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| ID | Type | Description | Link |
|---|---|---|---|
| IRB00001625 |
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| Name | Class |
|---|---|
| Merck Sharp & Dohme LLC | INDUSTRY |
| NGO Via Libre | OTHER |
| Universidad Peruana Cayetano Heredia | OTHER |
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The primary objectives of this study are to determine the acceptance and potential for the effective use of HPV vaccine in the standard and a modified schedule in female sex workers. Secondary objectives include ascertaining the prevalence of HPV types among female sex workers by age and sexual experience.
FSWs are at higher risk of HPV infection and presumably cervical cancer, and the recently available vaccine has been shown to protect against persistent infection from these types. If this study gives evidence showing the vaccine is acceptable in preventing cervical HPV infection by types 16 and 18 in this population, then the burden of cervical cancer and cancer precursors could be drastically decreased through widespread vaccination of this target group. Vaccination at the point of entry of brothel based sex work may become a requirement to lower the burden of cervical cancer among FSWs and also among all other sex partners of clients of FSWs. A modified schedule may prove beneficial for FSWs in Peru to complete the vaccine regimen.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Regular schedule | Active Comparator | Duration: Gardasil HPV vaccine administered intramuscularly at 0,2,6 months |
|
| Modified Schedule | Experimental | Duration: Gardasil HPV vaccine administered intramuscularly at 0,3,6 months |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Gardasil | Biological | Dosage Form: 0.5 ml intramuscular injection Dosage: Gardasil 0.5ml suspension Frequency: 3 doses |
|
| Measure | Description | Time Frame |
|---|---|---|
| Antibody Response to HPV Vaccine for HPV 6,11,16,18. | We measured anitbody response to HPV vaccine for HPV subtypes 6,11,16, and 18. This was compared by study arm, namely the regular and modified vaccination schedules. | Month 7 |
| Proportion of Female Sex Workers Who Complete the Three Dose (0, 2, 6 Month) HPV Schedule in a Timely Manner Compared to the Modified (0, 3, 6 Month) Schedule. | Completion of 3 doses of HPV4 vaccine was measured at 6 months for women receiving the vaccine in 0,2,6 month regimen or the modified 0,3,6 month regimen. Completion was measured as receiving dose 3 of the vaccine during the study. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of Infection With HPV Subtypes (6,11,16,18) Among Female Sex Workers | Type specific prevalence of HPV6,11,16,18 among study participants, calculated using Linear Array testing. | Baseline |
| Identify Barriers to Acceptance of HPV Vaccine Among Female Sex Workers |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Neal Halsey, MD | Johns Hopkins Bloomberg School of Public Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| NGO Via Libre | Lima | Lima Province | Peru |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17597569 | Background | de Sanjose S, Diaz M, Castellsague X, Clifford G, Bruni L, Munoz N, Bosch FX. Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. Lancet Infect Dis. 2007 Jul;7(7):453-9. doi: 10.1016/S1473-3099(07)70158-5. | |
| 15054172 | Background |
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Some eligible participants provided a false phone number, did not show up for their study appointment, refused to use birth control when receiving vaccine doses, and reported not having time to participate in the study. After the survey and Pap smear, vaccination was the final step in study enrollment.
FSWs 18-26 years of age were recruited in person between August 28, 2009 and March 3, 2010 from 49 different sex locales in Lima, Peru by trained medical staff and 8 health promoters. If they fulfilled inclusion criteria, women were asked to report to the study clinic for completion of surveys, vaccination, Pap smears, and counseling.
