Rural women are less likely to complete vaccinations for cervical-cancer virus; study finds vaccine does not increase sexual activity

Women living in rural areas of the U.S. were far less likely to return for their follow-up doses after they get the initial injection of the human papillomavirus vaccine, a study in the Journal of Rural Health has found. (Photo by Pete Rodman, Bowling Green Daily News)

The study contrasted the rates of vaccination follow-up by young women recruited from two rural locations and one urban location. "Despite being free, the researchers concluded that uptake of booster doses by rural women was problematic," states an article in the Rural Center for AIDS/STD Prevention's "RAP Time" publication. "This barrier might be resolved by providing the HPV doses at easy-to-access locations in rural communities, such as large grocery stores and area events."

The HPV vaccine requires three doses. The women who went to the rural clinic were seven times less likely to return for at least one follow-up dose.

The vaccine, which has proven to prevent most cervical cancers, has been approved for use in women ages 9 to 26 years, as well as boys. The vaccine is generally given at the age of 11 or 12 and is effective only if administered before a person becomes sexually active. As many as 80 percent of men and women become infected with HPV during their lives, but most do not develop symptoms or illness.

The vaccine has been met with reluctance by parents, some of whom fear it encourages sexual activity, but a study published in the American Journal of Preventive Medicine found girls or women who received the vaccine "were no more likely to be sexually active or have more partners than those not vaccinated."

Last year, just 49 percent of adolescent girls nationwide had received at least the first dose of the vaccine, and only a third had gotten all three. In Kentucky, just 25 percent of adolescent females had gotten the first dose and fewer than 11 percent had received all three doses.

In Kentucky, the annual death rate caused by cervical cancer is 2.9 deaths per 100,000. In the United States, it's 2.4 per 100,000. "The U.S. is remaining stable. Kentucky's is actually falling," gynecologist Dr. Mark Yurchisin told Alyssa Harvey of the Bowling Green Daily News.

The decrease is being attributed to an increase in screenings. "In certain counties in Kentucky there is a high incidence, they implemented outreach clinics because they didn't have clinics where they could get Pap screenings done," Yurchisin said. "They can diagnose it at an earlier and treatable stage." (Read more)

Get tested, get treatment, Bluegrass HIV Coalition encourages

Today is World AIDS Day and health advocates are asking Kentuckians to get tested and get treatment.

Hundreds of Kentuckians are diagnosed with AIDS each year, reports Mary Meehan of the Lexington Herald-Leader. Minority populations are hit particularly hard, with black men nearly 10 times more likely to die of AIDS than non-Hispanic white men. Black women are almost 23 more times more likely to die from the infections, compared to non-Hispanic white women.

Though people are still dying, AIDS is not a widely-discussed disease, in part because of its past association with homosexual activity. Mark Johnson, member of the Bluegrass HIV Coalition, said AIDS can be hard for people to talk about.

In addition, the infection is often seen as treatable, in part because of people like Magic Johnson, who has had the infection more than 20 years but is still in good health. What people don't see "is the often expensive regimen of drugs that is needed to keep the worst of the disease at bay, the side effects of those medicines or the ultimate end of what is still an incurable disease," Meehan reports. (Read more)

Dec. 1 is World AIDS Day; 1.2 million Americans are thought to be infected, but only 1 in 5 know it

Friday is World AIDS Day, an opportunity to learn the facts about the virus and show support for people living with it.

In the United States, there are 1.2 million people living with the HIV infection, which leads to AIDS. Of those who are infected with the virus in the U.S., only one in five know they have it, the Centers for Disease Control and Prevention report. Each year, about 50,000 Americans become infected. About 1,700 Kentuckians were diagnosed with HIV between Jan. 1, 2005 and Dec. 31, 2009; Kentucky ranks 19th in the country for the number of people who have the HIV infection.

Since the epidemic began, nearly 594,500 people have died with AIDS in the U.S. Between 1981 and 2007, more than 25 million people have died from the virus around the world.

