Posted: August 2nd, 2015

Topic: Human Papillomavirus (HPV) and the Fight to Protect Men?s and Women?s Health

Topic: Human Papillomavirus (HPV) and the Fight to Protect Men?s and Women?s Health

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Human Papillomavirus (HPV) and the Fight to Protect Men?s and Women?s Health

Human Papillomavirus (HPV) and the Fight to Protect Men?s and Women?s Health
The Human Papillomavirus (HPV) is a virus passed from one person to another through skin-to-skin contact. According to Henderson, Clements, & Damery (2013), HPV is the most common sexually transmitted infection (STI) among men and women. Most sexually active men and women will contract HPV at least once in their lifetime, but there are over forty types of HPV. This virus can be transmitted through vaginal, oral, or anal sex, but can also be caused by any exposure that allows skin-to-skin contact with a person who carries the virus (Jemal, Bray, Center, Ferlay, Ward, & Forman, 2011). Most types of HPV go away on its own, but there are four types out of over forty types of HPV that do not go away. These four types of HPV are very dangerous to one?s health and these four types can cause cancer or genital warts.
Seventy nine million people are currently affected by HPV, and fourteen million new cases of HPV are recorded each year. This topic is of high interest to me because so many people are affected by HPV, and also because the controversy about the new vaccination and its affect against HPV. Human papilloma virus (HPV) affects millions of men and women, and specific types of HPV can cause genital warts or cancer of the cervix, vulva, penis, vagina, oropharynx, or anus. Three hundred and sixty thousand women and men are affected by genital warts each year (Henderson, Clements, & Damery, 2013). Eleven thousand women are affected by cervical cancer each year (Henderson, Clements, & Damery, 2013). Men and women are both affected by HPV, but more women than men are affected and HPV cause severe health concerns in women. Women are more negatively affected by HPV, so more education is needed for better outcomes in women?s health. Women need to be educated on the importance of safe sex, HPV vaccinations, and the affects contracting HPV would have on one?s health. Women need to get their routine Pap smear test done because this is how HPV is diagnosed. The cells that are scraped from the cervix during a Pap smear are examined under a microscope, and if there are abnormal cells found these cells can possible change into genital warts or cancer. Cancer that is caught early has a better prognosis, so understanding risk factors, preventive measures, and early diagnosing can save lives.
There is no cure for HPV but there are three vaccinations that are readily available to prevent the disease. FDA and CDC have approved Cervarix, Gardasil, and Gardasil 9 as safe and effective HPV vaccinations, but there is controversy on the ages the vaccinations are given and the idea that it is protecting against a sexually transmitted disease (Knox, 2011). For example, some mothers do not want to protect there eleven year old daughter or son from a STI because it seems as if she is expecting her child to have sex, but if the vaccination is done after the child is sexually active it may be to late for protection against HPV.
Two questions related to the human papilloma virus (HPV) infection that I would like to explore and explained are:
1. What are the four types of HPV that do not go away and are very dangerous to one?s health?
2. What are the advantages and disadvantages of the HPV vaccines, and how the vaccines work to prevent most types of HPV?

The four types out of forty types of HPV that do not go away and are dangerous to one?s health include HPV types 16 and 18, which are high risk types of HPV. On the other hand, HPV types 6 and 11 are low-risk types and pose insignificant effects on the health conditions of the affected patient population. These HPV types can be prevented by use of HPV vaccines. The advantage of most HPV vaccines is that they prevent cervical cancer as well as preventing HPV types 16 and 18 infections (Riethmuller et al., 2015).
However, HPV vaccines are only effective in people who have yet to be exposed to these types of HPV. According to Smith and Canfell (2014), the vaccines rarely prevent HPV in those already exposed to these HPV types. The vaccines only protect one from being infected with particular HPV types. There is likelihood that the HPV vaccines could prevent HPV-related cancers, such as those cancers affecting the penis, head and neck areas though studies are yet to prove this.
The vaccines work to prevent most types of HPV through stimulation of the immune system of the body (Szarewski et al., 2013). In response, as if the person actually had the HPV virus, antibodies to the specific HPV types are produced by the body. Nevertheless, the vaccines do not protect the vaccinated person from being infected by other STIs or other HPV types. In most cases, HPV vaccines only prevent infections by some of the most common HPV types and may minimize the risks of being infected with cervical, vulvar, vaginal, anal cancers, pre-cancers and genital warts. However, since a vaccinated person can still be infected by HPV and STIs, it is advisable to practice safe sex.

