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Grant Details

Grant Number: 3R01CA114773-05S3 Interpret this number
Primary Investigator: Smith, Jennifer
Organization: Univ Of North Carolina Chapel Hill
Project Title: Effect of Male Circumcision on Penile HPV Infection
Fiscal Year: 2010
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Abstract

DESCRIPTION (provided by applicant): Human papillomavirus (HPV) is the central cause of invasive cervical cancer (ICC) in women, and other anogenital cancers, including anal, penile, vaginal and vulvar cancers. Public health intervention strategies are needed to reduce the genital acquisition of high-risk HPV types to prevent these cancers that affect women and men. Given that men are important in transmitting HPV to their female sexual partners, interventions that reduce HPV acquisition and persistence in men could be an important HPV prevention strategy benefiting both men and women. Limited cross-sectional data suggest that male circumcision may reduce the carriage of penile HPV infection. However, proof that male circumcision reduces HPV penile infection acquisition and/or persistence can only be obtained through the conduct of a prospective, randomized clinical trial (RCT). The University of North Carolina, in collaboration with the UNIM (Universities of Nairobi, Illinois and Manitoba Reproductive Health Project) Male Health Clinic, The University of Illinois at Chicago, the University of Nairobi, the Albert Einstein College of Medicine in New York City, and the Vrije Universiteit Medical Center in Amsterdam proposes to study of the effect of male circumcision on the risk and natural history of penile HPV infection in young, sexually active men in Kisumu, Kenya. This proposed study of penile HPV infection is nested within an ongoing "parent" RCT to assess the effect of male circumcision in reducing HIV incidence in 18-24 year-old men in Kisumu that began in February 2002. This HPV project proposes to determine the type-specific HPV DNA prevalence in penile exfoliated cell samples currently being collected as part of the ongoing RCT of male circumcision. An estimated 2,442 men are expected to contribute penile exfoliated cell specimens from two anatomical sites (the shaft and glans/coronal sulcus). These sample are being collected at enrollment and at the 6-, 12-, 18- and 24- month follow-up visits. Specimens will be tested using a sensitive PCR assay to detect a wide-range of HPV DNA types. HPV viral load of samples positive for HPV types 16, 18, 31, 33 and 45 will be determined using a real-time PCR. A new clinical examination (a visual inspection with 3% acetic acid and aided magnification) will be added to this ongoing RCT at the final 24-month visit to determine the presence of penile lesions (i.e., flat lesions, papular lesions, or condolymata acuminate). Study results will provide the most definitive evidence to date regarding the effect of male circumcision on HPV infection and penile lesions in men. If male circumcision is found to be effective and safe in reducing HPV infection or penile lesions in men, it could in turn reduce HPV prevalence and associated cervical neoplasia in women.

