There is a way a person can prevent themselves from getting HPV. There are vaccines to stop these health problems from happening ("HPV Fact Sheet," 2017). Boys and girls can get the vaccine at ages eleven or twelve, but catch up vaccines are also available to boys up to age twenty-one, and it is possible to girls up to age twenty-six if they did not get vaccinated when they were young, (HPV Fact Sheet,2017).

Also, a woman can have screenings done for HPV when she goes to her OBGYN, and the doctor will do a Pap smear. If a women's Pap comes back abnormal, HPV low risk or high risk is likely the cause as to why the Pap is abnormal. There are no treatments for the infection itself, but genital warts and cervical precancer can be treated (HPV Fact Sheet,2017). Human Papillomavirus infection affects African American women more than it will affect a White woman. According to the American Association for Cancer Research, African American women may be less likely to benefit from available HPV vaccines to prevent cervical cancer (Duke Medicine,2013). Why is it that African American women may less likely benefit from the HPV strains vaccine than White women? There was a study done at Duke Medicine, and the study proved the question that arises, "why do African American women less likely benefit from the Human Papillomavirus vaccine?". Two subtypes of HPV prevented by vaccines are half as likely to be found in African-American women as in white women with precancerous cervical lesions, according to researchers, (Duke Medicine,2013).

Public Health Issue Analysis

History of Human Papillomavirus (HPV)

Human papillomavirus was discovered by Scientists in 1956 first. Harold Zur Hausen learned about HPV and cloned cervical cancer to HPV 16 and HPV 18 in 1984 (Seo et al., 2017). Hausen also contributed to the making of vaccines of HPV type 6 (Seo et al., 2017). "Pap test has decreased the overall incidence and mortality of cervical cancer; this disease remains the eighth most common cancer among women in the United States" (Hirth et al., 2013). Human Papillomavirus is named in that manner due to strain that brings warts, also called papillomas.

The Population at Risk for HPV

Researchers have recruited races numerous times to compare the differences in women with a higher risk of HPV. These races have included African American, Hispanic, and White American women. Researchers have come to the decision that African American women have rates of cervical cancer and mortality higher than white women, Alberts et al. (2017). Researchers at Duke Medicine recruited 326 European American and 113 African American female college freshmen from Columbia South Carolina, Alberts et al. (2017). According to the source, the test was to compare the clearance of the women with a higher risk of HPV infection between ethnicities Alberts et al. (2017). The researchers tested the women every six months through HPV testing, pap smear Alberts et al. (2017).

Social Determinants of Health is the main factor that takes place in this unsolved case of HPV. Not many women are stable enough to continue to get these pap screening done with their doctors. Many women are uninsured, have low income, and some women do not care about their health. Stated by the source, "Socio-economic factors and access to healthcare have been postulated as possible explanations for the disparity in incidence and mortality rates of cervical cancer between different ethnic groups," Alberts et al. (2017). That is why African American women have the highest case of cervical cancer than white women, Alberts et al. (2017).

Social and Behavioral Factors that Contribute to HPV

Behaviorally and socially, risk factors primarily affect the acquirement for HPV infection. The risk factors are necessary for consideration for the HPV vaccination strategy. Some of the social and behavioral factors that contribute to HPV acquisition include the characteristics of the sexual history of the women and substance use. Sexual history entails the number of sexual companions the woman has had, the aspects of the sexual companions, the use of contraceptives, and parity. Substance use history may include alcohol use, cigarettes, and other illicit drugs.

Of the sexual history factor, an increasing count of lifetime sexual companion and having had a current, different sexual companion are two elements that have continuously been related to an increased risk of HPV infection. Moreover, being with a sexual companion who is 1.5 to 2 years older is also linked with an increased risk of HPV infection acquisition.

