Title

Acceptability of Human Papillomavirus (HPV) Vaccine in Female Sex Workers
Acceptability and Feasibility of a Modified HPV Vaccine Schedule in Brothel Based Female Sex Workers in Peru
  • Phase

    Phase 4
  • Study Type

    Interventional
  • Study Participants

    200
The primary objectives of this study are to determine the acceptance and potential for the effective use of HPV vaccine in the standard and a modified schedule in female sex workers. Secondary objectives include ascertaining the prevalence of HPV types among female sex workers by age and sexual experience.
FSWs are at higher risk of HPV infection and presumably cervical cancer, and the recently available vaccine has been shown to protect against persistent infection from these types. If this study gives evidence showing the vaccine is acceptable in preventing cervical HPV infection by types 16 and 18 in this population, then the burden of cervical cancer and cancer precursors could be drastically decreased through widespread vaccination of this target group. Vaccination at the point of entry of brothel based sex work may become a requirement to lower the burden of cervical cancer among FSWs and also among all other sex partners of clients of FSWs. A modified schedule may prove beneficial for FSWs in Peru to complete the vaccine regimen.
Study Started
Oct 31
2009
Primary Completion
Aug 31
2011
Study Completion
Aug 31
2011
Results Posted
Oct 11
2012
Estimate
Last Update
Oct 11
2012
Estimate

Biological Gardasil

Dosage Form: 0.5 ml intramuscular injection Dosage: Gardasil 0.5ml suspension Frequency: 3 doses

  • Other names: Human Papillomavirus Quadrivalent Vaccine

Regular schedule Active Comparator

Duration: Gardasil HPV vaccine administered intramuscularly at 0,2,6 months

Modified Schedule Experimental

Duration: Gardasil HPV vaccine administered intramuscularly at 0,3,6 months

Criteria

Inclusion Criteria:

Between the age of 18 and 26 years
Registered female sex worker living in Lima
Healthy with no known immune deficiency
Willing to participate in a study of HPV vaccine including a Pap smear, three pregnancy tests, blood draws, and three vaccine administrations over 7 months
Willing to provide informed consent

Exclusion Criteria:

Currently pregnant or planning to get pregnant in the next six months
Known immune deficiency disorder
Current receipt of immunosuppressive drugs
Allergy to yeast or known contraindication to HPV vaccine
Women who have had their cervix removed
Previous HPV vaccination
Current fever over 100 degrees Fahrenheit

Summary

Regular Schedule

Modified Schedule

All Events

Event Type Organ System Event Term

Antibody Response to HPV Vaccine for HPV 6,11,16,18.

We measured anitbody response to HPV vaccine for HPV subtypes 6,11,16, and 18. This was compared by study arm, namely the regular and modified vaccination schedules.

Regular Schedule

HPV11

745.06
Milli Merck Units (Geometric Mean)
95% Confidence Interval: 588.82 to 942.76

HPV16

3235.89
Milli Merck Units (Geometric Mean)
95% Confidence Interval: 2661.93 to 3933.61

HPV18

603.39
Milli Merck Units (Geometric Mean)
95% Confidence Interval: 487.81 to 746.35

HPV 6

1086.49
Milli Merck Units (Geometric Mean)
95% Confidence Interval: 854.16 to 1382.0

Modified Schedule

HPV11

776.84
Milli Merck Units (Geometric Mean)
95% Confidence Interval: 644.03 to 936.21

HPV16

2704.62
Milli Merck Units (Geometric Mean)
95% Confidence Interval: 2301.71 to 3178.06

HPV18

531.66
Milli Merck Units (Geometric Mean)
95% Confidence Interval: 441.68 to 639.97

HPV 6

1054.13
Milli Merck Units (Geometric Mean)
95% Confidence Interval: 808.42 to 1374.53

Proportion of Female Sex Workers Who Complete the Three Dose (0, 2, 6 Month) HPV Schedule in a Timely Manner Compared to the Modified (0, 3, 6 Month) Schedule.

Completion of 3 doses of HPV4 vaccine was measured at 6 months for women receiving the vaccine in 0,2,6 month regimen or the modified 0,3,6 month regimen. Completion was measured as receiving dose 3 of the vaccine during the study.

Regular Schedule

91.0
participants

Modified Schedule

93.0
participants

Prevalence of Infection With HPV Subtypes (6,11,16,18) Among Female Sex Workers

Type specific prevalence of HPV6,11,16,18 among study participants, calculated using Linear Array testing.

Regular Schedule

21.0
participants

Modified Schedule

25.0
participants

Identify Barriers to Acceptance of HPV Vaccine Among Female Sex Workers

Listed doubts about the HPV vaccine. Participants were asked if they had any doubts about the vaccine prior to learning about it from the health professional. Herein we present the total number of participants who reported doubts by study arm.

Regular Schedule

26.0
participants

Modified Schedule

20.0
participants

Total

200
Participants

Age Continuous

22.92
years (Mean)
Standard Deviation: 3.18

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Regular Schedule

Modified Schedule

Drop/Withdrawal Reasons

Regular Schedule

Modified Schedule