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Arnold School of Public Health

Researchers awarded grant to increase HPV vaccination, reduce disparities among adolescents in Carolinas

March 18, 2019 | Erin Bluvas,

An interdisciplinary team of researchers from Duke University and the University of South Carolina have won a $1 million grant from the Centers for Disease Control and Prevention (CDC). They will use the three-year award to investigate the drivers of rural-urban disparities in HPV vaccination in the Southern U.S. and then will develop a school-based intervention to increase HPV vaccine rates in rural areas of North and South Carolina.

Health promotion, education, and behavior (HPEB) research assistant professor Sayward Harrison and health services policy and management (HSPM) associate professor Jan Ostermann will lead the South Carolina initiative from the Arnold School of Public Health. Together, Duke and UofSC researchers are assessing the knowledge, attitudes, experiences, accessibility, perceived barriers and preferences of Southern parents and healthcare providers related to the HPV vaccine. They will then develop and test a tailored school-based intervention, INcrease VaccinE uptake among adoleScenTs (INVEST) in the rural South, that is designed to increase HPV vaccination rates.

“Human papillomavirus—often referred to as HPV—is the most common sexually transmitted infection,” says Harrison. “It’s so common, in fact, that nearly all sexually active adults will acquire HPV at some point in their lives—though many will not even know it.”

Many strains of HPV are low-risk, causing genital or anal warts that often clear without treatment. However, high-risk types of HPV cause cancer, including nearly all cases of cervical cancer, as well as anal, oropharyngeal, vaginal, vulvar and penile cancers.

There is a safe and effective vaccine that protects individuals against HPV, which is recommended by the CDC for all boys and girls at ages 11 or 12. However, the uptake of this life-saving vaccine has been slow and uneven in the U.S., particularly in rural areas.

Among 13- to 17-year-olds, only 30.8 percent of females and 27.4 percent of males in South Carolina have received their HPV vaccination series as recommended. These rates fall far below the Healthy People 2020 goal of at least 80 percent coverage. According to the CDC, these uptake rates are even lower for adolescents living in rural areas.

“This low uptake is alarming given that HPV will likely cause 30,000 new cases of anogenital cancer and 4,000 deaths from cervical cancer this year in the U.S. alone,” says Harrison. “If successful, the INVEST project will significantly improve our understanding of urban-rural vaccination disparities and yield an innovative, school-based intervention that can be scaled up across the Southern U.S. to increase vaccination coverage and prevent thousands of future cases of cancer.”

This study is supported by the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention (1U01IP001095-01-00).

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