Secretary of State Hillary Rodham Clinton spoke of the epidemic in a Nov. 8 address at the National Institutes of Health. "The fight against AIDS began three decades ago in June 1981. American scientists reported the first evidence of a mysterious new disease," she said. "Thirty years later, we ... know a great deal about the virus itself. We understand how it is spread, how it constantly mutates in the body, how it hides from the immune system. And we have turned this knowledge to our advantage."

Most at risk are gay, bisexual or other men who have sex with men. The CDC estimates that though this population accounts for just 2 percent of the U.S. population, it accounted for 61 percent of all new HIV infections in 2009. But heterosexuals and people who inject drugs can also contract the disease. Heterosexuals account for 27 percent of new cases. Another 9 percent of people who contracted the virus did so by using injected drugs.

Blacks accounted for 44 percent of new HIV infections in 2009, though they only represent 14 percent of the U.S. population. In 2009, the rate of new infection was 6.5 times greater for black men than it was for white men.

People can now be tested for the infection using a saliva sample and have the results in just 15 to 20 minutes. To find an HIV/AIDS prevention and service provider by county, click here.

Boys should get HPV vaccine to keep from spreading virus

A federal committee has recommended that boys receive the human papilloma virus vaccine, already recommended for girls, to fight the sexually transmitted virus that is known to cause cervical cancer. The vaccine could also protect boys against genital warts and anal cancer.

The Advisory Committee on Immunization Practices released its recommendation Wednesday. It is the first time there has been a public push for boys to receive the vaccine, though it has been licensed for male use for the past two years.

Dr. Baretta Casey, director of Cervical Cancer-Free Kentucky, applauded the move. "To stem the spread of the HPV virus and the many problems it causes is the best thing," she said.

The vaccine is usually given at the age of 11 or 12 and is only effective if it is given before a person becomes sexually active. As many as 80 percent of men and women are infected with HPV during the course of their lives, but most do not develop symptoms or illness, the Centers for Disease Control and Prevention reports.

The vaccine has been met with reluctance by parents, some of whom fear it would encourage sexual activity. Last year, just 49 percent of adolescent girls nationwide had received at least the first of its three doses, and only a third had gotten all three. In Kentucky, only 25 percent of adolescent females had received the first dose, and fewer than 11 percent had received all three doses.

Casey attributed parents' hesitation to a fear that the vaccine is harmful, though research shows otherwise. "It's our hope that people understand that this is a vaccine that has been around for quite a while now," she said. "The effects of the immunization are similar to other vaccines that we currently give our children. And if I can give my child a vaccine that would prevent them from ever developing cancer, I'm for it." On average, 391 Kentucky women develop cervical cancer and 66 die.

The cost of the vaccine — about $110 for each of the three doses — is also believed to be a factor in the low vaccination numbers, though Casey said Medicaid covers it, as do major health insurance providers such as Blue Cross Blue Shield and Anthem. Though the numbers are low, Casey said she is seeing some boys being vaccinated in Kentucky "but it's not a widely done practice." (Read more)

Parents, children should discuss HPV vaccine, study indicates

A study at Ohio State University found that college-aged women who have talked to their mothers about the human papillomavirus are more likely to get the vaccine that prevents it, Brandy Reeves, right, a certified sexuality educator and health education coordinator at the University of Kentucky, writes in the Lexington Herald-Leader.

HPV is known to cause cancer, including cervical cancer, oral cancer, vulvar cancer, anal cancer and penile cancer.

There are two vaccines for HPV approved by the Food and Drug Administration: Gardasil and Cervarix. "Because men can carry HPV and transmit it sexually to their partners, the FDA has approved the use of Gardasil in both genders, from ages 9 to 26," Reeves writes. "Parents who are nervous about bringing up the topic can focus on how the vaccine is safe and effective, and that it prevents cancer." (Read more)