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- Villa, Luisa L., et al.
(författare)
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Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions
- 2007
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 356:19, s. 1915-1927
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Human papillomavirus types 16 (HPV-16) and 18 (HPV-18) cause approximately 70% of cervical cancers worldwide. A phase 3 trial was conducted to evaluate a quadrivalent vaccine against HPV types 6, 11, 16, and 18 (HPV-6/11/16/18) for the prevention of high-grade cervical lesions associated with HPV-16 and HPV-18. METHODS: In this randomized, double-blind trial, we assigned 12,167 women between the ages of 15 and 26 years to receive three doses of either HPV-6/11/16/18 vaccine or placebo, administered at day 1, month 2, and month 6. The primary analysis was performed for a per-protocol susceptible population that included 5305 women in the vaccine group and 5260 in the placebo group who had no virologic evidence of infection with HPV-16 or HPV-18 through 1 month after the third dose (month 7). The primary composite end point was cervical intraepithelial neoplasia grade 2 or 3, adenocarcinoma in situ, or cervical cancer related to HPV-16 or HPV-18. RESULTS: Subjects were followed for an average of 3 years after receiving the first dose of vaccine or placebo. Vaccine efficacy for the prevention of the primary composite end point was 98% (95.89% confidence interval [CI], 86 to 100) in the per-protocol susceptible population and 44% (95% CI, 26 to 58) in an intention-to-treat population of all women who had undergone randomization (those with or without previous infection). The estimated vaccine efficacy against all high-grade cervical lesions, regardless of causal HPV type, in this intention-to-treat population was 17% (95% CI, 1 to 31). CONCLUSIONS: In young women who had not been previously infected with HPV-16 or HPV-18, those in the vaccine group had a significantly lower occurrence of high-grade cervical intraepithelial neoplasia related to HPV-16 or HPV-18 than did those in the placebo group.
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- Tydén, Tanja, 1949-, et al.
(författare)
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Evaluation of an STD-prevention program for Swedish university students.
- 1998
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Ingår i: Journal of American College Health. - : Informa UK Limited. - 0744-8481 .- 1940-3208. ; 47:2, s. 70-5
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Tidskriftsartikel (refereegranskat)abstract
- The authors evaluated a sexually transmitted disease (STD)-prevention program that combined a mass media campaign with peer education. The program was designed to increase Swedish university students' knowledge about STDs, improve attitudes toward condom use, and tell students where to get an STD checkup. Preintervention and postintervention postal questionnaires wer used with an intervention group and two types of control groups. Responses ranged from 32% to 67% for the randomly selected students and from 93% to 99% for classroom and clinic participants. The intervention was noticed by a majority of the students (85-98%) and discussed by 43% to 57%; more women than men observed and discussed the campaign. Knowledge about STDs, where to turn for STD checkups, and the intention of having an STD checkup increased. Attitudes toward condom use were equally positive before and after the intervention. Although it was successful in attracting attention and leading to discussion of STD prevention, the campaign did not encourage students to have an STD checkup.
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- Helstrom, L, et al.
(författare)
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Abortion rate and contraceptive practices in immigrant and native women in Sweden
- 2003
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 31:6, s. 405-410
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to analyse whether immigrant women request induced abortion more frequently than Swedish-born women and, if so, to study possible explanations, including contraceptive practices and attitudes. Methods: All women who requested induced abortion during a period of one year were included in the study. The 1,289 women, of whom 36% were born outside Sweden, were interviewed by a nurse-midwife who, using a structured protocol, gathered information on socioeconomic factors, reasons for abortion, experience of contraceptive methods, and family planning counselling. The proportion of women with non-Swedish origin in the study population was compared with the official demographic statistics of the corresponding area. Results: The number of women born outside Sweden who requested induced abortion was larger than expected from their proportion in the population. The immigrant women originated from 77 countries and four continents, the largest subgroup, 11%, coming from Iran. Immigrant women had less experience of contraceptive use, more previous pregnancies and more induced abortions than women born in Sweden. In a multivariate analysis, immigrant status and educational level were found to be independent risk factors for repeat abortion. Conclusion: Immigrant status seems to be an independent risk factor for induced abortion. The immigrant women originated from a wide range of cultures. There is no reason to believe that the women in this heterogeneous group should have any cultural factor in common that could explain their higher proneness to seek induced abortion. The most probable cause is that immigrant status is associated more often with low education, weak social network, poverty, unemployment, and being outside common pathways to healthcare.
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