Behavioral and Virologic Impact of HPV Immunization

HPV 免疫对行为和病毒学的影响

• 批准号: 7995170
• 负责人: JESSICA A KAHN
• 金额: $ 51.83万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-01-15 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7995170
• 关键词: 12 year old; 17 year old; Accounting; Address; Adolescent; Advisory Committees; Affect; Age; Anogenital venereal warts; Applications Grants; Area; Attitude; Behavior; Behavioral; Behavioral Sciences; Biological; Cervical dysplasia; Cervix carcinoma; Characteristics; Child; Clinical; Cohort Studies; Communication; Confidentiality; Critiques; Data; Death Rate; Development; Diagnosis; Disease; Educational Intervention; Effectiveness; Ensure; Epidemiology; Female Adolescents; Future; Genotype; Goals; Health; Healthy People 2010; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papilloma virus infection; Human papillomavirus 11; Human papillomavirus 16; Human papillomavirus 18; Human papillomavirus 6; Immunization; Incidence; Infection; Interdisciplinary Study; Interview; Knowledge; Lead; Link; Long-Term Effects; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Morbidity - disease rate; Mothers; Natural History; Parents; Perception; Persons; Population; Population Distributions; Prevalence; Principal Investigator; Provider; Public Health; Recommendation; Recording of previous events; Reporting; Research; Research Personnel; Risk; Risk Factors; Sampling; Screening procedure; Sex Behavior; Sexually Transmitted Diseases; Specific qualifier value; Testing; Time; United States Food and Drug Administration; Vaccinated; Vaccination; Vaccines; Viral; Virus; Woman; Work; behavior change; cohort; design; evidence base; girls; high risk; high risk sexual behavior; innovation; interdisciplinary approach; microbial; mortality; non-compliance; prevent; programs; prophylactic; response; risk perception; sex risk; sexually active; surveillance study; therapy design; vaccine efficacy; virology; young adult

DESCRIPTION (provided by applicant): Widespread implementation of prophylactic human papillomavirus (HPV) vaccines, one of which recently has become available for clinical use, could substantially decrease morbidity and mortality from cervical cancer and other HPV-related diseases. However, little is known about two factors fundamentally important to maximizing the health impact of vaccination: whether vaccination will change perceptions of risk, which may in turn impact sexual behaviors and risk for sexually transmitted infections (STI), and whether widespread virus-type-specific vaccination will affect the subsequent distribution of non-vaccine types in the population. The overall objectives of this application are to examine the impact of HPV vaccination on adolescent attitudes, sexual behaviors, STI acquisition, and HPV type distribution. The central hypotheses are that adolescent perceptions of reduced risk immediately post-vaccination will be associated subsequently with an increase in risky sexual behaviors and STI rates, and that widespread vaccination will shift the population distribution of HPV over time to non-vaccine genotypes. Guided by our preliminary data, this hypothesis will be tested by pursuing the following three specific aims: 1) Determine whether 13-17 year-old female adolescents' attitudes (e.g. risk perceptions) change as a result of HPV vaccination, whether parent and provider factors influence adolescent risk perceptions post-vaccination, and whether these risk perceptions predict subsequent sexual behaviors and STI diagnosis; 2) Explore qualitatively 11-12 year-old girls' knowledge and attitudes (e.g. risk perceptions) after HPV vaccination, whether parent and provider factors influence girls' knowledge and risk perceptions, and whether these risk perceptions influence subsequent sexual behaviors; and 3) Determine overall and type- specific HPV prevalence in a diverse sample of sexually active adolescent and young adult women, before and after widespread HPV vaccine implementation. In order to achieve the study objectives we will use the following approach. The first two aims will be addressed using longitudinal cohort studies of 11-12 year-old and 13-17 year-old girls, their mothers and their providers. The third aim will be addressed using two cross- sectional surveillance studies, before and after widespread HPV vaccination, in a diverse sample of sexually active young women. The approach is innovative, because the investigators are taking a multidisciplinary approach to understanding a previously unexplored area: the attitudinal, behavioral, and virologic impact of HPV vaccination in young women. The proposed research is significant, because the results are expected to help direct the development of evidence-based educational interventions designed to promote safe sexual behaviors after vaccination; contribute to the development of future multivalent vaccines; guide the design of post-vaccination surveillance studies of HPV epidemiology and vaccine efficacy; and create educational interventions and Pap screening recommendations that take into account shifts in viral type after vaccination. Relevance to Public Health: Examination of the attitudinal, behavioral, and virologic impact of type-specific HPV vaccination is an important but under-investigated area of behavioral science and virology that has direct implications for maximizing the public health impact of HPV vaccines. The results are expected to guide the development of evidence-based educational interventions and future multivalent HPV vaccines, both of which could maximize the effectiveness of vaccination in preventing HPV-related diseases such as cervical cancer. This application addresses several objectives of Healthy People 2010, including reducing the proportion of persons with HPV infection (objective 25-5) and reducing the death rate from cervical cancer (objective 3-4).

