Prevalence of depression, substance abuse, and stigma among men who have sex with men in coastal Kenya

Program/Project Purpose: Virtually all cases of cervical cancer are associated with persistent infection of high-risk serotypes of HPV. While cytology based screening programs have significantly reduced the cervical cancer incidence in high income countries they have proven ineffective in low and middle income countries (LMICs). This shortfall appears to be due to a number of factors, including the need for complex laboratory equipment, highly trained staff, informatics and logistics for follow up of results, and availability of treatment. HPV DNA testing may potentially decrease these programmatic requirements and thus presents a pragmatic and advantageous alternative for cervical cancer screening. Due to disproportionately higher rates of cervical cancer incidence and mortality, it is critical to ensure these technological advancements are feasible for LMIC’s to utilize in moving past opportunistic screening and towards scaling up cervical cancer screening programs. The World Health Organization (WHO) recently released cervical cancer guidelines recommending HPV testing for screening where resources permit . Ensuring that LMIC’s benefit from the new technology requires collaboration and a neutral facilitator for information flow between public and private institutions. In response to this need the National Cancer Institute of the United States Institutes of Health (NCI/NIH) and the Pan American Health Organization (PAHO/WHO) convened industry, representatives of Latin American and Caribbean (LAC) ministries of health as well as experts in the field to discuss testing options and programmatic needs. The meeting HPV testing’s Role in Reducing the Global Cancer Burden was held at PAHO on May 12 and 13, 2014. Structure/Method/Design: It included the participation of eight HPV testing diagnostic companies, representatives from six ministries of health from Latin America and the Caribbean, other U.S. Government agencies like CDC, international organizations including WHO and IARC, PATH and the Gates Foundation as well as U.S. universities working on global health. Outcomes & Evaluation: Discussion included the implementation of an up scaling process for the region and potential mechanisms available at both PAHO and WHO that could potentially assist to make the test more affordable to Member Countries in the LAC region. Other concrete products of the meeting include the development of a document that summarizes the available HPV tests and their requirements to be used by Ministries of Health and relevant agencies in Latin America and the Caribbean and a Training Manual pertaining HPV Testing for Health Officers in Latin America and the Caribbean that is expected to be ready by early 2015. Going Forward: The lessons learned from this meeting could be potentially applied to a similar initiative in other LMICs region including Africa and Asia. Funding: Costs were shared between the NCI and PAHO. Abstract #: 01NCD032