AIDS and Behavior

Preliminary Impact of Public Health Messaging on HPV Vaccine Uptake Among Adolescent Girls and Young Women Living with HIV in Central Uganda

We assessed the preliminary impact of public health messaging on HPV vaccine uptake among adolescents and young women living with HIV in central Uganda. We conducted a pilot randomized controlled trial involving 100 adolescent girls and young women (ages 10-24) living with HIV across four healthcare facilities in the Greater Masaka region of Uganda. Facilities were randomly assigned to either the treatment or control arm. Participants in the control arm were only exposed to informational posters about HPV vaccination, while those in the treatment arm received educational sessions on cervical cancer and HPV vaccination, supplemented by brochures in addition to the posters. A mixed-effects logistic regression model was used to evaluate the intervention's effect on HPV vaccine uptake. Adolescents in both the intervention and control groups did not differ significantly in HPV vaccine uptake at baseline. At baseline, 46 out of 69 unvaccinated girls (49%) were in the treatment arm, which decreased to 9 (20%) at follow-up, while the number of unvaccinated girls in the control arm remained unchanged. The intervention effect was evident through a significant time × group interaction (χ

The Impact of Antiretroviral Therapy (ART) on HPV Persistence and Cervical Cancer Progression Among Women with HPV/HIV Co-infection: A Systematic Review

Cervical cancer remains the leading cause of cancer-related morbidity and mortality among women globally, particularly in low- and middle-income countries. Women living with HIV are at risk of persistent high-risk human papillomavirus (HR-HPV) infections due to HIV-associated immunosuppression. Although antiretroviral therapy (ART) enhances immune function and reduces HIV-related complications, its influence on the persistence of HPV and the progression of cervical cancer remains inconclusive. This systematic review aimed to assess the impact of ART on HPV persistence and cervical cancer progression among HIV-positive women. A comprehensive search of PubMed, Web of Science, and Scopus was conducted for studies published between January 2010 and September 2024. Studies were screened, selected, and reviewed according to PRISMA guidelines using Rayyan. Data on HPV genotypes, ART status, CD4 counts, diagnostic methods, and cervical lesion grades were extracted and analyzed. Eighty studies met the inclusion criteria. HPV16 and HPV18 were the most frequently reported genotypes. Despite ART use, high-grade lesions (CIN II/III and HSIL) remained prevalent, particularly among women with CD4 counts < 350 cells/µL. Diagnostic methods varied, with pap smear and colposcopy most commonly used. ART adherence and duration were associated with improved outcomes, but not complete lesion resolution. ART contributes to immune restoration and may reduce HPV persistence, but does not fully prevent cervical disease progression, mostly in the advanced stage. Integration of regular cervical cancer screening within HIV care is essential to reduce disease burden in this high-risk population.

HPV Vaccine Uptake and its Predictors among Adolescent Girls and Young Women Living with HIV-in Central Uganda

This study aimed to assess HPV vaccine uptake and its predictors among adolescent girls and young women living with HIV. We analyzed cross-sectional baseline data from a pilot randomized controlled trial involving 100 girls and young women (aged 10-24 years) living with HIV and receiving care in Uganda's Greater Masaka region. The study was conducted in four Antiretroviral(ART) providing healthcare facilities between January and March 2024. Surveys were used to collect data on socio-demographics (age, religion, education), HPV acceptability, barriers to vaccination, perceived susceptibility, knowledge about HPV and cervical cancer, and HPV vaccine uptake. We then conducted a logistic regression analysis to determine the predictors of HPV vaccine uptake. We also tested assumptions for the logic regression. The health belief model guided us in selecting the variables to include in the final logistic regression model. The findings revealed a low vaccine uptake rate, with only 31% vaccinated participants. Significant predictors included sexual experience (OR = 4.08, p = 0.011) and HPV knowledge (OR = 1.41, p = 0.016). Participants without sexual experience were four times more likely to be vaccinated, and higher HPV knowledge increased the likelihood of vaccination. However, perceived barriers, susceptibility, and cervical cancer knowledge were not significant predictors. These findings highlight the need to address barriers and improve HPV knowledge to enhance vaccine uptake, particularly among adolescent girls and young women living with HIV.