Diss. (sammanfattning) Stockholm : Karolinska institutet, 2009.

Thesis (Ph. D.)--University of North Texas, Aug., 2009. / Title from title page display. Includes bibliographical references.

BACKGROUND: Human Papillomavirus (HPV) is the most common sexually-transmitted infection in the U.S. and is associated with a number of cancers. A vaccine that can prevent 90% of HPV-associated cancers has been available since 2006, yet millions of young adults remain unvaccinated. Low vaccination uptake has been observed in cisgender sexual minority communities and less is known about HPV vaccination among transgender and gender nonbinary (TGNB) people. The aims of this dissertation were: (a) to identify facilitators for and barriers to HPV vaccination among gender minority people; (b) to compare HPV vaccination rates, HPV risk and situational factors like barriers to care, access to care, preventive care, HPV knowledge and Internet use in a sample of TGNB people and cisgender sexual minority people; and (c) to explore the association of online health information and HPV vaccination receipt among TGNB people compared to cisgender sexual minority people and determine if eHealth Literacy or general health literacy moderate this relationship. METHODS: The dissertation comprised three studies. First, an integrative review of the literature included searches of three electronic databases to identify and appraise studies that explore patient-, provider- and system-level HPV vaccination barriers among gender minority people. Second, guided by the Integrative Model of eHealth Use, a cross-sectional secondary analysis of The Population Research in Identities and Disparities for Equality (PRIDE) Study Annual Questionnaire 2018-19, compared the rate of HPV vaccination among TGNB and cisgender sexual minority people and described situation factors (e.g., barriers to care, access to care, preventive care), Internet use, HPV knowledge, HPV risk, and HPV vaccination among these communities. Third, a novel cross-sectional online survey of TGNB and cisgender sexual minority participants recruited from The PRIDE Study, also guided by the Integrative Model of eHealth Use, explored the association between online health information seeking and receipt of HPV vaccine, and whether eHealth literacy and/or general health literacy moderate this relationship. Statistical methods for the cross-sectional studies included prevalence ratios (PR) using robust Poisson statistics and multivariable logistic regression with post hoc Bonferroni-Holm correction. RESULTS: The integrative review identified six cross-sectional studies and one qualitative study that explored HPV vaccine barriers and facilitators among gender minority people. The majority of the studies included <10% gender minority participants. Key barriers to vaccination identified were misperceptions of risk at patient-level, bias towards vaccinating female assigned individuals at the provider-level and population effects of recommendations for girls-only at the policy-level. The cross-sectional secondary analysis of The PRIDE Study 2018-19 Annual Questionnaire and included N = 5,500 responses and found that: (a) the prevalence of ever receiving HPV vaccine was 1.2 times greater among TGNB participants than cisgender participants (PR 1.2; 95% CI, 1.1-1.3); (b) the prevalence of ever receiving HPV vaccine was 2.4 times greater among transgender men who were assigned female at birth compared to transgender women who were assigned male at birth (PR 2.4; 95% CI, 2.0-2.8); and (c) no differences in vaccination initiation and vaccination completion based on gender identity, sex assigned at birth, sex organs born with, or current sex organs. The cross-sectional novel online survey of PRIDE participants yielded N = 3,258 responses (response rate 19.6%). After controlling for covariates including age, race/ethnicity and educational attainment, we found that TGNB as compared to cisgender participants had increased odds (aOR=1.5=; 95% CI, 1.1-2.2) of reporting receipt of HPV vaccine ever and decreased odds (aOR=0.7; 95% CI, 0.5-0.9) of ever receiving of HPV vaccine when they looked for info on vaccines in the past year. Conversely, TGNB participants had over twice the odds (aOR=2.4; 95% CI, 1.1-5.6) of ever receiving HPV vaccine if they visited a social networking site like Facebook or Instagram in the past year. There were no moderating effects observed from eHealth or general health literacy. CONCLUSIONS: TGNB communities are understudied in terms of HPV vaccination and the existing literature shows misperceptions about the need of HPV vaccination among TGNB communities at both the patient and provider level. TGNB participants were more likely to have ever received HPV vaccine compared to cisgender sexual minority participants in the cross-sectional secondary analysis of The PRIDE Study 2018-19 Annual Questionnaire which may be attributed to high primary engagement in the cohort. Finally, online health information seeking about vaccines was associated with decreased receipt of HPV vaccine (ever) whereas social media use increased HPV vaccine receipt (ever) among TGNB participants compared to cisgender sexual minority participants. These conflicting findings suggest that the quality of online health information relating HPV vaccines, how, when and why TGNB people search for health information online may affect health behaviors like HPV vaccination. More research is warranted to explore how online health information seeking may influence personal health decision-making among TGNB communities.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2009.

