The human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. According to the CDC African-American women are 40 percent more likely to develop cervical cancer caused by the STD human papillomavirus (HPV) and 20 percent more likely to die from it compared to white women. HPV in many women just clears up on its own, but researchers found that Black women have a harder time with the clearing up process. Depending on the strain of HPV, it can develop into cervical cancer.
The HPV vaccine is not without controversy. Last year, Texas Governor Rick Perry was at the center of a national debate about the controversial HPV vaccine. In 2007, he signed an executive order that required all sixth-grade girls in his state receive the human papillomavirus (HPV) vaccine. Although the order included an opt-out for those parents who didn’t want their daughters to receive the vaccination, it was met with opposition and overridden by the state in 2008.
Although the vaccine has proven health benefits, there are still plenty of unanswered questions and issues. In regards to health, many people are concerned that the vaccine doesn’t provide enough protection, since there are several strains of the disease. Since the vaccine is fairly new, people have also questioned the long-term side effects. Many parents also feel that the recommended for the vaccine is too young.
Just this week, researchers at Duke University are suggesting that African American women and white women may not be affected by the same subtypes of the human papillomavirus, which is troubling considering current available HPV vaccines do not protect against the subtypes that were most commonly found in African American women.
Researchers from the Duke University School of Medicine examined the HPV subtypes present in 572 people who were part of the Cervical Intraepithelial Neoplasia Cohort Study, all of whom had abnormal Pap tests. Of those women, 280 were African American and 292 were white.
They looked particularly at HPV subtypes present in the women’s cervical intraepithelial neoplasias (CIN), which are abnormalities in the cervix that are considered precursors to cervical cancer. They wanted to see what differences there may be in early CIN (called CIN1) and more advanced CIN (called CIN2 and CIN3).
In those with advanced precancerous cervical abnormalities, HPV 16, 18, 33, 39 and 59 were the most common genotypes detected in white women, whereas HPV 31, 35, 45, 56, 58, 66 and 68 were the most prevalent in African-American women.
“Compared with white women, we saw that African-American women had about half as many infections with HPV 16 and 18, the subtypes that are covered by HPV vaccines,” said Adriana Vidal, Ph.D., assistant professor of obstetrics and gynecology at Duke University School of Medicine and the study’s first author. “Since African-American women don’t seem to be getting the same subtypes of HPV with the same frequency, the vaccines aren’t helping all women equally.”
A new HPV vaccine targeting nine HPV subtypes (6, 11, 16, 18, 31, 33, 45, 52 and 58) is currently being tested in phase III trials. While the new vaccine may help prevent additional HPV infections by covering new subtypes, it may not address the disparities found in this study.
“The most disconcerting part of this new vaccine is it doesn’t include HPV 35, 66 and 68, three of the strains of HPV of which African-American women are getting the most,” Hoyo said. “We may want to rethink how we develop these vaccines, given that African-Americans tend to be underrepresented in clinical trials.”
With that said, the results of the study are only preliminary because of the small number of participants. To have conclusive results would mean the study would have to be done on a larger population.