Salud Pública de Méxicohttps://www.scielosp.org/feed/spm/2018.v60n6/2021-01-13T00:10:00ZVol. 60 No. 6 - 2018WerkzeugMPOWER component E: essential axis in the reduction of tobacco consumption in Peru10.21149/91752021-01-13T00:10:00Z2017-01-20T00:02:00ZSolano, Fiorela E.Meza-Liviapoma, Jessica
<em>Solano, Fiorela E.</em>;
<em>Meza-Liviapoma, Jessica</em>;
<br/><br/>
Realities of alternative HPV vaccination schedules10.21149/101902021-01-13T00:10:00Z2017-01-20T00:02:00ZStanley, Margaret
<em>Stanley, Margaret</em>;
<br/><br/>
Incidence, psychosocial burden, and economic impact of genital warts in Mexico10.21149/100082021-01-13T00:10:00Z2017-01-20T00:02:00ZDomenech-Viñolas, MartaLeón-Maldonado, LeithRamírez-Palacios, PaulaFlores, Yvonne NGranados-García, VíctorBrown, BrandonCorona, EdgarLiu, StephanieLazcano-Ponce, EduardoSalmerón, Jorge
<em>Domenech-Viñolas, Marta</em>;
<em>León-Maldonado, Leith</em>;
<em>Ramírez-Palacios, Paula</em>;
<em>Flores, Yvonne N</em>;
<em>Granados-García, Víctor</em>;
<em>Brown, Brandon</em>;
<em>Corona, Edgar</em>;
<em>Liu, Stephanie</em>;
<em>Lazcano-Ponce, Eduardo</em>;
<em>Salmerón, Jorge</em>;
<br/><br/>
Abstract: Objective: To estimate the burden of genital warts (GW) in Mexico. Materials and methods: We estimated the annual incidence of GW based on data reported by specialist physicians. We also assessed GW treatment practices, the average cost of treatment, and the psychosocial burden of GW among patients. Results: The annual incidence of GW in Mexico was estimated to be 547 200 cases. Treatment procedures vary by specialist and patient gender. The estimated annual cost was $195 million USD. The psychosocial impact of GW was slightly greater in males than females. Conclusions: This is the first evaluation of the burden of GW in Mexico. Our data suggest that GW are common, with significant health-related costs and psychosocial impact.HPV-FASTER: Combined strategies of HPV vaccination and HPV screening towards a one visit for cervical cancer preventive campaigns10.21149/101712021-01-13T00:10:00Z2017-01-20T00:02:00ZBosch, F XavierRobles, Claudia
<em>Bosch, F Xavier</em>;
<em>Robles, Claudia</em>;
<br/><br/>
HPV vaccine implementation and monitoring in Latin America10.21149/90902021-01-13T00:10:00Z2017-01-20T00:02:00ZLuciani, SilvanaBruni, LaiaAgurto, IreneRuiz-Matus, Cuauhtémoc
<em>Luciani, Silvana</em>;
<em>Bruni, Laia</em>;
<em>Agurto, Irene</em>;
<em>Ruiz-Matus, Cuauhtémoc</em>;
<br/><br/>
Abstract: Objective: To describe HPV vaccine program implementation, monitoring and evaluation experiences in Latin America. Materials and methods: We reviewed published articles in peer-reviewed journals and reports from government websites, as well as the PAHO/WHO/UNICEF Joint Reporting form and the ICO/IARC HPV Information Centre database. Results: By December 2016, 13 countries/territories in Latin America (56%) have introduced HPV vaccines. The majority have done so in the past three years, targeting 10-12 year old girls with a two dose schedule, through school programs. Vaccine coverage ranges from 30 to 87%. Safety monitoring is well established, but monitoring vaccine impact is not, and data are not available. Conclusions: Although Latin America is the most advanced developing region with HPV vaccine introduction, systems for its monitoring are weak and there is a paucity of consistently available coverage data for this vaccine. Challenges remain to introduce HPV vaccines in several countries, to achieve high coverage, and to strengthen monitoring, evaluation and reporting.Propuesta de un esquema simple de antivirales de acción directa para tratamiento de VHC en un sistema de salud público con bajo presupuesto10.21149/94922021-01-13T00:10:00Z2017-01-20T00:02:00ZValdez-Hernández, PedroRodríguez-Aguilar, Erika FaridePáez-Zayas, Víctor ManuelLizárraga-Gómez, EnriqueGarcía-Juárez, Ignacio
