Sexually Transmitted Infections in HIV-Infected Adults and Special Populations by Laura Hinkle Bachmann

Author:Laura Hinkle Bachmann
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

There is a paucity of data on HPV vaccine uptake among HIV-infected individuals in both high and lower income countries. However, timely implementation of widespread HPV vaccination offers an excellent opportunity to decrease the burden of HPV disease among young and newly HIV-infected individuals. This is particularly relevant in lower income countries where the prevalence of HIV is high and the infrastructure for cervical and anal cancer screening is not readily available.

Conclusion

The increased life expectancy of PLWH has led to a growing interest in the prevention of long-term complications from HIV infection, including HPV-related malignancies. Although preventable, cervical cancer still causes substantial morbidity and mortality in lower income countries where national screening programs are unavailable. Anal HSIL screening is not widely available due to limited availability of HRA-trained providers and the absence of data conclusively establishing its effectiveness. Although prophylactic HPV vaccines offer an excellent means to prevent HPV disease, their short-term impact is limited by relatively low vaccine uptake and absence of an effect in individuals already exposed to HPV. Fortunately, screening for prevention of both cervical and anal cancer in PLWH are areas of active interest and research. See-and-treat programs to prevent cervical cancer are actively being implemented in many lower income countries, while results from an ongoing, large, randomized-controlled trial of anal HSIL treatment should establish the efficacy of anal cancer prevention efforts and help implement guidelines on how to treat anal HSIL among PLWH [121].

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