By Anne Coyle | May 5, 2010
The human papilloma virus is the most common sexually transmitted disease in the United States. A new Brown study may help immunize an especially vulnerable population: incarcerated adolescent girls.
Six million Americans are expected to become infected with the human papilloma virus (HPV) annually, and an estimated 50 percent of sexually active people will have HPV at some point in their lives.
Given these rates of infection and the availability of several FDA-approved vaccines for girls and women, a research team from Miriam Hospital and Brown University – Courtney E. Henderson, administrative director for the Center for Clinical and Translational Sciences; Josiah D. Rich, professor of medicine and community health; and Michelle A. Lally, director of the HIV Vaccine Clinical Trials Unit for Brown University/The Miriam Hospital – decided to study the vaccination rates of girls and young women in the juvenile justice system. Their study, which appears in the May issue of the Journal of Adolescent Health, is the first nationwide review of HPV vaccinations among this population.
Girls in juvenile justice facilities may be at particularly high risk for HPV and often do not receive consistent health care. The researchers recommend that all states make the HPV vaccine available to girls in the system, make the consent procedure easier, and increase HPV-vaccine education efforts.
TAB spoke with Courtney Henderson about the need for an improved prevention program.
Why is this study significant?
This is the first known study of HPV vaccination practices among juvenile justice facilities in the United States, and one of the very few studies of vaccination practices in general among this population. We hope that our research will provide new insights into how to improve the health of this marginalized population.
Most states, including Rhode Island, administer the HPV vaccine to girls in juvenile justice facilities. Of the states that provide the vaccine, 69 percent allow the state or facility superintendent to provide consent for vaccination of the adolescents. Of the states that did not provide the vaccine, the most commonly cited barrier was a lack of education among adolescents regarding the vaccine and its benefits.
What is the risk of a young woman getting HPV?
HPV is the most common sexually transmitted infection in the United States and poses a health risk for all Americans who are sexually active. Certain strains of HPV are associated with genital warts and some cancers, particularly cervical cancer. The Food and Drug Administration licensed a preventive vaccine in 2006, and the Advisory Committee on Immunization Practices recommends universal vaccination for all females between the ages of 11 and 26 years.
Are young women in the juvenile justice system at greater risk?
Yes. These girls have an earlier onset of sexual activity and an increased number of sexual partners when compared to national averages of sexual activity among youth. In 2001, the American Academy of Pediatrics recommended that special attention be focused on the immunization status of incarcerated adolescents, as many of these youth lack a medical “home” in which to receive consistent health care. The juvenile justice setting provides a unique opportunity to administer the HPV vaccine to a population that may not otherwise seek healthcare services.
Why don’t we already vaccinate all incarcerated adolescent girls?
The good news is that 39 states offer the HPV vaccine in their juvenile justice facilities. However, only 15 of these states offer the HPV vaccine to all the girls entering those facilities. This includes both committed girls, who will be housed within the juvenile justice system for an extended period of time, and detained girls, who will only be in the system for a short period of time. The remaining states either offer the vaccine inconsistently to their detained population or do not offer it at all, primarily due to the brevity of the detainees’ stays.
Other barriers that we identified included a general lack of education among adolescents regarding HPV vaccination, parental consent requirements, a lack of adequate healthcare staff to administer the vaccine, adolescents’ fear of needles, and cost.
What do you anticipate the impact of your study will be?
We would hope to see a greater awareness about the benefits of the HPV vaccine and an increase in vaccination rates in this population. Girls in juvenile justice facilities will eventually become part of the general population again, so any opportunity we have to improve their health will ultimately lead to improvements in the overall health of our communities.
Source: Today at Brown