On the other hand, it has been challenging to assess the effect, impact, and relationship of the use of the substance with its risk on the acquisition of HPV infection and other related diseases. Current or past history of smoking of cigarettes has been linked with HPV infection acquisition, progression to precancerous lesions, and cervical cancer in some of the studies. However, most of the studies have failed to support this connection. Far fewer investigations have surveyed the role of the use of illegal drug and acquisition of HPV infection as well as related diseases, and results of these examinations additionally show mixed associations. One of the reasons these affiliations might be so shifted is because substance use may, in certainty, be a marker for other, unmeasured, sexual practices that impact the risk of HPV disease.

Contributions by Public Health Agencies in Delivering Public Health Services for HPV

The US Centers for Disease Control and Prevention (CDC) offers worldwide technical assistance for implementing and evaluating the HPV vaccination pilot projects, programs, and laboratory activities related to HPV assessment. CDC has partnered worldwide in developing global screening manuals as well as a recommendation, creating standardized tools for evaluation, and providing expertise in monitoring the outcomes.

Through Gardasil Access Program (GAP), Merck & Co. Inc. has pledged in donating Gardasil [Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine majorly to countries of low and middle income (Anderson et al., 2016). The main objective of GAP is to enable institutions in countries that qualify as low and middle-income earners to acquire experience in operation and implementation of the HPV vaccination program, to support the development of adolescent models of immunization (Anderson et al., 2016).

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection (STI) in the United States. The most significant percentage of the 85% sexually active women affected by HPV are African Americans (Coyne-Beasley & Hochwalt, 2016). Studies have shown that HPV infections cause vulvar, vaginal, and cervical cancers in women. Various programs have been developed to combat HPV infection in African American women to address this issue.

Girls OnGuard Program

Regardless of being at a higher risk of HPV infection, African American women are underserved when they seek treatment for STIs. Studies have proved that GARDASIL vaccination is effective in preventing HPV infection (Zhai & Tumban, 2016). However, its uptake is low among this population, mainly due to a lack of awareness (Galbraith-Gyan et al., 2019). This program, therefore, sought to increase uptake of the GARDASIL vaccine among African American adolescent females. It was based in Atlanta, Georgia, and targeted 280 females aged between 13 and 18 years old. It ran from October 2009 to March 2014 ("National Library of Medicine," n.d.). The project aimed to enhance HPV awareness and hence increase the rates of vaccination.

Contributions Made by Public Agencies

The project was sponsored by the Merck Sharp and Dohme Corp, and the American pharmaceutical company that manufactures GARDASIL. The support, financial and otherwise, offered by the company contributed to the success of the project. Also, collaboration with scholars at Emory University helped provide technical expertise ("National Library of Medicine," n.d.).

Program or Intervention Analysis

The Success of the Program

The program was mostly successful. It proved that clinic-based promotion is a potent way of enhancing HPV vaccine uptake among the underserved African American girls. Though the initiation and completion of the vaccination series were lower compared to the national coverage, an increase in compliance was observed among the participants ("National Library of Medicine," n.d.).

The Social and Behavioral Factors Addressed

The low uptake of the GARDASIL vaccine among African American women was the behavioral factor that the program sought to address. Lack of awareness of HPV vaccines was also to be addressed. Addressing the issue contributed to the increased compliance among the participants ("National Library of Medicine," n.d).

Determinants of Health

Personal knowledge, attitudes, and beliefs, as well as the socio-economic status of the participants, were some of the determinants of health that the study targeted. It was established that the personal factors play a more prominent role than the socio-economic factors in the low uptake of HPV vaccines (National Library of Medicine).

Public Health Principles and Theories Used

The health belief model was used to help understand the low uptake of HPV vaccines (a preventive intervention) among African American women (Grace-Leitch & Shneyderman, 2016). Components of the social-ecological model are also visible in the program since by understanding the behavior of the participants in the underserved environments, successful interventions would be developed (Kolff, Scott, & Stockwell, 2018).

Challenges Faced

The limited sample size used restricted the evaluation of the interventions. Since the program targeted school girls, a factor that contributed to the small sample size, change in bus routes affected the patient throughput. Resultantly, some participants might have gotten subsequent vaccinations from clinics not included in the program. It was also difficult to pinpoint which of the three interventions led to the increase in uptake of vaccines (DiClemente, Murray...