A community perspective: On Human Papillomavirus (HPV)-related cancer among women and, trans and gender diverse people

Positive Life NSW & Femfatales, April 2019

Authors: Liz Sutherland, Lance Feeney, Katya Samodurov

Human papillomavirus (HPV) is a common virus which can be passed through skin to skin contact during sexual activity. Evidence to date shows that women living with HIV are 3 to 6 times more likely to develop cervical cancer than the general female population. They are also at greater risk of developing anal, vaginal, oropharyngeal and vulvar cancers.

There are other groups who may have a higher but preventable risk because they are often left out of the conversation about HPV and related cancers. Trans men are less likely to be up-todate with Pap tests to screen for cervical cancer. Furthermore, several studies have highlighted that trans and gender diverse people, and lesbian and bisexual cis-gendered women are often disregarded as not being at risk.

Positive Life and Femfatales developed a cross-sectional study to:

• Assess awareness and knowledge of HPV infection and risk for 4 HPV-related cancers (cervical, vaginal, vulvar, and anal) among women and, trans and gender diverse people in Australia;

• Assess the knowledge gaps to inform the development and implementation of population-specific educational resources to increase community and healthcare professional awareness of HPV and related cancers;

• Assist with the prevention of morbidity and mortality by increasing screening, early detection and treatment of HPV-related cancers, and;

• Assess rates of HPV vaccination in women and, trans and gender diverse people

KEY FINDINGS:

1. The results from this survey highlighted a lack of awareness of risk, prevention,
symptoms, and early detection of HPV-related vaginal, vulvar, and anal cancers.

2. Approximately 28% of HIV-positive respondents were unaware that a vaccination
against HPV exists and 71% of HIV-positive respondents had not been vaccinated
against HPV.

3. Over half (60%) of HIV-positive respondents believe their risk of anal cancer was either‘about the same’, ‘lower’, or ‘much lower’ than the general female population’s risk.

4. While all HIV-positive respondents had screened for cervical cancer at some point in
their lives, 91.7% had never had an anal examination for anal cancer.

5. Among HIV-positive and HIV-negative but immunocompromised respondents who had undergone staging or treatment for either cervical, vaginal, or vulvar cancer, none had ever screened for anal cancer.

6. Of the HIV-positive respondents who do not receive screening reminder notifications, none were aware of the new 3 yearly National Cervical Screening Guidelines and changes.

7. Qualitative responses indicated that respondents generally preferred having clinician-initiated conversations with female doctors or nurses who were non-judgemental, non-dismissive, clear, and made them feel comfortable.

8. In an open-ended short-answer question, more than 25% of qualitative respondents felt that more awareness and normalising talking about HPV in the public realm would help increase their chance of detecting HPV-related cancer early.

Cervical Screening Update recording now available!

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SHINE SA, August 2018

SHINE SA is proud to present our pilot Clinical Education Forum recording. This recording is available free of charge,  and access is limited to three months only.

Topic: Cervical Screening Update

Presenters: Megan van Zanten & Dr Amy Moten

The forum ensures your knowledge of the National Cervical Screening Renewed Guidelines is accurate and in line with best practice principles.

  • To watch the recording click the link here and set up a free account/sign in. Under Course Categories click Clinical Education to find the course, and then click Enrol Me. You can now watch the recording.

Survey for all women and anyone with a cervix: HPV-related cancer awareness

Positive Life in partnership with Femfatales, the National Network of Women Living with HIV, 2018

All women and anyone with a cervix in Australia, both HIV-positive and HIV-negative, are invited to take an online, anonymous survey about awareness of HPV and related cancers.

Positive Life NSW in partnership with Femfatales, the National Network of Women Living with HIV, has developed a survey to assess levels of HPV-related cancer awareness among women.

The results of this survey will help them better understand how they can support women to prevent HPV-related cancer and how they can support women in recovery from HPV-related cancer. The responses will also assist in the development of targeted educational resources for immunocompromised women and women living with HIV, who are three times more likely to develop cervical cancer. No identifying information will be collected.

The online survey will take approximately eight minutes to complete. If you require a hard-copy of the survey, they can mail some to you with reply paid envelopes: please feel free to contact Katya on (02) 9206 2178 or at KatyaS@positivelife.org.au

Disclaimer – the responsibility for the ethical aspects of this survey are with the organisation Positive Life NSW. SHINE SA accepts no responsibility or liability for the survey.

Gardasil 9 now on the National Immunisation Program

AJP, 9th Oct 2017

The Government has announced free access for young people to the improved HPV vaccine.

From 2018, Gardasil 9, which protects against nine HPV strains (up from four) will be offered through school-based immunisation programs to all 12 to 13-year-old boys, and girls in years seven or eight.

Healthy Communities: HPV immunisation rates in 2014–15

Australian Institute of Health and Welfare, 2017

Immunisation against the highly contagious human papillomavirus (HPV) can prevent cervical and other cancers, and other HPV-related diseases. The National HPV Vaccination Program has been immunising adolescent girls since 2007 and was extended to boys in 2013.

This third Healthy Communities report on HPV immunisation shows the percentage of girls aged 15 across 31 Primary Health Network (PHN) areas who were fully immunised against HPV in 2014–15. For the first time, the percentage of boys fully immunised are also shown by PHN area.

The report finds that in 2014–15:

  • Nationally, nearly 79% of girls aged 15 were fully immunised against HPV, an increase from 74% in 2013–14 and 72% in 2012–13
  • There remains relatively large variation in HPV immunisation rates for girls across PHN areas, ranging from 86% of girls fully immunised in Murrumbidgee (NSW) to 67% in Tasmania
  • Nationally, 67% of boys aged 15 were fully immunised against HPV and across PHN areas percentages ranged from 78% in Gippsland (Vic) to 57% in the Northern Territory.

Download Healthy Communities: HPV immunisation rates in 2014–15 (PDF, 3.5 MB)

New study shows HPV vaccine is working to reduce rates of genital warts

The Conversation, March 29, 2017 6.04am AEDT

The human papillomavirus (HPV) vaccine was introduced in Australia in 2007 and New Zealand in 2008 to prevent cervical cancer. It was free for women up to age 26 in Australia and to all women under 20 in New Zealand. This is because 99.7% of cervical cancers are associated with the sexually transmissible infection.

There is mounting evidence the HPV vaccination program is preventing cervical disease. But the human papillomavirus is also responsible for causing genital warts. Despite a range of questions about the vaccine’s efficacy in this area, a recent New Zealand study has shown a large reduction in genital warts.

  • Read more here
  • View study abstract here