ASPO Abstracts

Immune Response to HPV4 Among Appalachian Women Age 18-26 Years: Impact of Behaviors and Stress

Authors: Ruffin MT, Hade, EM, Harper DM

Category: Cancer Health Disparities, Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2018

Abstract Body:
Context: Appalachian women suffer a disparate burden of cervical cancer even with adequate cervical cancer screening. There is local belief that they will not respond to the HPV vaccine due to the stresses of their lives. Objective: We hypothesized Appalachian women’s immune response to the quadrivalent HPV vaccine three shot series will be blunt by stress which will be mediated by other variables. Design: Cohort Setting: Patients recruited from primary care offices in Appalachian Ohio to an HPV vaccine trial. Participants: Women 18-26 years not previously received HPV vaccine. Women were excluded if had any ablative treatment of the cervix. All participants had to be willing to complete the quadrivalent HPV vaccine three shot series. Instruments: 14-item Perceived Stress Scale (PSS), CES-D, Appalachian self-identity and Health Behaviors (smoking, sex). Outcomes: Serum HPV titers for HPV 6,11,16,18 at baseline, month 2, month 6, and month 12. Results: Study population of 185 was 85.4% white. At baseline 50.3% of the women were cervical HPV DNA positive. At baseline 19% of participants were HPV 16 sero-positive; 8.7 % were HPV 18 sero-positive; 19.5% were HPV 6 sero- positive; and 5.4% were HPV 11 sero-positive. By month 12, 100% of study participants were sero-positive for HPV 6, 11, and 16. 93.2% were sero-positive for HPV 18. There was no relationship to immune response by demographics, BMI, smoking, PSS, CES-D, baseline HPV serology status, baseline cervical HPV DNA status, baseline serum EBV titers, or Appalachian self-identity. Conclusion: Appalachian women immune response to the quadrivalent HPV vaccine three shot series was not blunted by stress or any other measures collected. The population at higher risk for cervical HPV infection and cervical cancer benefit from the HPV vaccine series.

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