<em>Valdez-Hernández, Pedro</em>;
<em>Rodríguez-Aguilar, Erika Faride</em>;
<em>Páez-Zayas, Víctor Manuel</em>;
<em>Lizárraga-Gómez, Enrique</em>;
<em>García-Juárez, Ignacio</em>;
<br/><br/>
Diseño de un cuestionario de actitudes hacia el aborto inducido10.21149/91822021-01-13T00:10:00Z2017-01-20T00:02:00ZMarván, María LuisaLagunes-Córdoba, RobertoOrihuela-Cortés, Fabiola
<em>Marván, María Luisa</em>;
<em>Lagunes-Córdoba, Roberto</em>;
<em>Orihuela-Cortés, Fabiola</em>;
<br/><br/>
México y el derecho a la salud: hora de expectativas y decisiones10.21149/101072021-01-13T00:10:00Z2017-01-20T00:02:00ZArtaza-Barrios, Osvaldo
<em>Artaza-Barrios, Osvaldo</em>;
<br/><br/>
Palabra impresa y salud mental: el papel de los medios10.21149/93372021-01-13T00:10:00Z2017-01-20T00:02:00ZTreviño-Elizondo, Francisco AQuiroga-Garza, AngélicaWillis-Sánchez, Guillermo B
<em>Treviño-Elizondo, Francisco A</em>;
<em>Quiroga-Garza, Angélica</em>;
<em>Willis-Sánchez, Guillermo B</em>;
<br/><br/>
The effect of a booster dose of HPV tetravalent vaccine after 51 months: implications for extended vaccination schedules10.21149/101832021-01-13T00:10:00Z2017-01-20T00:02:00ZLazcano-Ponce, EduardoCarnalla-Cortés, MarthaBarrientos-Gutiérrez, TonatiuhTorres-Ibarra, LeticiaCruz-Valdez, AurelioSalmerón, JorgeHernández-Ávila, Mauricio
<em>Lazcano-Ponce, Eduardo</em>;
<em>Carnalla-Cortés, Martha</em>;
<em>Barrientos-Gutiérrez, Tonatiuh</em>;
<em>Torres-Ibarra, Leticia</em>;
<em>Cruz-Valdez, Aurelio</em>;
<em>Salmerón, Jorge</em>;
<em>Hernández-Ávila, Mauricio</em>;
<br/><br/>
Abstract: Objective: To asses the non-inferiority between two different vaccination schedules one month after the administration of the third dose. Materials and methods: We evaluated the anti-HPV 16/18 antibody titers induced by quadrivalent HPV vaccine administered using two different schedules in girls 9 to 10-year-old girls: a traditional (0-2-6) and an alternative (0-6-50). Blood samples were collected at month 7, 21 and 51. Results: The antibody geometric mean titer ratios one month after the application of the third dose -month 51 for the alternative and month 7 for the traditional- were 1.55 for HPV16 (95%CI, 1.15-2.08) and 1.53 for HPV18 (95%CI, 1.12-2.09). The seropositive rate was above 99% in both groups. Conclusions: The application of an alternative 3-dose schedule in 9 to 10-year-old girls induces a non-inferior immune response compared to the standard one month after the last dose. Further research is needed to understand the minimal number of doses and their timing to provide the best coverage for HPV infection.Prevalence and incidence of anal human papillomavirus infection in Mexican men: Need for universal prevention policies10.21149/84542021-01-13T00:10:00Z2017-01-20T00:02:00ZPosso, HectorLeón-Maldonado, LeithAllen-Leigh, BetaniaSalmerón, JorgeQuiterio, ManuelGiuliano, Anna RSudenga, Staci LNyitray, Alan GTorres, B NelsonAbrahamsen, MarthaLazcano-Ponce, Eduardo
<em>Posso, Hector</em>;
<em>León-Maldonado, Leith</em>;
<em>Allen-Leigh, Betania</em>;
<em>Salmerón, Jorge</em>;
<em>Quiterio, Manuel</em>;
<em>Giuliano, Anna R</em>;
