1. Acceptability Survey of HPV Vaccine Among Female Sex Workers in Lima, Peru Brandon Brown 1, Cesar Carcamo 2, Maria Valderrama 2, Magaly Blas 2, and Neal Halsey 1 1 Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD. 2 Epidemiology, STI & HIV Unit, University Peruana Cayetano Heredia, Lima, Peru. Background Cancer of the cervix is the leading cause of death in Peruvian women aged 15-64 [1, 2]. HPV 16 and 18 account for 70% of all cervical cancer cases in Latin America [3,4]. Data on subtypes affecting the 18,000 female sex workers (FSWs) in Peru are lacking, and although at high risk, these women have not been included in HPV vaccine trials [5,6]. In a study of type specific prevalence among FSWs in Mexico, only 14.7% of FSWs were positive for either 16 or 18, yielding data for the potential effectiveness of HPV vaccination [7]. HPV vaccines protect against persistent HPV 16, 18 infection in women 9-26 years old. The objective of this study is to obtain data on HPV knowledge and potential acceptability of HPV vaccine among FSWs. Methods Study Population 319 healthy FSWs 18-29 years of age in Lima, Peru Recruitment at Patrucco Clinic and surrounding venues Data Collection Convenience sampling Women given info about the study, asked to participate, screened for eligibility, and informed consent obtained Questionnaires administered by a trained interviewer Conclusions FSWs are a population at high risk of cervical cancer, and should have access to HPV vaccine Due to low knowledge of HPV, FSWs should be targeted for education campaigns Most FSWs want to receive HPV vaccine and are willing to pay but underestimate the price Barriers to vaccination of FSWs can be overcome with education on the HPV vaccine Results The average age of the women in our study was 23.7 years and the mean age of first sex work is approximately 21 years [table] Knowledge of HPV and cervical cancer is low, with 44% knowing of HPV, and 6% knowing of a vaccine to prevent cervical cancer [chart] 97.5% of participants would like to receive HPV vaccine, but several barriers exist for participation in an HPV vaccine study [diagram] Only eight women said they would not pay for an HPV vaccine, while on average, women were willing to pay 27.7 dollars (range 1.8-357 dollars) Approximately 99% of women reported that they would be able to complete all 3 doses of vaccine 113 (35.4%) women reported an STI in the past year, 16.8%-candida, 47.8%-cervicitis, and 15.0%-vaginitis HPV Knowledge Barriers to HPV Vaccination References 1. IARC, Monographs: HPV. 2005, Vol 90: Lyon 2. Ferlay J, et. al. Globocan 2002: 2004, IARC. 3. Santos C, et. al.Brit. J. Cancer, 2001. 85(7):p.966-71. 4. Clifford G, et. al. Lancet, 2005. 366(9490):p. 991-8. 5. Calhoun B, et.al. Global Hlth. Lec. 2005:Puget Sound. 6. Mak R, et. al. Sex. Trans. Inf., 2007. 80: p. 118-120. 7. Juarez L, et. al. STD., 2001. 28(3):p. 125-130. “I want to know more about the vaccine” “Fear the vaccine will be bad for me/ a bad reaction” “I don’t want to experiment with my health” “Because they will practice the vaccine on me” “I’m afraid” “If its free, I don’t trust it” “I don’t have time” “fear for my baby” “I have to talk with my partner about it” Demographics and More N (%)Mean (Range) Age (years)-23.7 (18-29) Marital Status Single Married Cohabitating 210 (66.0) 17 (5.35) 81 (25.5) - Have Children212 (79.1)- Age of first sex-16.5 (7-26) Age of first sex work-20.5 (13-29) Duration of Sex work (yrs)-2.35 (.08-11) Clients in past week-31.6 (0-150) Money received in last month (dollars) -660.4 (0-3571.4) Always use condoms with new clients 1 245 (99.2)- Money received for sex without condoms (dollars) 2 26.9 (0.7-53.6) Have history of smoking272 (85.27)- “Its not very secure” Contact person for poster: Brandon Brown at bbrown@jhsph.edu