HPV Research from BC to Uganda

The BC HPV Research Group presented a Forum this week, and Positive Women’s Network staffer Marcie Summers brought back some interesting information. Discussions at the Forum presented information on HPV and cervical cancer here in BC and as far away as Uganda. Inspiring reports show much can be done; statistics show much needs to be done.

Cervical cancer, which can be the end result for women infected with a strain of humanpapillomavirus or HPV, is the second most common cause of cancer death in women worldwide. Given that we’ve had screening for HPV around for decades in the form of Paps, that’s one distressing statistic; but health literacy, accessible and affordable health care are certainly not universal anywhere.

From here to Uganda 

Drs Gina Ogilvie and Deborah Money reported on ASPIRE, a partner project between BC researchers and Uganda’s Makerere University. Drs. Ogilvie, Money and other Canadians of the ASPIRE project are supporting the development of HPV screening and prevention programs for Ugandan girls and women. Considering that 75% of Ugandan women diagnosed with cervical cancer die soon after diagnosis, comprehensive screening and prevention is a desperate need. ASPIRE is trying to build a supportive community of women who can act as leaders in bringing change. The team knows that building collaborative relationships is essential if things are going to change for women.

The project is looking at the feasibility of self-collection of cervical swabs (80% of women surveyed would do it) and at introducing HPV vaccination programs for school aged girls as well. One of many challenges is communication: Lugandan, the commonly used language in Uganda, has no word for cervix. Developing appropriate health education pathways will be part of the process. 

Diagnosing and Treating HPV in BC

The Forum swung back here to BC to look at the incidence of cervical dysplasia in women living with HIV. Cervical dysplasia is a marker for cervical cancer, and HIV+ women with higher viral loads are more likely to have dysplasia. But the use of antiretroviral therapy (ART) is associated with lower rates of dysplasia, another argument for treating people soon after diagnosis, as the STOP program is suggesting.

Another trial going on in BC women (not necessarily HIV+) is the HPV Focal Study. This research is examining whether an HPV test (different from a Pap test) is a better option than Paps for screening and early detection of cervical cancer. Because the HPV test is more precise, it would only need to be done about every four years (in populations of HIV negative women. I don’t have the suggested timing for HIV+ women, if there is one at press time). Pap screening is recommended more frequently, so a shift in screening will also require significant education on reassuring women the four year schedule is safe. This study is ongoing.

Dr Money brought up the issue of whether anal Paps should be performed as part of regular screening for HIV+ women. We do know that vaginal HPV infection can lead to anal HPV infection, so this may become more of a part of regular care. This topic needs more research before final recommendations will be made.

The possibility of HPV infection can be reduced through the HPV vaccine and condom use. It can’t be avoided entirely, as it can be passed through skin to skin contact. Not all strains of HPV lead to cervical cancer, but even those that do can be caught early through detection. That’s why early screening and diagnosis are so important. Cervical cancer is preventable. 

Janet 

This was posted on Friday, May 20th, 2011 at 6:30 am and is filed under Body Health, Education & Resources, HIV progression, HIV Treatment, Inflammation, menopause . Feel free to respond, or trackback. Read our comments policy.

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