Page 79 - S. Ličen, I. Karnjuš, & M. Prosen (Eds.). (2019). Women, migrations and health: Ensuring transcultural healthcare. Koper, University of Primorska Press.
P. 79
Human Papillomavirus Infection and Cervical Cancer in Immigrant and Refugee Women
The highest prevalence of HPV has been described in female sex workers
as they have multiple risk factors for HPV infection, such as young age and
multiple sexual contacts. There is wide heterogeneity in reported HPV preva-
lence in female sex workers in different geographical areas; 43 in Mexico,
48 in Japan and 63 in India. In Spain, the HPV prevalence among migrants
Latin American countries was found three times higher than the 8.2 preva-
lence in Spanish-borne women (Gonzalez, 2006) and a pick of 61 in HPV
prevalence was observed among sex workers from Eastern Europe (del Amo,
2005). Over the last few years, an increasing proportion of the female sex
workers in European countries are migrants especially from Eastern Europe.
(Tornesello et al., 2007). The Eastern European countries are still experiencing
high incidence of cervical cancer, lack of appropriate cervical cancer preven-
tion programs and paucity of HPV epidemiological surveys (Bruni et al., 2010).
It is likely that migrant female sex workers differ from other groups of the
population in terms of sociodemographic characteristics, sexual and health
seeking behaviour, as well as HPV prevalence and types. The knowledge of
these characteristics is essential to design appropriate preventive and cura-
tive strategies for immigrant sexual workers.
Vaccination against HPV
HPV vaccination is a safe and effective primary prevention strategy for cervi-
cal cancer especially in developed countries. Vaccination against HPV shows
great potential. Unfortunately, refugee and recently immigrated women are
among the least likely to participate in screening or vaccination. Gerend, Zap-
ata, and Reyes (2013) reported that despite generally favourable views of HPV
vaccination, observed rates of vaccine uptake among Hispanic adolescents
living in the United States were substantially lower than national estimates
(Gerend et al., 2013).
In Slovenia, HPV vaccination became the first non-mandatory vaccine to
be included in the national vaccination program in the 2009/2010 school year
(Troha, Šterbenc, Mlaker, & Poljak, 2018). Routine vaccination is for girls aged
11 or12 years whereas boys are not included in the program. Because parental
permission is required for vaccination of girls under age 18 years, parental at-
titudes and behaviour play a central role in vaccine uptake. There are signifi-
cant differences in HPV vaccine uptake among different regions in Slovenia,
ranging from very high (79.0) to very low (32.2) (Učakar, Poljak, & Klavs,
2012). There is no research dedicated to analysing HPV vaccination rates of
refugees in Slovenia.
Lower uptake of HPV vaccination among immigrants and refugees has
been documented in other countries, although exploration of underlying
77
The highest prevalence of HPV has been described in female sex workers
as they have multiple risk factors for HPV infection, such as young age and
multiple sexual contacts. There is wide heterogeneity in reported HPV preva-
lence in female sex workers in different geographical areas; 43 in Mexico,
48 in Japan and 63 in India. In Spain, the HPV prevalence among migrants
Latin American countries was found three times higher than the 8.2 preva-
lence in Spanish-borne women (Gonzalez, 2006) and a pick of 61 in HPV
prevalence was observed among sex workers from Eastern Europe (del Amo,
2005). Over the last few years, an increasing proportion of the female sex
workers in European countries are migrants especially from Eastern Europe.
(Tornesello et al., 2007). The Eastern European countries are still experiencing
high incidence of cervical cancer, lack of appropriate cervical cancer preven-
tion programs and paucity of HPV epidemiological surveys (Bruni et al., 2010).
It is likely that migrant female sex workers differ from other groups of the
population in terms of sociodemographic characteristics, sexual and health
seeking behaviour, as well as HPV prevalence and types. The knowledge of
these characteristics is essential to design appropriate preventive and cura-
tive strategies for immigrant sexual workers.
Vaccination against HPV
HPV vaccination is a safe and effective primary prevention strategy for cervi-
cal cancer especially in developed countries. Vaccination against HPV shows
great potential. Unfortunately, refugee and recently immigrated women are
among the least likely to participate in screening or vaccination. Gerend, Zap-
ata, and Reyes (2013) reported that despite generally favourable views of HPV
vaccination, observed rates of vaccine uptake among Hispanic adolescents
living in the United States were substantially lower than national estimates
(Gerend et al., 2013).
In Slovenia, HPV vaccination became the first non-mandatory vaccine to
be included in the national vaccination program in the 2009/2010 school year
(Troha, Šterbenc, Mlaker, & Poljak, 2018). Routine vaccination is for girls aged
11 or12 years whereas boys are not included in the program. Because parental
permission is required for vaccination of girls under age 18 years, parental at-
titudes and behaviour play a central role in vaccine uptake. There are signifi-
cant differences in HPV vaccine uptake among different regions in Slovenia,
ranging from very high (79.0) to very low (32.2) (Učakar, Poljak, & Klavs,
2012). There is no research dedicated to analysing HPV vaccination rates of
refugees in Slovenia.
Lower uptake of HPV vaccination among immigrants and refugees has
been documented in other countries, although exploration of underlying
77