<em>Sudenga, Staci L</em>;
<em>Nyitray, Alan G</em>;
<em>Torres, B Nelson</em>;
<em>Abrahamsen, Martha</em>;
<em>Lazcano-Ponce, Eduardo</em>;
<br/><br/>
Abstract: Objective: Describe the natural history of anal HPV among men. Materials and methods: Prospective study among men 18-70 years (n=665), from Cuernavaca, Mexico who completed questionnaires and provided specimens (HPV genotyped) at enrollment and 1+ follow-up visit. HPV prevalence and incidence were estimated. Prevalence ratios were calculated with Poisson regression using robust variance estimation. Person-time for incident HPV infection was estimated using number of events modeled as Poisson variable for total person-months. Results: Anal infection prevalence: any HPV type=15%, high-risk=8.4%, HPV16=1.4%, tetravalent vaccine types (4vHPV)=4.4%, nonavalent vaccine types (9vHPV)=6.3%. Factors associated with prevalence: 50+ lifetime female sex partners (adjusted prevalence ratio, a PR=3.25, 95% CI:1.12-9.47), 10+ lifetime male sex partners (aPR=3.06, 95%CI:1.4-6.68), and 1+ recent male anal sex partners (aPR=2.28, 95%CI:1.15-4.5). Anal incidence rate: high-risk HPV=7.8/1 000 person-months (95%CI:6.0-10.1), HPV16=1.8/1 000 person-months (95%CI:1.1-2.9),4vHPV=3.4/1 000 person-months (95%CI:2.3-4.9) and 9vHPV=5.5/1000 person-months (95%CI:4.1-7.5). Conclusions: Implementation of universal HPV vaccination programs, including men, is a public health priority.HPV vaccine acceptance is high among adults in Mexico, particularly in people living with HIV10.21149/101822021-01-13T00:10:00Z2017-01-20T00:02:00ZPortillo-Romero, Alejandra JalilLeón-Maldonado, LeithAllen-Leigh, BetaniaBrown, BrandonMagis, CarlosGarcía-Fuentes, Norma BeatrizSalmerón, JorgeHurtado, ErikaTorres-Ibarra, LeticiaRivera-Paredez, BereniceHernández-López, RubíYunes-Díaz, ElsaLazcano-Ponce, Eduardo
<em>Portillo-Romero, Alejandra Jalil</em>;
<em>León-Maldonado, Leith</em>;
<em>Allen-Leigh, Betania</em>;
<em>Brown, Brandon</em>;
<em>Magis, Carlos</em>;
<em>García-Fuentes, Norma Beatriz</em>;
<em>Salmerón, Jorge</em>;
<em>Hurtado, Erika</em>;
<em>Torres-Ibarra, Leticia</em>;
<em>Rivera-Paredez, Berenice</em>;
<em>Hernández-López, Rubí</em>;
<em>Yunes-Díaz, Elsa</em>;
<em>Lazcano-Ponce, Eduardo</em>;
<br/><br/>
Abstract: Objective. To measure HPV vaccine acceptance in diverse Mexican adult populations, taking into account HIV status. Materials and methods: A total of 1 329 men and women, with and without HIV, participated in one of three intervention studies, offering HPV vaccination, carried out in the states of Morelos, Tlaxcala and Mexico City; either the bivalent (Morelos n=103, Tlaxcala n=127) or quadrivalent HPV-vaccine (Mexico City n=1 099) was offered. Results: HPV vaccine was accepted by 80.3% of participants; acceptance was higher in people living with HIV than those without (84.4 vs. 78%, p=0.004). Women had greater HPV infection knowledge (p<0.0001) than men and slightly higher (p=0.4) vaccine acceptance. The main reason for vaccine non-acceptance among HIV-positive participants was their doctor recommended they not get vaccinated. Conclusion: Acceptance of HPV-vaccine was high in men and women regardless of HIV status. Even higher rates of acceptability may be achieved by educating healthcare providers to recommend HPV vaccine to their patients.Prevention of cervical cancer in Latin America: Future challenges and opportunities10.21149/100712021-01-13T00:10:00Z2017-01-20T00:02:00ZFranco, Eduardo L.
