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HIV-Cervical Cancer Prevention

The HIV-Cervical Cancer Prevention Program has an overall goal of improving clinical care options for immunosuppressed HIV-infected women in resource-limited settings. We are engaged in conducting clinical, epidemiological, and implementation research and research training initiatives in India, Zambia, and China. Our program is spearheaded by Vikrant Sahasrabuddhe, MBBS, M.P.H., Ph.D., and with Sten H. Vermund, M.D., Ph.D. Our goal is to develop and implement evidence-based, cost-effective cervical cancer prevention services for women with HIV, as well as eventually provide cervical cancer screening services for all women in our implementation catchment area. Our initial work has shown the extraordinary need for screening in this high-risk population of HIV-infected women, the usefulness of single-visit approaches for cervical cancer screening and the necessity of undertaking research on HPV molecular epidemiology to inform screening and vaccination strategies.

India

The HIV-Cervical Cancer Prevention Research Consortium in India is jointly funded by National Institutes of Health (NIH) and the Indian Council of Medical Research (ICMR). The goal of this consortium is to generate evidence for improving clinical care options for immunosuppressed HIV-infected women in India. We partner with National AIDS Research Institute (NARI) and B.J. Medical College-Sassoon General Hospitals (BJMC-SGH) in Pune, Maharashtra; J.N. Medical College (JNMC) in Belgaum, Karnataka; K.E.M. Hospital Research Center (KEMHRC) in Vadu, Maharashtra; and National Institute of Epidemiology (NIE) in Chennai, Tamil Nadu. As a result of our research training and capacity building efforts, a large multi-site cohort study evaluating cervical cancer screening approaches among HIV-infected women in India is now underway that will provide the backbone for future prevention clinical trials in this population at high-risk of HPV-induced cervical cancer. Our training efforts have focused on clinical training, clinical research, HPV molecular epidemiology research, and social and behavioral research, and have involved clinicians, nurses, counselors, data management personnel, epidemiologists, statisticians, community outreach workers and laboratory technicians. Our collaborating investigators include Dr. Sanjay Mehendale (NARI), Dr. Seema Sahay (NARI), Dr. Arun Risbud (NARI), Dr. Ramesh Bhosale (BJMC-SGH), Dr. Shivaprasad Goudar (JNMC), Dr. Babasaheb Desai (JNMC), Dr. V.S. Padbidri (KEMHRC), Dr. V. Kumaraswami and Dr. Vidya Ramachandran (NIE).

Zambia

Our partnership with the Center for Infectious Disease Research in Zambia (CIDRZ), the Zambian Ministry of Health and the University Teaching Hospital (UTH) in Lusaka, Zambia includes training and capacity building efforts in support of the Cervical Cancer Prevention Program in Zambia (CCPPZ) that has screened over 45,000 women since 2006. CCPPZ is the first ever population-based screening program in Africa built upon the HIV/AIDS treatment and care infrastructure developed through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Dr. Mulindi Mwanahamuntu and Dr. Groesbeck Parham are our in-country collaborators and our training efforts are supported by NIH-Fogarty and CDC.

China

We collaborate with the Cancer Institute of the Chinese Academy of Medical Sciences (CICAMS) and the Chinese Centers for Disease Control and Prevention (CDC) to undertake research and training related to HIV and cervical cancer in Yunnan Province in southern China, the epicenter of the HIV epidemic in China. With NIH-Fogarty support, we conducted the first ever training workshop in China focused on HIV and cervical cancer in Kunming (capital of Yunnan Province) and trained over 100 physicians and nurses in screening and treatment methods. We are now developing an HIV-cervical cancer prevention research study in Yunnan incorporated within the population-based screening program organized by CICAMS and Cancer Foundation of China (CFC), in collaboration with Dr. Youlin Qiao (Professor and Director, Department of Epidemiology, CICAMS).