EPIC-STI PROJECT 4 (WHEELER): Population-Based Impact of HPV vaccination and Cervical Screening on Sexually Transmitted Infections and Outcomes. SUMMARY The New Mexico Human Papillomavirus (HPV) Pap Registry (NMHPVPR) is a cornerstone of the Epidemiology and Prevention Center for Sexually Transmitted Infections (EPIC-STI) representing an innovative and important public health resource for the United States. The NIH supports this large-scale population- based surveillance activity which holds the capacity to link cervical screening and outcomes to HPV vaccination status and HPV genotyping assessments. Through data linkages, the NMHPVPR can evaluate the population-based effectiveness HPV vaccines in reducing abnormal cytologic and histologic outcomes, evaluate potential HPV type replacement or competing risks from non-vaccine HPV genotypes, assess differences in the population effectiveness of current and next generation HPV vaccines, estimate the parallel impact of evolving changes in cervical screening practices among vaccinated versus non vaccinated populations and examine the impact of these changes on screening practices, detection and population dynamics of non-HPV sexually transmitted infections (STI). We will delineate the population-based impact of primary and secondary cervical prevention strategies through overarching objectives using real-world evaluations building on our past accomplishments and our unique strengths: As a measure of HPV vaccine impact and effectiveness, HPV genotype frequencies will be compared between two population-based samples of liquid cytology specimens and two population-based samples of cervical tissue biopsies ascertained at an average of 7 and 9 years post initial HPV vaccine licensure. Cervical screening practices in the NM population will be characterized over a ten year period (2008-2017) including intervals between screening episodes, between screening and diagnosis and between diagnosis and treatment. The population-based impact of changes in cervical screening on HPV and non-HPV STIs will be examined given the recent elimination of opportunistic cervical screening in women aged <21 years and the recommendation to increase intervals between cervical screening episodes among all women aged 21-65 years. With a focus on Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis infections, we will report population-based age-specific clinical STI-test utilization and positive test outcomes by type of sample (urine, swab, or liquid cytology specimen) across 2008-2017. The collaborative EPIC-STI will establish infrastructures to enable linkages to assess longer term clinical outcomes throughout the state including pelvic inflammatory disease, tubal pregnancies, premature births and infertility.

Public Health Relevance

- EPIC-STI PROJECT 4 (WHEELER) In the background of highly successful US cervical cancer screening, our project conducted in populations suffering many health disparities, will characterize real-world HPV vaccine effectiveness decades before any potential impact on cervical cancer incidence will be realized. Further we employ unique health informatics systems to delineate the effects of evolving cervical cancer screening practices on the burden of STIs and their associated disease outcomes using population-based approaches.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Research Program--Cooperative Agreements (U19)
Project #
Application #
Study Section
Special Emphasis Panel (ZAI1)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of New Mexico Health Sciences Center
United States
Zip Code
Lijek, Rebeccah S; Helble, Jennifer D; Olive, Andrew J et al. (2018) Pathology after Chlamydia trachomatis infection is driven by nonprotective immune cells that are distinct from protective populations. Proc Natl Acad Sci U S A 115:2216-2221
Frietze, Kathryn M; Lijek, Rebeccah; Chackerian, Bryce (2018) Applying lessons from human papillomavirus vaccines to the development of vaccines against Chlamydia trachomatis. Expert Rev Vaccines 17:959-966
Yokoyama, Christine C; Baldridge, Megan T; Leung, Daisy W et al. (2018) LysMD3 is a type II membrane protein without an in vivo role in the response to a range of pathogens. J Biol Chem 293:6022-6038
Castle, Philip E; Wheeler, Cosette M; Campos, Nicole G et al. (2018) Inefficiencies of over-screening and under-screening for cervical cancer prevention in the U.S. Prev Med 111:177-179
Arrossi, Silvina; Temin, Sarah; Garland, Suzanne et al. (2017) Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline. J Glob Oncol 3:611-634
Zhai, Lukai; Peabody, Julianne; Pang, Yuk-Ying Susana et al. (2017) A novel candidate HPV vaccine: MS2 phage VLP displaying a tandem HPV L2 peptide offers similar protection in mice to Gardasil-9. Antiviral Res 147:116-123
Ramírez-Peinado, Silvia; Ignashkova, Tatiana I; van Raam, Bram J et al. (2017) TRAPPC13 modulates autophagy and the response to Golgi stress. J Cell Sci 130:2251-2265
Cuzick, Jack; Myers, Orrin; Lee, Ji-Hyun et al. (2017) Outcomes in Women With Cytology Showing Atypical Squamous Cells of Undetermined Significance With vs Without Human Papillomavirus Testing. JAMA Oncol 3:1327-1334
Peabody, Julianne; Muttil, Pavan; Chackerian, Bryce et al. (2017) Characterization of a spray-dried candidate HPV L2-VLP vaccine stored for multiple years at room temperature. Papillomavirus Res 3:116-120
Laborde, Rady J; Sanchez-Ferras, Oraly; Luzardo, María C et al. (2017) Novel Adjuvant Based on the Pore-Forming Protein Sticholysin II Encapsulated into Liposomes Effectively Enhances the Antigen-Specific CTL-Mediated Immune Response. J Immunol 198:2772-2784

Showing the most recent 10 out of 18 publications