<em>Franco, Eduardo L.</em>;
<br/><br/>
Eliminación del cáncer de cérvix en América Latina10.21149/101702021-01-13T00:10:00Z2017-01-20T00:02:00ZHerrero, Rolando
<em>Herrero, Rolando</em>;
<br/><br/>
Características del adulto mayor institucionalizado en el área metropolitana de Monterrey10.21149/100112021-01-13T00:10:00Z2017-01-20T00:02:00ZCoindreau-Frias, FernandoRamos-Bacco, MauricioBarba-Marines, AlejandraGutiérrez-Torres, AníbalBarrera-Saldaña, Hugo AlbertoValero-Gómez, Javier
<em>Coindreau-Frias, Fernando</em>;
<em>Ramos-Bacco, Mauricio</em>;
<em>Barba-Marines, Alejandra</em>;
<em>Gutiérrez-Torres, Aníbal</em>;
<em>Barrera-Saldaña, Hugo Alberto</em>;
<em>Valero-Gómez, Javier</em>;
<br/><br/>
Salud deteriorada. Opacidad y negligencia en el sistema público de saludS0036-363420180006000172021-01-13T00:10:00Z2017-01-20T00:02:00ZLazcano-Ponce, Eduardo
<em>Lazcano-Ponce, Eduardo</em>;
<br/><br/>
Adopción e implementación del ofrecimiento de la autotoma VPH por agentes sanitarios en Jujuy, Argentina10.21149/88542021-01-13T00:10:00Z2017-01-20T00:02:00ZCurotto, MarianaZalacaín-Colombo, JulietaPaolino, MelisaArrossi, Silvina
<em>Curotto, Mariana</em>;
<em>Zalacaín-Colombo, Julieta</em>;
<em>Paolino, Melisa</em>;
<em>Arrossi, Silvina</em>;
<br/><br/>
Resumen: Objetivo: Evaluar la adopción e implementación en escala de la estrategia orientada a ofrecer puerta a puerta la autotoma de la prueba del virus del papiloma humano (AT-VPH), por parte de agentes sanitarios (AS), en Jujuy, Argentina. Material y métodos: Se aplicó una encuesta autoadministrada a 478 AS. Las dimensiones de adopción e implementación fueron evaluadas con el modelo RE-AIM. Resultados: Adopción: 81.8% de los AS ofreció la AT-VPH y 86.4% expresó gratificación con la estrategia. Implementación: los problemas encontrados fueron la demora en la entrega de tubos (61.3%) y resultados (70.0%); falta de recursos humanos (28.3%), y dificultades al obtener turnos para realizar el triage (26.1%). El principal obstáculo fue la sobrecarga de trabajo (50.2%), mientras que la capacitación (38.0%) y el listado de mujeres a contactar (28.7%) fueron los elementos facilitadores. Conclusiones: La adopción de la AT-VPH fue alta entre los AS. Deben reforzarse las estrategias programáticas para motivar a los AS y reducir su carga de trabajo al implementar la AT-VPH.Alternative HPV vaccination schedules in Latin America10.21149/98102021-01-13T00:10:00Z2017-01-20T00:02:00ZRobles, ClaudiaHernández, María de la LuzAlmonte, Maribel
<em>Robles, Claudia</em>;
<em>Hernández, María De La Luz</em>;
<em>Almonte, Maribel</em>;
<br/><br/>
Abstract: In 2008, the first HPV vaccination program in Latin America started in Panama, targeting girls aged 10-11 years with a 3-dose vaccine schedule, an initiative that was to be followed by other Latin American countries after local feasibility and population acceptability evaluations were completed. A 3-dose vaccine regimen over six months was originally chosen for HPV vaccines, copying the Hepatitis B vaccine schedule (0, 1-2, 6 months). Alternative vaccine schedules have been proposed afterwards based on: i) noninferior immunogenicity or immune response levels compared to those