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| ID | Title | Description |
|---|---|---|
| FG000 | Regular Schedule | Duration: 0,2,6 months each dose Dose form: standard injectable HPV4 vaccine Groups: FSWs 18-26 years of age |
| FG001 | Modified Schedule | Duration: 0,3,6 months each dose Dose form: standard injectable HPV4 vaccine Groups: FSWs 18-26 years of age |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Regular Schedule | Duration: 0,2,6 months |
| BG001 | Modified Schedule | Duration: 0,3,6 months |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Antibody Response to HPV Vaccine for HPV 6,11,16,18. | We measured anitbody response to HPV vaccine for HPV subtypes 6,11,16, and 18. This was compared by study arm, namely the regular and modified vaccination schedules. | All participants who returned for the final blood draw considered in the final antibody analysis. The analysis applies to antibody levels after vaccination for HPV6, HPV11, HPV16, and HPV18. This is done for each study arm, namely the regular schedule and the modified schedule. | Posted | Geometric Mean | 95% Confidence Interval | Milli Merck Units | Month 7 |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Regular Schedule | Duration: 0,2,6 months |
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Small time difference between study arms (0,2,6 and 0,3,6 months); We cannot distinguish between antibodies resulting from vaccination and antibodies resulting from natural HPV infection;
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Brandon Brown | Johns Hopkins University | 949-266-4401 | bbrown@jhsph.edu |
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| ID | Term |
|---|---|
| D030361 | Papillomavirus Infections |
| D014777 | Virus Diseases |
| ID | Term |
|---|---|
| D015229 | Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D003141 | Communicable Diseases |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D000068857 | Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 |
| ID | Term |
|---|---|
| D017778 | Vaccines, Combined |
| D014612 | Vaccines |
| D001688 | Biological Products |
| D045424 | Complex Mixtures |
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|
Listed doubts about the HPV vaccine. Participants were asked if they had any doubts about the vaccine prior to learning about it from the health professional. Herein we present the total number of participants who reported doubts by study arm. |
| Month 0 |
| Mak R, Van Renterghem L, Cuvelier C. Cervical smears and human papillomavirus typing in sex workers. Sex Transm Infect. 2004 Apr;80(2):118-20. doi: 10.1136/sti.2002.003749. |
| 11289192 | Background | Juarez-Figueroa LA, Wheeler CM, Uribe-Salas FJ, Conde-Glez CJ, Zampilpa-Mejia LG, Garcia-Cisneros S, Hernandez-Avila M. Human papillomavirus: a highly prevalent sexually transmitted disease agent among female sex workers from Mexico City. Sex Transm Dis. 2001 Mar;28(3):125-30. doi: 10.1097/00007435-200103000-00001. |
| 14596772 | Background | Ford K, Reed BD, Wirawan DN, Muliawan P, Sutarga M, Gregoire L. The Bali STD/AIDS study: human papillomavirus infection among female sex workers. Int J STD AIDS. 2003 Oct;14(10):681-7. doi: 10.1258/095646203322387947. |
| 15681729 | Background | del Amo J, Gonzalez C, Losana J, Clavo P, Munoz L, Ballesteros J, Garcia-Saiz A, Belza MJ, Ortiz M, Menendez B, del Romero J, Bolumar F. Influence of age and geographical origin in the prevalence of high risk human papillomavirus in migrant female sex workers in Spain. Sex Transm Infect. 2005 Feb;81(1):79-84. doi: 10.1136/sti.2003.008060. |
| 15004111 | Background | Canadas MP, Bosch FX, Junquera ML, Ejarque M, Font R, Ordonez E, de Sanjose S. Concordance of prevalence of human papillomavirus DNA in anogenital and oral infections in a high-risk population. J Clin Microbiol. 2004 Mar;42(3):1330-2. doi: 10.1128/JCM.42.3.1330-1332.2004. |
| 10987448 | Background | Kjaer SK, Svare EI, Worm AM, Walboomers JM, Meijer CJ, van den Brule AJ. Human papillomavirus infection in Danish female sex workers. Decreasing prevalence with age despite continuously high sexual activity. Sex Transm Dis. 2000 Sep;27(8):438-45. doi: 10.1097/00007435-200009000-00003. |
| 14678594 | Background | Tideman RL, Thompson C, Rose B, Gilmour S, Marks C, van Beek I, Berry G, O'Connor C, Mindel A. Cervical human papillomavirus infections in commercial sex workers-risk factors and behaviours. Int J STD AIDS. 2003 Dec;14(12):840-7. doi: 10.1258/095646203322556192. |
