Quadrivalent human papillomavirus vaccination successfully reduces the prevalence of vaccine-targeted genotypes in a young, vaccine-eligible-age sample of Australian females
Asvini K. Subasinghe
A B H I , John D. Wark C D , Samuel Phillips A B , Alyssa Cornall A B E , Julia M. L. Brotherton F G and Suzanne M. Garland A B E
A Centre for Women’s Infectious Diseases Research, Royal Women’s Hospital, 20 Flemington Road, Parkville, Vic. 3052, Australia.
B Murdoch Children’s Research Institute, Infection and Immunity, Royal Women’s Hospital, Flemington Road, Parkville, Vic. 3052, Australia.
C The University of Melbourne Department of Medicine, Royal Melbourne Hospital, Parkville, Vic. 3050, Australia.
D Bone and Mineral Medicine, Royal Melbourne Hospital, Parkville, Vic. 3050, Australia.
E Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Vic. 3052, Australia.
F VCS Population Health, VCS Foundation, East Melbourne, Vic. 3002, Australia.
G Melbourne School of Population and Global Health, The University of Melbourne, Vic. 3053, Australia.
H Present address: Department of General Practice, Monash University, 1/270 Ferntree Gully Road, Notting Hill, Vic. 3168, Australia.
I Corresponding author. Email: asvini.subasinghe@monash.edu
Sexual Health 17(6) 510-516 https://doi.org/10.1071/SH20033
Submitted: 11 March 2020 Accepted: 26 October 2020 Published: 21 December 2020
Abstract
Background: The prevalence of genital tract vaccine-type human papillomavirus (HPV) is on the decline due to high vaccine uptake through the national HPV immunisation program in Australia. The aim of this study was to investigate HPV vaccine coverage and factors associated with HPV in a vaccine-eligible sample of young Australian females. Methods: Females aged 16–25 years were recruited into the Young Female Health Initiative study, a young women’s health study, via Facebook advertising from 2012 to 2017. Sexually active participants were asked to provide a self-collected vaginal swab for the detection of HPV DNA; positive samples were genotyped. Self-reported HPV vaccination status was confirmed by the National HPV Vaccination Program Register. Outcomes of the study were HPV acquisition and genotype, HPV vaccination status and factors associated with HPV. Results: Overall, 22.8% of samples (95% confidence interval (CI) 17.8–27.8%; n = 62/272) were positive for any HPV DNA, of which 19.1% (95% CI 14.4–23.8%; n = 52/272) were oncogenic types. HPV 16 was detected in three samples (1.1%; 95% CI –0.1%, 2.3%; two not HPV vaccinated and one vaccinated after sexual debut). Early sexual debut (<16 years) and multiple sexual partners were independently associated with an increased risk of any HPV. Conclusions: In a community sample of vaccine-eligible-age females with a high vaccine uptake, the prevalence of vaccine-related HPV genotypes is extremely low. Early sexual debut and multiple sexual partners are positively associated with HPV, underscoring the importance of vaccination at the routinely recommended age of 12–13 years for best vaccine impact.
Keywords: human papillomavirus (HPV), papillomavirus, public health, vaccines, women.
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