at which clinical efficacy has been proven (i.e., those observed in a 3-dose HPV vaccine schedule in women aged 15-26), and, ii) proven efficacy in clinical trials and/or effectiveness among women who were provided less than three doses due to a lack of adherence to a 3-dose vaccine schedule. In 2014, based on the available evidence and the potential increase in coverage by expansion of vaccination target groups, particularly in low and middle income countries (LMIC), the World Health Organization recommended a 2-dose schedule with at least a 6-month interval between doses for females up to 15 years of age and a 3-dose schedule for older women. More recently, it has been suggested that 1-dose HPV vaccination schemes may provide enough protection against HPV infection and may speed up the introduction of HPV vaccination in LMIC, where most needed.Nuevas estrategias de prevención y control de cáncer de cuello uterino en Chile10.21149/85772021-01-13T00:10:00Z2017-01-20T00:02:00ZFerreccio, Catterina
<em>Ferreccio, Catterina</em>;
<br/><br/>
Resumen: Objetivos: Discutir el cáncer cervicouterino (CC), el virus del papiloma humano (VPH), el programa de control del CC y proponer alternativas para Chile. Material y métodos: Se analiza el programa nacional del CC 1966-2015 y la guía clínica 2015-2020, la prevalencia de VPH en mujeres y en casos de CC; la infección y serología de VPH; la autotoma; la precisión y rentabilidad del tamizaje con VPH contra el Papanicolaou y las opciones de triaje en VPH AR positivas. Resultados: En Chile mueren 600 mujeres (principalmente de bajos recursos) al año por CC. La cobertura del Papanicolaou es < 70%, sensibilidad muy inferior al test de VPH, por lo que el cambio es rentable. Desde 2015 se vacuna contra VPH a niñas menores de 13 años. Conclusiones: Las condiciones técnicas y económicas existen en Chile para lograr una mejoría sustancial del CC: se sugiere el reemplazo del Papanicolaou por el examen de VPH; tamizaje cada cinco años con opción de autotoma; triaje con base en la tipificación de VPH 16/18 o Papanicolaou.Prevalence and risk factors for oral human papillomavirus infection in Mexican HIV-infected men10.21149/98342021-01-13T00:10:00Z2017-01-20T00:02:00ZAblanedo-Terrazas, YuriaRomero-Mora, KarlaGómez-Palacio, MaríaAlvarado-de la Barrera, ClaudiaRuiz-Cruz, MatildeHernández-Juan, RamónReyes-Terán, Gustavo
<em>Ablanedo-Terrazas, Yuria</em>;
<em>Romero-Mora, Karla</em>;
<em>Gómez-Palacio, María</em>;
<em>Alvarado-De La Barrera, Claudia</em>;
<em>Ruiz-Cruz, Matilde</em>;
<em>Hernández-Juan, Ramón</em>;
<em>Reyes-Terán, Gustavo</em>;
<br/><br/>
Abstract: Objective: To determine the prevalence and risk factors for oral high-risk human papillomavirus (HR-HPV) infection in human immunodeficiency virus(HIV)-infected men. Materials and methods: Consecutive male outpatients with HIV-infection were enrolled. Demographic and behavioral risk data were obtained. Anal swabs and oral rinses were tested for HR-HPV DNA. Oral, pharyngeal and video laryngoscopy examinations were performed for detection of lesions. Results: The prevalence of HR-HPV oral infection was 9.3% (subtypes other than HR HPV 16/18 predominated). The