Behavioral and Virologic Impact of HPV Immunization

HPV 免疫对行为和病毒学的影响

• 批准号: 7753141
• 负责人: JESSICA A KAHN
• 金额: $ 51.68万
• 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/7753141
• 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（由申请人提供）：预防性人乳头瘤病毒（HPV）疫苗的广泛实施，最近已用于临床使用，可以大大降低子宫颈癌和其他HPV相关疾病的发病率和死亡率。但是，关于最大化疫苗接种的健康影响至关重要的两个因素知之甚少：疫苗接种是否会改变风险的看法，这可能影响性行为行为和性传播感染（STI）的风险（STI），以及广泛的病毒特异性疫苗接种是否会影响非疫苗类型中人群的随后分布。该应用程序的总体目标是检查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。核心假设是，在疫苗接种后立即降低风险的青少年看法随后将与风险的性行为和性病率的增加有关，并且广泛的疫苗接种将使HPV的人口分布随时间转移到非疫苗的基因型。在我们的初步数据的指导下，将通过追求以下三个具体目的来检验该假设：1）确定13-17岁的女性青少年的态度（例如，风险感知）是否因HPV疫苗接种而发生变化，因为HPV疫苗接种，父母和提供者的态度，父母和提供者因素是否会影响这些危险感知的青春期风险感知，以及这些次级性行为的诊断，以及是否会预测性行为的行为以及是否及时诊断性行为行为。 2）在HPV疫苗接种后，质量性11-12岁的女孩的知识和态度（例如，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后来的性行为； 3）在广泛的HPV疫苗实施之前和之后，在多种性活跃的青少年和年轻妇女的多种样本中确定总体和类型的HPV患病率。为了实现研究目标，我们将使用以下方法。前两个目标将使用11-12岁和13-17岁的女孩，他们的母亲及其提供者的纵向队列研究来解决。在广泛的HPV疫苗接种之前和之后，将使用两项横截面监视研究来解决第三个目标。这种方法具有创新性，因为研究人员正在采用多学科方法来理解以前未开发的领域：HPV疫苗接种对年轻女性的态度，行为和病毒学影响。拟议的研究很重要，因为预计结果将有助于指导旨在促进疫苗接种后安全性行为的循证教育干预措施的发展；为未来多价疫苗的开发做出贡献；指导HPV流行病学和疫苗功效的疫苗接种后监视研究的设计；并创建教育干预措施和子宫颈抹片检查建议，以考虑疫苗接种后病毒类型的转变。与公共卫生有关：特异性HPV疫苗接种的态度，行为和病毒学影响的检查是行为科学和病毒学领域的重要但不足的领域，对最大程度地影响了HPV疫苗的公共健康影响。结果预计将指导基于证据的教育干预措施和未来的多价HPV疫苗的发展，即 这两者都可以最大化疫苗接种在预防HPV相关疾病（如宫颈癌）方面的有效性。该申请解决了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）并降低了宫颈癌的死亡率（目标3-4）。