Frequently Asked Questions

Human Papilloma Virus (HPV) is the most common sexually transmitted infection in the USA. Approximately 80% of the sexually active population are infected with HPV at some point in their lives.   There are over 200 types of HPV. The virus can cause changes in the infected tissue that may progress to lesions or cancer.

HPV can be transmitted through skin-to-skin contact or any kind of sexual contact (anal, vaginal, and oral). People who are asymptomatic can still spread the virus.

In many cases you can have the virus and not show any symptoms. If symptoms appear, the most common are warts (common, genital, plantar, flat) or lesions on the part of the body that is infected. Signs can appear years after the infection.

A lesion is an area of abnormal tissue. Squamous intraepithelial lesions are the abnormal growth of squamous cells in the tissue. This means that there is an area of abnormal cells on the top layer of the skin.

There are two categories of lesions: Low-grade squamous intraepithelial lesions (LSIL) and High-grade squamous intraepithelial lesions (HSIL). Cellular changes that are just starting and still appear similar to normal cells are called LSIL. Cells in  HSIL  look very abnormal but the changes are only seen on the surface of the skin.

Usually your body can resolve a HPV infection on its own. There is no established treatment for the virus. Your healthcare provider will continue to monitor your condition in case any changes develop.

Warts and lesions (LSIL, HSIL) can be treated with medication, cauterization, cryogenic therapy, or surgical removal.

HPV can be diagnosed trough a Pap test, also known as a cytology test. An HPV DNA test can also be performed to detect different types of HPV. Another procedure that can be performed is a colposcopy or anoscopy where the healthcare provider observes your cervix through a magnifying device called a colposcope, or your anus though a magnifying device called an anoscope.

Certain types of HPV called oncogenic or high-risk HPV can cause the development of anogenital cancers. The changes in the tissue caused by these types of HPV can progress to the deeper layers on the skin, causing cancer.

Anal cancer develops when abnormal tissue starts growing in the anal canal. Some people may have pre-cancerous cells (LSIL, HSIL). Early on, there are no symptoms, so it is very important to visit your healthcare provider for check-ups. Some of the symptoms of anal cancer include anal bleeding, pain, masses or growths on the anal opening, itching, changes in bowel habits, purulent or mucous discharge, and swollen nymph nodes in the anal or groin area.

Anal cancer can be diagnosed through digital exam, anoscopy, cytology, biopsy, and imaging test (ultrasound and MRI).

Specific treatment depends on multiple factors, but it usually involves surgery, radiation therapy, and chemotherapy.

Cervical cancer develops when abnormal tissue starts growing in the cervix. Some people may have pre-cancerous cells (LSIL, HSIL). Early on, there are no symptoms, so is very important to visit your Healthcare Provider for check-ups. When the cancer is progressing, symptoms may include abnormal bleeding (after sex and between periods), abnormal discharge (watery, bloody, and stinky), pelvic pain, or pain during sexual intercourse.

Cervical cancer can be diagnosed through cytology, colposcopy, biopsy and imaging test (ultrasound and MRI).

Specific treatments depend on multiple factors, but usually involve surgery (removal of the cancer, the cervix, or the cervix and uterus), radiation therapy, and chemotherapy.

Studies have shown that people living with HIV (PLWH) have significantly higher rates of HPV infection and HPV related cancers. There is also evidence that shows a relationship between low CD4 T lymphocyte (CD4) and cancer risk. People living with HIV are more likely to have persitent infection with HPV. 

The US-Latin American-Caribbean HIV/HPV Cancer Prevention Clinical Trials Network (ULACNET) is a network from the National Institute of Health (NIH) that focuses on developing evidence to improve and optimize approaches to prevent HPV-related cancers in people living with HIV. The network has collaborators from USA, Puerto Rico, México, Brazil, Perú, and the Dominican Republic.

California-México-Puerto Rico Partnership (CAMPO) Center for Prevention of HPV-related Cancer in HIV Populations is part of the ULACNET network. This consortium will perform three clinical research studies focused on the prevention of anogenital cancer among people living with HIV.

Optimization of screening algorithms for cervical and anal high-grade squamous intraepithelial lesions in people living with HIV in Mexico and Puerto Rico (ULACNET 101) is the first of the three CAMPO studies. In this study, PLWH (21 years and older with no previous cancer diagnosis and no treatment for anogenital lesions in the last 18 months) will be evaluated to determine the most efficient algorithm for the detection of anogenital HPV-related cancers and HSIL.

You must provide your contact information and a team member will contact you.

You will recieve a detailed screening for the detection of cervical and anal cancer and HSIL, and you will receive counseling regarding cancer prevention. If you have HSIL, you will be referred for treatment if you choose not to participate in additional research studies. The results will help researchers develop better approaches to detect cancer and HSIL, which will  help other PLWH in the future. There is no cost for any of the procedures performed in the study. Economic compensation will be available for every procedure performed.

What are the risks of the study?

If you choose to take part in this study, there is a risk that:

• You may lose time at work or home and spend more time in the hospital or doctor’s office than usual.
• You may be uncomfortable when asked sensitive or private questions regarding sexual practices and or drug use during interviews or for the questionnaires.
• There is a risk someone could get access to the personal information in your medical records or other information researchers have kept about you. The study team will keep your information as secure as possible The researchers believe the chance that someone will identify you is very small, but the risk may change in the future as people come up with new ways of tracing information.
• Learning that you have cervical or anal HPV, HSIL or cancer may cause some anxiety.
• Some of the procedures (swabs, colposcopy, anoscopy, biopsies) may cause discomfort, minor bleeding, irritation.

In Puerto Rico, the study will be taking place at the Comprehensive Cancer Center Hospital in San Juan. The address for the hospital is:

HOSPITAL CCCUPR

BO MONACILLO URBANO

RIO PIEDRAS CARR 21

INT CARR 18

SAN JUAN PR 00927