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Schlecht, N., Rojas, M., Lorde-Rollins, E., Nucci-Sack, A., Strickler, H., Burk, R., & Diaz, A.
(2013). Burden of cervical, anal, and oral HPV in an inner-city pre-vaccine adolescent
population. Journal Of Urban Health: Bulletin Of The New York Academy Of
Medicine, 90, 141-146. doi:10.1007/s11524-012-9756-9
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I chose this article HPV in inner city teenagers because I remember hearing about the

vaccine at the end of high school and being told it was probably too late for me to have the

vaccine! I was interested in find out how many girls are getting the vaccine these days. I plan to

have all my children, boys included vaccinated against HPV. As future health professional I may

also find myself in the position to recommend the vaccine to the patients or clients I work with.

The article states that the current recommendations are to vaccinate young people before

they become exposed to HPV. However women up to the age of 26 may “catch up” and get

vaccinated. Only about a third of adolescent women have had all three doses of vaccine as

recommended. While cervical HPV rates are highest among young women, rates of infection in

other parts of the body (e.g, mouth, anus) are currently being examined. The aim of this study

was to assess the prevalence of HPV in the three main sites on the body in a group of young

unvaccinated inner city women.

METHODS

Participants

In the Bronx, New York City, 97 sexually active women aged 15-22 were enrolled in the

study at Mt. Sinai Adolescent Health Center between July 2005 and March 2006. All women

coming in for gynecological exams, sexually transmitted infection treatment or screening, and

follow up for abnormal pap smears or genital warts were included. The women in the study were

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mostly African American (54%) and Latina (39%) with an with a median age of 19. The median

age for losing virginity was 14. Most (82%) reported having 3 more sexual partners. Almost half,

forty-seven percent, had contracted a sexually transmitted infection before. Over a third had

atypical pap results as well as having previously being diagnosed with chlamydia.

All the young women provided cervical and anal specimens collected using “Thin Prep”

using a “Cytobrush” while oral specimens were collected using a “Scope” oral rinse. All samples

from the participants were tested for the presence of HPV DNA using polymerase chain reaction

process that makes L1-HPV gene easier to detect. Forty different specific types of HPV were

tested for. HPV types were grouped by their severity, e.g., high risk types.

RESULTS

The DNA testing results showed that 59% of the women detectable HPV in the cervix.

Thirty different types of HPV were identified in the cervical samples. Almost as many women’s

anal samples (57%) tested positive with over 24 types of HPV found. Fewer women, only 12%,

had HPV detected in their oral samples. Only 6 different types of HPV were found in the oral

samples. Of the types found, 20% of the cervical, 17% of the anal, and 2% of the oral samples

contained types of HPV targeted by the vaccine.

Almost three quarters (73%) of the women were infected with HPV in any location, 44%

in two locations and 9% in all three places. The same type of HPV was identified in both the anal

and cervical samples in just over half the women (53%). In 30%, HPV16 was detected in both

locations and in 20% HPV18 was identified in the anal and cervical samples. The same type of

HPV in all three locations was not observed in any of the women.

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DISCUSSION

The researchers state their study was limited because the subjects were not selected at

random, so they can’t represent all young people. The sample in the study also doesn't generalize

to all young men. These women were all sexually active (non virgins). HPV can be transmitted

without having vaginal penetration. Also these women were all from the New York City.

Doing this assignment I learned that there are many types of HPV, I didn’t know there

were so many and that the vaccine only targeted 4 types. I found it very interesting that so many

of these young women were not protecting themselves. So many had STDs! I think the next

study needs to ask more sex questions. We don’t know how many of the young women in the

study are using condoms or other forms of birth control. I really think it would be important to

also ask young women what they know about HPV and STDs and ways to protect themselves.

NOTE: THIS IS A SAMPLE PAPER. IT IS NOT “PERFECT.”

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