prevalence of anal HR-HPV infection was 75.7%. The risk factors for oral infection with HR-HPV were tonsillectomy (OR=13.12) and years from HIV diagnosis (OR=1.17). Conclusions: Tonsillectomy and years from HIV diagnosis were associated with oral HPV infection. No association was found between oral and anal HR-HPV infections. This is the first study reporting the prevalence and risk factors for oral HR-HPV infection in Mexican HIV-infected population.Temporal trends of lung cancer, other cancers and COPD hospitalizations in Mexicans age ≥40 years, 2000-201410.21149/90522021-01-13T00:10:00Z2017-01-20T00:02:00ZHernández-Garduño, Eduardo
<em>Hernández-Garduño, Eduardo</em>;
<br/><br/>
Incidence of external genital lesions related to human papillomavirus among Mexican men. A cohort study10.21149/84612021-01-13T00:10:00Z2017-01-20T00:02:00ZLazcano-Ponce, EduardoSudenga, Staci LTorres, B NelsonStoler, MarkLeón-Maldonado, LeithAllen-Leigh, BetaniaPosso, HéctorQuiterio, ManuelHernández-Nevarez, María del PilarSalmerón, JorgeGiuliano, Anna R
<em>Lazcano-Ponce, Eduardo</em>;
<em>Sudenga, Staci L</em>;
<em>Torres, B Nelson</em>;
<em>Stoler, Mark</em>;
<em>León-Maldonado, Leith</em>;
<em>Allen-Leigh, Betania</em>;
<em>Posso, Héctor</em>;
<em>Quiterio, Manuel</em>;
<em>Hernández-Nevarez, María Del Pilar</em>;
<em>Salmerón, Jorge</em>;
<em>Giuliano, Anna R</em>;
<br/><br/>
Abstract: Objective: To determine external genital lesion (EGL) incidence -condyloma and penile intraepithelial neoplasia (PeIN)- and genital HPV-genotype progression to these EGLs. Materials and methods: Participants (healthy males 18-74y from Cuernavaca, Mexico, recruited 2005-2009, n=954) underwent a questionnaire, anogenital examination, and sample collection every six months; including excision biopsy on suspicious EGL with histological confirmation. Linear array assay PCR characterized 37 high/low-risk HPV-DNA types. EGL incidence and cumulative incidence were calculated, the latter with Kaplan-Meier. Results: EGL incidence was 1.84 (95%CI=1.42-2.39) per 100-person-years (py); 2.9% (95%CI=1.9-4.2) 12-month cumulative EGL. Highest EGL incidence was found in men 18-30 years: 1.99 (95%CI=1.22-3.25) per 100py. Seven subjects had PeIN I-III (four with HPV16). HPV11 most commonly progresses to condyloma (6-month cumulative incidence=44.4%, 95%CI=14.3-137.8). Subjects with high-risk sexual behavior had higher EGL incidence. Conclusion: In Mexico, anogenital HPV infection in men is high and can cause condyloma. Estimation of EGL magnitude and associated healthcare costs is necessary to assess the need for male anti-HPV vaccination.Use of HPV testing in cervical cancer screening services in Mexico, 2008-2018: a nationwide database study10.21149/98912021-01-13T00:10:00Z2017-01-20T00:02:00ZHurtado-Salgado, ErikaOrtiz-Panozo, EduardoSalmerón, JorgeSaavedra-Lara, NenetzenKuri-Morales, PabloPesqueira-Villegas, EduardoLuna-Gordillo, RufinoFranco, Eduardo LLazcano-Ponce, Eduardo
<em>Hurtado-Salgado, Erika</em>;
<em>Ortiz-Panozo, Eduardo</em>;
<em>Salmerón, Jorge</em>;
<em>Saavedra-Lara, Nenetzen</em>;
<em>Kuri-Morales, Pablo</em>;
<em>Pesqueira-Villegas, Eduardo</em>;
<em>Luna-Gordillo, Rufino</em>;
