Marisa Felsher

This study aims to explore the contrasting trends of decreasing cervical cancer (CC) rates among women and increasing oropharyngeal cancer (OPC) rates among men. The analysis examines public health initiatives, including CC screening programs and HPV vaccination efforts, alongside the changing epidemiology of OPC. Declines in CC incidence are attributed to improved screening and HPV vaccination. Conversely, OPC rates are rising among men, linked primarily to HPV infection and lack of established screening programs. Data indicate a higher OPC burden in men compared to CC in women in several countries. Addressing the rising OPC trend requires a multifaceted approach, including gender-neutral HPV vaccination, the development of OPC screening methods, and increased public awareness. Sustained efforts in HPV-related cancer prevention are crucial to mitigate these opposing trends.

The uptake of human papillomavirus (HPV) vaccine remains suboptimal despite being a part of routine vaccination within national immunization program(s). This indicates probable challenges with the implementation of HPV immunization program(s) in various countries. The objective of this systematic literature review (SLR) was to identify implementation strategies for HPV vaccination within national and regional immunization programs worldwide with an aim to provide guidance for countries targeting to increase their HPV vaccine coverage rate (VCR). A comprehensive literature search was conducted across Medline and Embase and included articles published between January 2012 and January 2022. Of the 2,549 articles retrieved, 168 met inclusion criteria and were included in the review. Strategies shown to improve HPV vaccination uptake in the reviewed literature include campaigns to increase community awareness and knowledge of HPV, health care provider trainings, integrating HPV vaccination within school settings, coordinated efforts via multi-sectoral partnerships, and vaccination reminder and recall systems. Findings may help national authorities understand key considerations for HPV vaccination when designing and implementing programs aiming to increase HPV VCR in adolescents.

Head and neck cancers (HNCs) are the seventh most common tumors worldwide, with an estimated annual burden of 870 000 new cases and 440 000 deaths in 2020.¹ In addition to being a necessary cause of cervical cancer, human papillomavirus (HPV) is a cause of a growing subset of HNC, including oropharyngeal cancer (OPC).² In the US, the incidence of OPC has surpassed cervical cancer and is the most common HPV-related cancer.³ Of concern is that the incidence of HPV-related OPC continues to increase at a rate of 2.8% per year among men in the US.⁴ The proportion of OPC due to HPV has significantly increased over time, with recent publications indicating that more than 80% of OPCs are attributable to HPV infection.⁵ Human papillomavirus types recognized as carcinogens are HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59, and as such are considered high-risk HPV types (HR HPV).⁶ Human papillomavirus–16 alone is responsible for 85% to 96% of HPV-positive OPC cases.⁷ Low-risk HPV types (LR HPV), most commonly 6 and 11, are responsible for anogenital and oral warts and recurrent respiratory papillomatosis, a rare and debilitating disease, both of which reduce quality of life.^5,8

Introduction: Human Papillomavirus (HPV) causes 4.5% of all new cancer cases. Efficient HPV vaccination programs are crucial to reduce the global burden of cancer. As of June 2020, 107/194 World Health Organization (WHO) Member States have introduced HPV vaccination, one-third of which are gender...

Background: Overdose is a leading cause of morbidity and mortality among people who inject drugs. Illicitly manufactured fentanyl is now a major driver of opioid overdose deaths. Methods: Semi-structured interviews were conducted with 23 participants (19 persons who inject drugs and 4 service providers) from rural southern Illinois. Data were analyzed using constant comparison and theoretical sampling methods. Results: Participants were concerned about the growing presence of fentanyl in both opioids and stimulants, and many disclosed overdose experiences. Strategies participants reported using to lower overdose risk included purchasing drugs from trusted sellers and modifying drug use practices by partially injecting and/or changing the route of transmission. Approximately half of persons who inject drugs sampled had heard of fentanyl test strips, however fentanyl test strip use was low. To reverse overdoses, participants reported using cold water baths. Use of naloxone to reverse overdose was low. Barriers to naloxone access and use included fear of arrest and opioid withdrawal. Conclusions: People who inject drugs understood fentanyl to be a potential contaminant in their drug supply and actively engaged in harm reduction techniques to try to prevent overdose. Interventions to increase harm reduction education and information about and access to fentanyl test strips and naloxone would be beneficial.

Pre-exposure prophylaxis (PrEP) is a promising but underutilized HIV prevention strategy for Women who Inject Drugs (WWID). Stigma and disclosure concerns have been key barriers to PrEP use among women in PrEP efficacy trials. Social support has been found to buffer against some PrEP stigma, though these factors have been largely unexplored among WWID. Investigating how WWID disclose PrEP use is important given evidence that disclosure is associated with higher adherence. We aimed to identify the impact of stigma and support on PrEP disclosure within social networks of WWID participating in a PrEP demonstration project in Philadelphia, PA, USA. PrEP-using WWID ≥ 18 years completed social network surveys. Generalized estimating equations were used to account for the correlation of network structure. Thirty-nine WWID (i.e. egos) named an average of 9.5 ± 3.3 network members (i.e. alters), for a total sample of 371 unique relationships. Egos disclosed their PrEP use to an average of 4.0 alters (SD = 2.8). Related to PrEP stigma, participants had 0.4 times decreased odds of PrEP disclosure with alters who would disapprove of them taking PrEP (95% CI: 0.1–0.9). Related to support, participants had 2.5 times higher odds of disclosure among peers who could provide PrEP advice (95% CI: 1.0–6.0). Interventions that increase social support and decrease stigma are pivotal for increasing PrEP use disclosure among WWID.