1699. Low Human Papillomavirus Vaccination Coverage in HIV-Positive Patients in Denver, Colorado
Session: Poster Abstract Session: HIV: HIV, HPV, and other STDs
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • IDSA poster 20151005.pdf (645.4 kB)
  • Background:

    Human papillomavirus (HPV) causes the majority of cervical and anal cancers and a substantial percentage of head and neck cancers.  HPV-related disease is known to be more prevalent and aggressive in persons with human immunodeficiency virus (HIV) co-infection. Despite reassuring data regarding HPV vaccine safety and immunogenicity in patients with HIV, vaccination coverage among the HIV-infected population has not been well described.  We evaluated HPV vaccine coverage at Denver Health, a large urban public healthcare system. 

    Methods:

    Retrospective, dynamic cohorts were assembled of adult HIV-positive and HIV-negative patients who receive care at Denver Health and who were age-eligible for HPV vaccine according to national guidelines. Each cohort was comprised of patients who visited a primary care clinic twice within an 18 month period while age-eligible for the HPV vaccine, between 2006 and 2014. Vaccination records were compiled from the electronic medical record and the state-wide vaccination registry.

    Results:

    The HIV-positive and HIV-negative cohorts consisted of 304 and 54,298 patients, respectively.  Rates of HPV vaccination were low in both cohorts. 2.3% of the HIV-positive cohort and 13.2% of the HIV-negative cohort completed the 3-dose vaccine series; vaccination increased by calendar year.  HIV infection (p<0.001) and male gender (p=0.03) were significantly associated with lower rates of HPV vaccine series completion.

    Table 1.

    HPV vaccine series initiation (%)

    HPV vaccine series completion (%)

    HIV-Positive (n= 304)

    27 (8.9)

    7 (2.3)

    Female  (n= 36)

    10 (27.8)

    1 (2.8)

    Male  (n= 268)

    17 (6.3)

    6 (2.2)

    HIV-Negative  (n= 54,298)

    13,213 (24.3)

    7,159 (13.2)

    Female  (n= 34,662)

    10,749 (31.0)

    6,194 (17.9)

    Male  (n= 19,636)

    2,464 (12.5)

    965 (4.9)

    Conclusion:

    HPV vaccination rates were much lower in HIV-positive patients than in HIV-negative patients receiving continuity care at Denver Health. Male gender, HIV infection, and earlier calendar year were associated with lower HPV vaccination. A tailored approach is needed to increase provider engagement to strongly recommend the HPV vaccine and enhance patient vaccine awareness.

    Grace E. Marx, MD, MPH1, Matthew F. Daley, MD2, William J. Burman, MD3 and Judith C. Shlay, MD, MSPH3, (1)Infectious Disease, Univ. of Colorado, Aurora, CO, (2)Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, (3)Denver Publ. Health, Denver, CO

    Disclosures:

    G. E. Marx, None

    M. F. Daley, None

    W. J. Burman, None

    J. C. Shlay, None

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