Impact of the Human Papillomavirus (HPV) Vaccine in Low-Resource Settings
The Human Papillomavirus (HPV) Vaccine has been approved since 2006 and there is extensive evidence that it significantly decreases the incidence of cervial cancer, yet adoption of the vaccine has been sluggish, especially in sub-Saharan Africa. Only 14 of 26 countries in the region have national HPV vaccination programs. Published in The Lancet Global Health, an article entitled, "Impact of the Human Papillomavirus (HPV) Vaccine in Low-Resource Settings," looks at Rwanda as a case study for examining the effect of the HPV vaccine at a population level.
Rwanda was one of the first African countries to adopt a national school-based HPV vaccination program in 2011. Now, the first girls to be vaccianted through this program are becoming sexually active, so the effect of the vaccine can be seen. Although it is too early to see how the vaccine has effected the incidence of cervical cancer, it has shown promising results in reducing HPV. This data can be used in future studies to see the efficacy of the HPV vaccine in reducing the incidence of cervical cancer in Rwanda. This will be enormously important research, as most HPV studies have been done in high-income countries, where the study cohorts of HPV-vaccinated people are older.
One important concern noted by the researchers is the difficulty of preventing HPV among women living with HIV. The study found that HPV vaccination effectiveness was lower among HIV-positive women compared to HIV-negative women. This is potentially worrying for sub-Saharan African countries because they have the greatest burden of HIV infection. However, this finding spotlights the need to research additional ways to prevent HPV in women living with HIV.
What are the key lessons learned through this study that might be useful in your work? What are future research questions that should be investigated in HPV studies? What other vulnerable groups, besides women living with HIV, should be researched in future studies?
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