Human Papillovirus Testing in Adolescents

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DESCRIPTION (provided by applicant): Jessica Kahn, M.D., M.P.H., completed clinical training in Adolescent Medicine and Gynecology at Children's Hospital, Boston and an MPH degree at the Harvard School of Public Health in 1999. She then joined the faculty at Children's Hospital Medical Center to pursue a career in patent-oriented research. David Bernstein, MD, the project Sponsor, brings expertise in clinical research regarding viraI STI, has extensive NIH funding, and has experience mentoring new investigators. The Sponsor, Advisory Board Members and Collaborators form a multidisciplinary research team with diverse expertise. The research environment will support a didactic program that includes relevant courses in advanced qualitative and quantitative methods, training in research ethics, and interaction with other clinical investigators. Dr. Kahn's overall career goal is to become an independent clinical investigator whose work will focus on the prevention of HPV infection and cervical cancer. She plans to achieve this goal through the translation of data regarding 1) the biomedical aspects of HPV infection and 2) the psychological and behavioral impact of testing for HPV into adolescent- specific, effective clinical strategies for cervical cancer prevention at the individual and population levels. The objective of this research plan is to explore the potential role of HPV testing in cervical cancer prevention programs targeting adolescents. The specific aims and methods for achieving each aim follow. Aim 1 To determine predictors of Pap smear foIlow-up in adolescents. Aim 1 will be examined using existing prospective data from a sample of 490 urban, racially diverse adolescents. Aim 2 To examine the psychological and behavioral effects of positive HPV testing in female college students. Aim 2 will be examined using existing longitudinaI data from a sample of 608 racially diverse college women. Aim 3 To explore the psychological, behavioral, and relationship-related effects of positive HPV and Pap smear testing in adolescents. Aims 3, 4, and 5 will be examined using prospectively collected, qualitative and quantitative data in a sample of 250 urban adolescent girls at high risk for HPV infection. Aim 4 To determine the accuracy and acceptability of self-testing for HPV DNA in the above sample of urban adolescent girls. Aim 5 To determine the cumulative prevalence and rates of persistence and regression of HPV infection, and correlation of HPV test results with cervicaI cytology, in the above sample of urban adolescent girls.