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Publications

Risk of HIV acquisition among circumcised and uncircumcised young men with penile human papillomavirus infection.
Authors: Rositch AF, Mao L, Hudgens MG, Moses S, Agot K, Backes DM, Nyagaya E, Snijders PJ, Meijer CJ, Bailey RC, Smith JS
Source: AIDS, 2014 Mar 13;28(5), p. 745-52.
PMID: 24149088
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Growing evidence that HPV infection is associated with an increase in HIV acquisition: exploring the issue of HPV vaccination.
Authors: Rositch AF, Gravitt PE, Smith JS
Source: Sex Transm Infect, 2013 Aug;89(5), p. 357.
PMID: 23858496
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Knowledge, attitudes, practices, and perceived risk of cervical cancer among Kenyan women: brief report.
Authors: Sudenga SL, Rositch AF, Otieno WA, Smith JS
Source: Int J Gynecol Cancer, 2013 Jun;23(5), p. 895-9.
PMID: 23694983
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Sexual behaviour and less frequent bathing are associated with higher human papillomavirus incidence in a cohort study of uncircumcised Kenyan men.
Authors: Backes DM, Snijders PJ, Hudgens MG, Bailey RC, Bogaarts M, Agot K, Agingu W, Moses S, Meijer CJ, Smith JS
Source: Sex Transm Infect, 2013 Mar;89(2), p. 148-55.
EPub date: 2012 Sep 1.
PMID: 22941862
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Vaccine-relevant human papillomavirus (HPV) infections and future acquisition of high-risk HPV types in men.
Authors: Rositch AF, Hudgens MG, Backes DM, Moses S, Agot K, Nyagaya E, Snijders PJ, Meijer CJ, Bailey RC, Smith JS
Source: J Infect Dis, 2012 Sep 1;206(5), p. 669-77.
EPub date: 2012 Jun 18.
PMID: 22711906
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Multiple human papillomavirus infections and type competition in men.
Authors: Rositch AF, Poole C, Hudgens MG, Agot K, Nyagaya E, Moses S, Snijders PJ, Meijer CJ, Bailey RC, Smith JS
Source: J Infect Dis, 2012 Jan 1;205(1), p. 72-81.
EPub date: 2011 Nov 4.
PMID: 22058418
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Male circumcision is associated with a lower prevalence of human papillomavirus-associated penile lesions among Kenyan men.
Authors: Backes DM, Bleeker MC, Meijer CJ, Hudgens MG, Agot K, Bailey RC, Ndinya-Achola JO, Hayombe J, Hogewoning CJ, Moses S, Snijders PJ, Smith JS
Source: Int J Cancer, 2012 Apr 15;130(8), p. 1888-97.
EPub date: 2011 Aug 2.
PMID: 21618520
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Age-specific prevalence of human papillomavirus infection in males: a global review.
Authors: Smith JS, Gilbert PA, Melendy A, Rana RK, Pimenta JM
Source: J Adolesc Health, 2011 Jun;48(6), p. 540-52.
PMID: 21575812
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Discrete-time semi-Markov modeling of human papillomavirus persistence.
Authors: Mitchell CE, Hudgens MG, King CC, Cu-Uvin S, Lo Y, Rompalo A, Sobel J, Smith JS
Source: Stat Med, 2011 Jul 30;30(17), p. 2160-70.
EPub date: 2011 May 3.
PMID: 21538985
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HPV vaccine acceptability among Kenyan women.
Authors: Becker-Dreps S, Otieno WA, Brewer NT, Agot K, Smith JS
Source: Vaccine, 2010 Jul 12;28(31), p. 4864-7.
EPub date: 2010 Jun 4.
PMID: 20566394
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Increased risk of HIV acquisition among Kenyan men with human papillomavirus infection.
Authors: Smith JS, Moses S, Hudgens MG, Parker CB, Agot K, Maclean I, Ndinya-Achola JO, Snijders PJ, Meijer CJ, Bailey RC
Source: J Infect Dis, 2010 Jun 1;201(11), p. 1677-85.
PMID: 20415595
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Prevalence and risk factors of human papillomavirus infection by penile site in uncircumcised Kenyan men.
Authors: Smith JS, Backes DM, Hudgens MG, Bailey RC, Veronesi G, Bogaarts M, Agot K, Ndinya-Achola JO, Maclean I, Agingu W, Meijer CJ, Moses S, Snijders PJ
Source: Int J Cancer, 2010 Jan 15;126(2), p. 572-7.
PMID: 19626601
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Herpes simplex virus type 2 antibody detection performance in Kisumu, Kenya, using the Herpeselect ELISA, Kalon ELISA, Western blot and inhibition testing.
Authors: Smith JS, Bailey RC, Westreich DJ, Maclean I, Agot K, Ndinya-Achola JO, Hogrefe W, Morrow RA, Moses S
Source: Sex Transm Infect, 2009 Apr;85(2), p. 92-6.
EPub date: 2008 Oct 27.
PMID: 18955387
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Human papillomavirus detection by penile site in young men from Kenya.
Authors: Smith JS, Moses S, Hudgens MG, Agot K, Franceschi S, Maclean IW, Ndinya-Achola JO, Parker CB, Pugh N, Meijer CJ, Snijders PJ, Bailey RC
Source: Sex Transm Dis, 2007 Nov;34(11), p. 928-34.
PMID: 17621251
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