| 15371283 | Background | Anhang R, Goodman A, Goldie SJ. HPV communication: review of existing research and recommendations for patient education. CA Cancer J Clin. 2004 Sep-Oct;54(5):248-59. doi: 10.3322/canjclin.54.5.248. |
| 16990853 | Background | Roden R, Wu TC. How will HPV vaccines affect cervical cancer? Nat Rev Cancer. 2006 Oct;6(10):753-63. doi: 10.1038/nrc1973. |
| 16950018 | Background | Burchell AN, Winer RL, de Sanjose S, Franco EL. Chapter 6: Epidemiology and transmission dynamics of genital HPV infection. Vaccine. 2006 Aug 31;24 Suppl 3:S3/52-61. doi: 10.1016/j.vaccine.2006.05.031. Epub 2006 Jun 2. |
| 16219398 | Background | Stanley M. Immune responses to human papillomavirus. Vaccine. 2006 Mar 30;24 Suppl 1:S16-22. doi: 10.1016/j.vaccine.2005.09.002. |
| 16950017 | Background | Moscicki AB, Schiffman M, Kjaer S, Villa LL. Chapter 5: Updating the natural history of HPV and anogenital cancer. Vaccine. 2006 Aug 31;24 Suppl 3:S3/42-51. doi: 10.1016/j.vaccine.2006.06.018. Epub 2006 Jun 23. |
| 10037103 | Background | Holowaty P, Miller AB, Rohan T, To T. Natural history of dysplasia of the uterine cervix. J Natl Cancer Inst. 1999 Feb 3;91(3):252-8. doi: 10.1093/jnci/91.3.252. |
| 16949997 | Background | Parkin DM, Bray F. Chapter 2: The burden of HPV-related cancers. Vaccine. 2006 Aug 31;24 Suppl 3:S3/11-25. doi: 10.1016/j.vaccine.2006.05.111. |
| 11592767 | Background | Santos C, Munoz N, Klug S, Almonte M, Guerrero I, Alvarez M, Velarde C, Galdos O, Castillo M, Walboomers J, Meijer C, Caceres E. HPV types and cofactors causing cervical cancer in Peru. Br J Cancer. 2001 Sep 28;85(7):966-71. doi: 10.1054/bjoc.2001.1948. |
| 16168781 | Background | Clifford GM, Gallus S, Herrero R, Munoz N, Snijders PJ, Vaccarella S, Anh PT, Ferreccio C, Hieu NT, Matos E, Molano M, Rajkumar R, Ronco G, de Sanjose S, Shin HR, Sukvirach S, Thomas JO, Tunsakul S, Meijer CJ, Franceschi S; IARC HPV Prevalence Surveys Study Group. Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet. 2005 Sep 17-23;366(9490):991-8. doi: 10.1016/S0140-6736(05)67069-9. |
| 10861478 | Background | Jacobs MV, Walboomers JM, Snijders PJ, Voorhorst FJ, Verheijen RH, Fransen-Daalmeijer N, Meijer CJ. Distribution of 37 mucosotropic HPV types in women with cytologically normal cervical smears: the age-related patterns for high-risk and low-risk types. Int J Cancer. 2000 Jul 15;87(2):221-7. |
| 8386137 | Background | Melkert PW, Hopman E, van den Brule AJ, Risse EK, van Diest PJ, Bleker OP, Helmerhorst T, Schipper ME, Meijer CJ, Walboomers JM. Prevalence of HPV in cytomorphologically normal cervical smears, as determined by the polymerase chain reaction, is age-dependent. Int J Cancer. 1993 Apr 1;53(6):919-23. doi: 10.1002/ijc.2910530609. |
| 16950019 | Background | Kitchener HC, Castle PE, Cox JT. Chapter 7: Achievements and limitations of cervical cytology screening. Vaccine. 2006 Aug 31;24 Suppl 3:S3/63-70. doi: 10.1016/j.vaccine.2006.05.113. |
| 17117182 | Background | Villa LL, Costa RL, Petta CA, Andrade RP, Paavonen J, Iversen OE, Olsson SE, Hoye J, Steinwall M, Riis-Johannessen G, Andersson-Ellstrom A, Elfgren K, Krogh Gv, Lehtinen M, Malm C, Tamms GM, Giacoletti K, Lupinacci L, Railkar R, Taddeo FJ, Bryan J, Esser MT, Sings HL, Saah AJ, Barr E. High sustained efficacy of a prophylactic quadrivalent human papillomavirus types 6/11/16/18 L1 virus-like particle vaccine through 5 years of follow-up. Br J Cancer. 2006 Dec 4;95(11):1459-66. doi: 10.1038/sj.bjc.6603469. Epub 2006 Nov 21. |
| 17494925 | Background | FUTURE II Study Group. Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. N Engl J Med. 2007 May 10;356(19):1915-27. doi: 10.1056/NEJMoa061741. |
| 10353936 | Background | Halsey NA, Moulton LH, O'Donovan JC, Walcher JR, Thoms ML, Margolis HS, Krause DS. Hepatitis B vaccine administered to children and adolescents at yearly intervals. Pediatrics. 1999 Jun;103(6 Pt 1):1243-7. doi: 10.1542/peds.103.6.1243. |
| 15191449 | Background | Nunez JT, Delgado M, Giron H, Pino G. Prostitution and other cofactors in preinvasive and invasive lesions of the cervix. Aust N Z J Obstet Gynaecol. 2004 Jun;44(3):239-43. doi: 10.1111/j.1479-828X.2004.00222.x. |
| 16790697 | Background | Winer RL, Hughes JP, Feng Q, O'Reilly S, Kiviat NB, Holmes KK, Koutsky LA. Condom use and the risk of genital human papillomavirus infection in young women. N Engl J Med. 2006 Jun 22;354(25):2645-54. doi: 10.1056/NEJMoa053284. |