<em>Franco, Eduardo L</em>;
<em>Lazcano-Ponce, Eduardo</em>;
<br/><br/>
Abstract: Objective: To describe the methods of a study aimed at evaluating high risk-HPV (hrHPV)-based screening and cervical cytology as triage compared to conventional cervical cytology as primary screening in the detection of grade 2+ cervical intraepithelial neoplasia in the National Cancer Screening Program (NCSP) of Mexico. Materials and methods: We will use information originated from the Womens Cancer Information System of Mexico regarding cervical cancer from 2008 to 2018. The database includes cytology results, diagnostic confirmation by histopathology and/or treatment colposcopy. We will then carry out statistical analyses on approximately 15 million hrHPV. Results: We will evaluate the overall performance of hrHPV-based screening as part of the NCSP and compare hrHPV-based to cytology-based screening under real-life conditions. To guarantee an unbiased comparison between hrHPV with cytology triage and conventional cytology we will use propensity score matching. Conclusion: Decision makers may use our results to identify areas of opportunity for improvement in NCSP processes.Prevention and control of neoplasms associated with HPV in high-risk groups in Mexico City: The Condesa Study10.21149/100342021-01-13T00:10:00Z2017-01-20T00:02:00ZLazcano-Ponce, EduardoSalmerón, JorgeGonzález, AndreaAllen-Leigh, BetaniaLeón-Maldonado, LeithMagis, CarlosAranda-Flores, CarlosConde-González, CarlosPortillo-Romero, Alejandra JalilYunes-Díaz, ElsaRivera-Rivera, LeonorVargas, GalileoNyitray, Alan GGiuliano, Anna R
<em>Lazcano-Ponce, Eduardo</em>;
<em>Salmerón, Jorge</em>;
<em>González, Andrea</em>;
<em>Allen-Leigh, Betania</em>;
<em>León-Maldonado, Leith</em>;
<em>Magis, Carlos</em>;
<em>Aranda-Flores, Carlos</em>;
<em>Conde-González, Carlos</em>;
<em>Portillo-Romero, Alejandra Jalil</em>;
<em>Yunes-Díaz, Elsa</em>;
<em>Rivera-Rivera, Leonor</em>;
<em>Vargas, Galileo</em>;
<em>Nyitray, Alan G</em>;
<em>Giuliano, Anna R</em>;
<br/><br/>
Abstract: Objective: To evaluate the effectiveness of a combined strategy of human papillomavirus virus (HPV) vaccination and high-risk HPV screening to reduce the occurrence of anogenital and oropharyngeal neoplasms among men who have sex with men, people with HIV, homeless people, transgender women, female sex workers and rape victims. Materials and methods: This mixed methods study evaluates the effectiveness of a combined vaccination-screening strategy to reduce HPV prevalence/incidence and occurrence of cervical intraepithelial neoplasms grade 2+ and/or anal intraepithelial neoplasms grade 2+, using Kaplan-Meier. The time-to-event method will evaluate time from positive results for specific anogenital HPV to incidence of anogenital lesions containing that HPV type. Results: People vaccinated against HPV and screened for HPV as a primary test will have lower prevalence and incidence of HPV infection and consequently lower frequency of HPV-related anogenital and oropharyngeal lesions. Conclusions: This study will generate scientific evidence on effectiveness of a combined vaccination-screening strategy to reduce the burden of HPV-associated neoplasms.