Global Cancer Health

Division Of Cancer Epidemiology And Genetics

Investigators

Linked publications & trials

Abstract

My research program and group are focused on discovery, development, and evaluation/validation of new technologies for the prevention and control of cancer in underserved populations globally. Our current objectives are 1) to optimize screening and prophylactic HPV vaccination to prevent anogenital cancers, especially in those living with HIV, 2) developing novel strategies to oral cavity cancer; 3) risk prediction of and intervention for cancers of the upper aerodigestive track; 4) management of palpable breast masses in low- and middle-income countries; and 5) symptom science and etiology. This ZIA currently includes research for the research project below: HPV Natural History in HIV-positive and HIV-negative Women: The Long-Term Human Papillomavirus Vaccination (HPV) Effectiveness and Immunity in Rwandan Women Living with and without Human Immunodeficieny Virus (HIV) study is an observational study of women living with HIV (WLWH) and HIV-negative women who did and did not receive the HPV vaccine in Rwanda. Rwanda is a high-burden cervical cancer country where the prevalence of HIV is 3.7% among adult women. In 2011, Rwanda implemented a national HPV vaccination program with Gardasil®. To answer questions about HPV effectiveness in WLWH, 757 vaccinated WLWH, 757 unvaccinated WLWH, and 757 vaccinated HIV-negative women will be enrolled in the study. Participants will provide blood, anal, oral and cervicovaginal specimens and complete a questionnaire on sexual health and history. Cervicovaginal, anal and oral specimens will be HPV genotyped using type-specific genotyping assays. Blood will be antibody tested to compare the immune resonse in WLWH and HIV-negative women, and the impact of switching from 3 doses to 2 doses of Gardasil® in 2015. Participants who test HPV positive at baseline will return in six months to assess type-specific HPV persistence. Risk factors for HPV persistence including vaginal microbiome will also be studied. A long-term goal of the study is to establish a cohort of WLWH in whom we can examine the long-term effectiveness of HPV vaccination in WLWH now and in the future. This research is significant as it will establish the population effectiveness of HPV vaccination in WLWH in sub-Saharan Africa, the group of women at the highest risk of cervical cancer, for which there is a dearth of evidence.