Research Review
AlObaid, A., Al-Badawi, I. A., Al-Kadri, H., Gopala, K., Kandeil, W., Quint, W., & … DeAntonio, R. (2014). Human Papillomavirus Prevalence And Type Distribution Among Women Attending Routine Gynecological Examinations In Saudi Arabia. BMC Infectious Diseases, 14(1), 132-149. doi:10.1186/s12879-014-0643-8
In this article, the authors sought to establish the level of awareness and the different types of HPVs among Saudi women. In particular, the authors hypothesized that the epidemiology of HPV was poorly understood among Saudi women. In order to verify the hypothesis, the researchers conducted an observational cross-sectional study, where cervical samples were taken for examination and a questionnaire on HPV infection were given to patients receiving routine gynecological services. Results from this study indicated that the most prevalent high risk HPV to be HPV-68/73, HPV-18 and HPV-16. On the other hand, low risk HPV types identified in this study included HPV-6, HPV-42, HPV-53 and HPV-54. Of more significance, the study established that only 32.2% of total sample population was aware of HPV infection and that 89.9% were interested in vaccination.
Smith, M. A., & Canfell, K. (2014). Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake. Plos ONE, 9(8), 1-10. doi:10.1371/journal.pone.0101048.
Szarewski, A., Skinner, S. R., Garland, S. M., Romanowski, B., Schwarz, T. F., Apter, D., & … Martens, M. (2013). Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation. Journal Of Infectious Diseases, 208(9), 1391-1396. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=90612495
In this study, the hypothesis by Szarewski et al. (2013) is that it is apparent to protect individuals from low-risk HPV types through vaccination whereas that of Smith and Canfell (2014) is that men should be added to HPV vaccination programs if choice of a partner is influenced by factors that influence the uptake of vaccine. Szarewski et al. (2013) used case control studies for a period of four years in which a group vaccinated for over 6-months was observed against those not yet vaccinated. On the other hand, Smith and Canfell (2014) simulated a model whose data was obtained from observations made in Australia and USA.
In addition, Szarewski et al. (2013) findings were that among the population that was not vaccinated, the HPV-16/18 AS04-adjuvanted vaccine had moderate efficacy against the infections that were persistent with some low-risk HPV types that are significantly responsible for external genital warts. Smith and Canfell (2014) found that the impact of more male vaccination was less likely to affect the levels of heterogeneity in vaccine uptake. The findings by Smith and Canfell emphasize the continual importance of having high vaccine coverage especially amongst groups infected with HPV to achieve equality of outcomes.

References
AlObaid, A., Al-Badawi, I. A., Al-Kadri, H., Gopala, K., Kandeil, W., Quint, W., & … DeAntonio, R. (2014). Human papillomavirus prevalence and type distribution among women attending routine gynecological examinations in Saudi Arabia. BMC Infectious Diseases, 14(1), 132-149. doi:10.1186/s12879-014-0643-8
Henderson, L., Clements, A., & Damery, S. (2013). A false sense of security?? Understanding the role of the HPV vaccine on future cervical screening behaviour: A qualitative study of UK parents and girls of vaccination age. Journal of Medical Screening, 18(1), 41-45. doi:10.1258/jms.2011.010148
Jemal, A., Bray, F., Center, M. M., Ferlay, J., Ward, E., & Forman, D. (2011). Global cancer statistics. CA: a cancer journal for clinicians, 61(2), 69-90.
Knox, R. (2011). HPV Vaccine: The Science Behind The Controversy. Retrieved from http://www.npr.org/2011/09/19/140543977/hpv-vaccine-the-science-behind-the-controversy
Riethmuller, D., Jacquard, A., St Guily, J.L., Aubin, F., Carcopino, A., Pradat, P., Dahlab, A & Pr?tet, J. (2015). Potential impact of a nonavalent HPV vaccine on the occurrence of HPV-related diseases in France. BMC Public Health, 15:453. Retrieved from DOI 10.1186/s12889-015-1779-1
Smith, M. A., & Canfell, K. (2014). Incremental Benefits of Male HPV Vaccination: Accounting for Inequality in Population Uptake. Plos ONE, 9(8), 1-10. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=5&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=97800780
Szarewski, A., Skinner, S. R., Garland, S. M., Romanowski, B., Schwarz, T. F., Apter, D., & … Martens, M. (2013). Efficacy of the HPV-16/18 AS04-Adjuvanted Vaccine Against Low-Risk HPV Types (PATRICIA Randomized Trial): An Unexpected Observation. Journal Of Infectious Diseases, 208(9), 1391-1396. Retrieved from http://eds.a.ebscohost.com/eds/detail/detail?vid=2&sid=77c3cef7-5dcc-4552-9ddd-9f69b82d647b%40sessionmgr4004&hid=4203&bdata=JnNpdGU9ZWRzLWxpdmU%3d#db=aph&AN=90612495

********************PLEASE READ CAREFULLY BECAUSE THESE ARE THE DIRECTIONS FOR THIS PAPER
For Part 3 of the research review paper, you will do a synthesis of the literature and create a research proposal.
Before you begin, review the overall assignment instructions from Weeks 1 and 2. Revise Parts 1 and 2 of your paper, as needed, on the basis of instructor feedback, new knowledge acquired in class, or discussion questions and/or additional readings.
Part 3 will probably be the most challenging part of the assignment, so allow yourself plenty of time to think about what you’ve read and develop an argument for further research. Using the knowledge gained from work on Parts 1 and 2, identify one research question that has not been investigated previously or that you would address in a different way than you’ve read about so far. This is sometimes known as gap analysis, in that you are looking for a gap in the existing body of knowledge where new research would contribute to an understanding of the issue in a way that could improve clinical practice for the nurse practitioner and improve patient outcomes.
Your research question must be clearly related to Parts 1 and 2. Be sure to state this clearly as a research question. Explain why you think this is a gap in existing research (relate directly to published research), its clinical relevance (why you think your specific research question is an important area to explore), and your ideas about research design (how you would conduct research to investigate it). Include a discussion of whether your question would lend itself to a quantitative, qualitative, or mixed design; why; and how you might be able to acquire participants for the study.
Submission Details:
? Submit your answers in a 2- to 3-page Microsoft Word document.

Assignment 2 Grading Criteria Maximum Points
Identified and clearly stated a research question that represents a gap in current research. 5
Described the clinical relevance of the proposed research question. 5
Presented a possible research design for investigating the proposed question. 5
Maintained the originality of the research question. 3
Used correct spelling, grammar, and professional vocabulary and cited all sources using APA style. 2

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