Human Papilloma Virus (HPV) and HIV/AIDS
April 28, 2017
There are currently three HPV vaccines: Gardasil (made by Merck; also known as Silgard), Gardasil-9 (also made by Merck), and Cervarix (made by GlaxoSmithKline). All three have been approved by the U.S. Food and Drug Administration (FDA), Health Canada, and the European Medicines Agency (EMA). Gardasil-9 is still awaiting approval in the UK. There are now demonstration projects that are bringing HPV vaccines to girls and women in low-income countries as well.
In the U.S., Gardasil products have been approved for females and males ages 9 to 26, while Cervarix has been approved for females ages 10 to 25. Gardasil -9 will soon be the only HPV vaccine available in the U.S.
The vaccines protect against types of HPV that cause the majority of cervical cancers and genital warts. Recent studies have shown that these vaccines can also provide protection against HPV-related vaginal cancers, vulvar cancers, and anal cancer in women. The vaccines do not protect against less common HPV types. Therefore, health care providers still recommend regular cancer screening tests to look for signs of cancer.
It is best if young people get all doses of the vaccine before their first sexual contact. This helps them develop an immune response before they are exposed to HPV. People who are infected with some types of HPV may still benefit from the vaccine's effects against other types of HPV. The U.S. Centers for Disease Control and Prevention (CDC) recommends HPV vaccines for both females and males. The HPV vaccine is routinely given at ages 11 or 12; however, it is approved for use from ages nine through 26.
In Canada, the National Advisory Committee on Immunization (NACI) recommends Gardasil vaccination for females ages nine through 45 and males ages nine through 26, or vaccination with Cervarix for girls and young women ages nine through 45. In the UK, vaccination with Gardasil is offered to girls ages 12 and 13 through the National Health Service.
Pregnant women should not receive the vaccine. However, it is safe to get the vaccine while breastfeeding. Speak to your health care provider about the HPV vaccine to see if it is right for you. In the U.S., there are payment assistance programs for people who cannot afford the HPV vaccines; see the resource section of this article for contact information.
Based on recent study data showing that HPV vaccines are very good at getting the body to produce a strong immune response, there is a move toward reducing the number of doses from three to two. Girls and boys ages nine to 13 have a stronger response to the vaccine than older adolescents. Therefore, the European Medicines Agency recently approved that Cervarix be offered as a two-dose vaccination for nine to 14-year-old girls and boys and that Gardasil be offered as two-dose vaccination for nine to 13-year-old girls and boys. In October 2016, the CDC recommended that girls and boys under 15 years of age receive two doses of HPV vaccine, while those 15 to 26 years continue to receive three doses of HPV vaccine.
To reduce the total number of injections, future HPV vaccine development includes the possibility of adding HPV vaccine to another existing vaccine (e.g., combining it with measles in one shot).
Regular pelvic and anal exams and cervical screening tests are very important. While they cannot prevent HPV-related problems, they can help catch warts and dysplasia (abnormal or pre-cancerous cells) before they get worse and cause greater problems.
Studies have shown that, although women living with HIV are at an increased risk for cervical cancer, nearly one in four women living with HIV in the U.S. did not get their recommended yearly cervical screening tests (note: two cervical cancer screenings are recommended in the first year after a woman is first diagnosed with HIV). It is very important that women living with HIV get yearly routine cervical screening testing and follow up as needed to identify problems before cancer develops. Follow up involves seeing a gynecologist so that the cells of the cervix can be looked at closely with a microscope to look for abnormal cells that might be pre-cancerous. Prevention is always better -- healthier, less painful, and less costly -- than treatment.
Even though condoms do not fully protect against HPV, when used correctly they can help reduce the chances that HPV will be spread.
Smoking has been shown to increase the chance of developing several types of cancer including cervical and anal cancers. If you smoke, it is a good idea to try and quit. Talk with your health care provider about stopping smoking -- there are many tools to help you quit. You can also find lots of information and support online (www.smokefree.gov).
HPV can be very serious for people living with HIV. Since there are frequently no symptoms, getting regular exams from your health care provider is the best way to be sure that any problems are found and treated early.
[Note from TheBody.com: This article was created by The Well Project, who last updated it on Apr. 28, 2017. We have cross-posted it with their permission.]
This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with TheBody.com to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from TheBody.com or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.
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