描述(申请人提供)：广泛实施预防性人乳头瘤病毒(HPV)疫苗，其中一种最近已可用于临床，可大幅降低宫颈癌和其他HPV相关疾病的发病率和死亡率。然而，对最大限度地扩大疫苗接种对健康影响的两个基本重要因素知之甚少：接种疫苗是否会改变人们对风险的看法，进而可能影响性行为和性传播感染(STI)的风险，以及广泛接种针对病毒类型的疫苗是否会影响随后非疫苗类型在人群中的分布。这项应用的总体目标是检查HPV疫苗接种对青少年态度、性行为、性传播感染和HPV类型分布的影响。中心假设是，青少年对接种疫苗后立即降低风险的看法将与随后危险性行为和性传播感染率的增加相关，广泛接种疫苗将随着时间的推移将HPV的人口分布转变为非疫苗基因型。根据我们的初步数据，我们将通过以下三个具体目标来检验这一假设：1)确定13-17岁女性青少年的态度(如风险感知)是否因接种HPV而发生变化，父母和提供者因素是否影响接种后青少年的风险感知，以及这些风险感知是否预测随后的性行为和性感染诊断；2)定性地探讨11-12岁女孩接种HPV后的知识和态度(如风险感知)，父母和提供者因素是否影响女孩的知识和风险感知，以及这些风险感知是否影响随后的性行为；以及3)在广泛应用HPV疫苗前后，确定在性行为活跃的青少年和年轻成年女性中的不同样本中的总体和特定类型的HPV流行率。为了实现研究目标，我们将采用以下方法。前两个目标将通过对11-12岁和13-17岁女孩、她们的母亲和她们的养育者进行纵向队列研究来实现。第三个目标将通过在广泛接种HPV疫苗之前和之后在不同的性活跃年轻女性样本中进行的两项横断面监测研究来实现。这种方法是创新的，因为研究人员正在用多学科的方法来了解一个以前没有探索过的领域：年轻女性接种HPV疫苗的态度、行为和病毒学影响。拟议的研究具有重要意义，因为这些结果有望帮助指导旨在促进接种后安全性行为的循证教育干预措施的发展；有助于未来多价疫苗的开发；指导接种后HPV流行病学和疫苗效力监测研究的设计；以及创建教育干预和巴氏筛查建议，考虑到接种后病毒类型的变化。与公共卫生的相关性：对特定类型的HPV疫苗的态度、行为和病毒学影响的检查是行为科学和病毒学中一个重要但研究不足的领域，对最大限度地发挥HPV疫苗对公共健康的影响具有直接影响。这一结果有望指导循证教育干预措施和未来多价HPV疫苗的发展， 这两者都可以最大限度地发挥疫苗接种在预防宫颈癌等HPV相关疾病方面的效果。这项申请涉及2010年健康人的几个目标，包括减少HPV感染者的比例(目标25-5)和降低宫颈癌死亡率(目标3-4)。