Abstract C176: Implementing HPV vaccination services in people living with HIV in Trinidad and Tobago: COVID-19 vaccination may have boosted HPV vaccination
Authors: Galindo Tessa , Edwards Jonathan , Song Gaole , Soyer Sharon , Todd Selena , Boyce Gregory , Ashing Kimlin , Edwards Jeffrey 
Published: September 2024

Abstract
Background: Globally, Caribbean countries are among the most heavily burdened by both HIV and cervical cancer (CCA). People living with HIV (PLWH) are more susceptible and vulnerable to cancer due to their immune-compromised status. There is a pressing need for clinic-based CCA prevention in PLWH. Objective: A preliminary quality improvement evaluation of the vaccination program targeting PLWH in Trinidad and Tobago from October 2018 to May 2024. Methodology: The electronic health information system from a large clinic was used to abstract HPV vaccination data. No personal identifiers were collected from the system to protect the privacy of individuals and abide by Trinidad and Tobago’s data protection law. Evaluation of quality improvement of interventions approach was applied. Descriptive analyses were conducted using SPSS. Results: A total of 5,615 PLWH were eligible to participate in the HPV Vaccination clinic from October 2018 to May 2024. The average age was 39.6 (age range: 18- 51); 51.4% were women and 48.6% were men. Most (81.7%) PLWH reported their sexual orientation was heterosexual. Among our participants, 62.4% were Afro-Caribbean, 18.6% were Mixed, and 7.4% were East Indian/Indian. The majority of PLWH completed at least secondary education (69.8%). Half were single (50.5%), and 42.1% were employed/self-employed. Among these HPV vaccine-eligible persons, 1,157 patients (20.6%) received HPV vaccines. For those who had received vaccines, 254 patients (22.0%) were vaccinated with at least 1dose of the HPV vaccine, 301 (26.0%) were vaccinated up to dose 2 HPV vaccine, and 602 (52.0%) were vaccinated up to dose 3 HPV vaccine. Importantly, of those who received the HPV vaccine, the rate of uptake varied for each year. The uptake of HPV vaccine from January to May 2024 was 10.5% and in 2023 it was 18.5%. The highest uptake was in 2021 which was 22.4% followed by that in 2022 which was 20.3%. Between 2018 and 2020, the uptakes were 13.7% for 2020, 12.1% for 2019, and 5.3% for 2018. Discussion: Overall, the HPV vaccination rate for PLWH was relatively low; only 1 in 5 was vaccinated. Still, we saw an interesting trend with the highest vaccination uptake during the peak years of COVID-19 vaccinations. Hence, our data suggest that the COVID-19 vaccination program may have boosted HPV vaccination. Given our lessons learned, our goal is to seek funding for an implementation and dissemination science approach for adopting, implementing, and sustaining clinic-based HPV-related cancer prevention by bundling services such as Pap-Testing, PSA testing and/or co-vaccination (e.g., flu, shingles) to improve reach and uptake towards reducing cancer-related morbidity and mortality among PLWH.
Citation Format: Tessa Galindo, Jonathan Edwards, Gaole Song, Sharon Soyer, Selena Todd, Gregory Boyce, Kimlin Ashing, Jeffrey Edwards. Implementing HPV vaccination services in people living with HIV in Trinidad and Tobago: COVID-19 vaccination may have boosted HPV vaccination [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C176.