| 10817135 | Background | Ohshige K, Morio S, Mizushima S, Kitamura K, Tajima K, Suyama A, Usuku S, Tia P, Hor LB, Heng S, Saphonn V, Tochikubo O, Soda K. Behavioural and serological human immunodeficiency virus risk factors among female commercial sex workers in Cambodia. Int J Epidemiol. 2000 Apr;29(2):344-54. doi: 10.1093/ije/29.2.344. |
| 15167641 | Background | Miller GA, Mendoza W, Krone MR, Meza R, Caceres CF, Coates TJ, Klausner JD. Clients of female sex workers in Lima, Peru: a bridge population for sexually transmitted disease/HIV transmission? Sex Transm Dis. 2004 Jun;31(6):337-42. doi: 10.1097/00007435-200406000-00003. |
| 10029987 | Background | Trujillo L, Munoz D, Gotuzzo E, Yi A, Watts DM. Sexual practices and prevalence of HIV, HTLV-I/II, and Treponema pallidum among clandestine female sex workers in Lima, Peru. Sex Transm Dis. 1999 Feb;26(2):115-8. doi: 10.1097/00007435-199902000-00010. |
| 10029985 | Background | Paris M, Gotuzzo E, Goyzueta G, Aramburu J, Caceres CF, Castellano T, Jordan NN, Vermund SH, Hook EW 3rd. Prevalence of gonococcal and chlamydial infections in commercial sex workers in a Peruvian Amazon city. Sex Transm Dis. 1999 Feb;26(2):103-7. doi: 10.1097/00007435-199902000-00008. |
| 15508193 | Background | Garcia PJ, Chavez S, Feringa B, Chiappe M, Li W, Jansen KU, Carcamo C, Holmes KK. Reproductive tract infections in rural women from the highlands, jungle, and coastal regions of Peru. Bull World Health Organ. 2004 Jul;82(7):483-92. |
| 8712268 | Background | Sanchez J, Gotuzzo E, Escamilla J, Carrillo C, Phillips IA, Barrios C, Stamm WE, Ashley RL, Kreiss JK, Holmes KK. Gender differences in sexual practices and sexually transmitted infections among adults in Lima, Peru. Am J Public Health. 1996 Aug;86(8):1098-107. doi: 10.2105/ajph.86.8_pt_1.1098. |
| 12671544 | Background | Sanchez J, Campos PE, Courtois B, Gutierrez L, Carrillo C, Alarcon J, Gotuzzo E, Hughes J, Watts D, Hillier SL, Buchanan K, Holmes KK. Prevention of sexually transmitted diseases (STDs) in female sex workers: prospective evaluation of condom promotion and strengthened STD services. Sex Transm Dis. 2003 Apr;30(4):273-9. doi: 10.1097/00007435-200304000-00001. |
| 16573364 | Background | Barnabas RV, Laukkanen P, Koskela P, Kontula O, Lehtinen M, Garnett GP. Epidemiology of HPV 16 and cervical cancer in Finland and the potential impact of vaccination: mathematical modelling analyses. PLoS Med. 2006 May;3(5):e138. doi: 10.1371/journal.pmed.0030138. Epub 2006 Apr 4. |
| BG002 |
| Total |
Total of all reporting groups |
| Participants |
|
| Age Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
Duration: 0,3,6 months
|
|
|
| Primary | Proportion of Female Sex Workers Who Complete the Three Dose (0, 2, 6 Month) HPV Schedule in a Timely Manner Compared to the Modified (0, 3, 6 Month) Schedule. | Completion of 3 doses of HPV4 vaccine was measured at 6 months for women receiving the vaccine in 0,2,6 month regimen or the modified 0,3,6 month regimen. Completion was measured as receiving dose 3 of the vaccine during the study. | All participants were included | Posted | Number | participants | 6 months |
|
|
|
|
| Secondary | Prevalence of Infection With HPV Subtypes (6,11,16,18) Among Female Sex Workers | Type specific prevalence of HPV6,11,16,18 among study participants, calculated using Linear Array testing. | All participants were included in the analysis for baseline HPV DNA prevalence | Posted | Number | participants | Baseline |
|
|
|
|
| Secondary | Identify Barriers to Acceptance of HPV Vaccine Among Female Sex Workers | Listed doubts about the HPV vaccine. Participants were asked if they had any doubts about the vaccine prior to learning about it from the health professional. Herein we present the total number of participants who reported doubts by study arm. | All participants who listed doubts about the vaccine are counted here. | Posted | Number | participants | Month 0 |
|
|
|
| 0 |
| 200 |
| 0 |
| 200 |
| EG001 | Modified Schedule | Duration: 0,3,6 months | 0 | 200 | 0 | 200 |
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| D004266 | DNA Virus Infections |
| D014412 | Tumor Virus Infections |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D053918 |
| Papillomavirus Vaccines |
| D014765 | Viral Vaccines |