Introdução: A infecção genital pelo papilomavírus humano (HPV) é um fator necessário para o desenvolvimento do câncer cervical. Vacinas para prevenir a infecção pelos tipos de alto risco HPV 16 e 18 foram desenvolvidas e idealmente devem ser administradas antes da exposição ao HPV através do contato sexual. As variações na prevalência do HPV e na de seus tipos específicos em diferentes populações podem influenciar as recomendações da vacina contra o HPV em diferentes locais. A vacinação após o primeiro parto poderia ser uma estratégia em potencial para atingir mulheres jovens e saudáveis, dependendo da proporção de mulheres desse grupo ainda não infectadas pelos tipos de alto risco, HPV 16 e 18. Objetivos: O objetivo principal deste estudo foi determinar a prevalência genital do DNA de tipos específicos do HPV e avaliar a associação dessa infecção com fatores de risco selecionados em mulheres após o primeiro parto, usuárias de uma maternidade pública. Métodos: Esse estudo transversal foi realizado no Hospital Maternidade Leonor Mendes de Barros (HMLMB), uma das maiores maternidades públicas da cidade de São Paulo. Durante junho de 2006 até fevereiro de 2007, 301 primíparas de 15-24 anos, cujos partos ocorreram no referido Hospital, foram incluídas no estudo entre 43 e 60 dias após o parto. Na detecção de DNA do HPV extraído das células cervicais esfoliadas foi utilizado protocolo padrão da Reação em Cadeia por Polimerase (PCR), utilizando primers PGMY09/11. Para estimar a associação da infecção por HPV com fatores de risco selecionados, foi calculada a Razão de Prevalência (RP) e o intervalo de 95% de confiança [IC]; o ajuste foi realizado utilizando-se o Modelo Linear Generalizado (MLG) com distribuição binomial e função de ligação logarítmica. Resultados: O DNA do HPV foi detectado em 58,5% (IC 95% 52,7%-64,0%) das jovens mulheres. Os tipos de HPV mais comumente encontrados foram: HPV 16, HPV 51, HPV 52, HPV 58 e HPV 71. A prevalência dos tipos de HPV incluídos nas vacinas profiláticas foi: HPV 16 - 12,0%, HPV 18 - 2,3% e HPV 6+11 - 4,3%. Os tipos de alto risco de HPV foram encontrados em 133 (44,2%) mulheres, enquanto 43 delas (14,3%) apresentaram somente tipos de HPV de baixo risco. Cento e duas mulheres (33,9%) foram positivas para apenas um tipo de HPV; entretanto, 43 (14,3%) apresentaram dois tipos, e 31 (10,3%) apresentaram três ou mais tipos virais. A análise multivariada revelou que somente a idade (p=0,020) e o hábito de fumar (p <0,001) foram fatores de risco independentemente associados com a infecção por HPV. Conclusões: Essas adolescentes e jovens primíparas apresentaram elevada prevalência de infecção genital por tipos de alto risco do HPV, mostrando que constituem um grupo de risco para o desenvolvimento de câncer cervical. Contudo, apenas 17,3% apresentaram pelo menos um dos quatro tipos virais presentes na vacina quadrivalente (HPV 6, 11, 16 ou 18), 13,3% apresentaram infecção pelos tipos HPV 16 ou 18, e somente 1,0% apresentou concomitantemente infecção por esses dois tipos virais de alto risco presentes nas vacinas. Portanto, esse estudo indica que a grande maioria dessas jovens primíparas poderia ainda se beneficiar da imunização (catch-up) contra o HPV e constitui um grupo que deve ser alvo de programas efetivos de prevenção primária e secundária para o câncer cervical / Introdution: Genital infection by human papillomavirus (HPV) is a necessary factor in the development of cervical cancer. Vaccines to prevent infection by high risk HPV genotypes 16 and 18 were developed and ideally should be administered before exposure to HPV through sexual contact. Variations in HPV prevalence in different populations and of specific HPV types could affect vaccine recommendations in different settings. Vaccination after first delivery could be a potential strategy for reaching healthy young women depending on the baseline prevalence of high risk genotypes 16 and 18 in this target group. Objectives: The main objective of this study was to determine genital type specific HPV DNA prevalence and selected risk factors associated with HPV infection after the delivery of the first child among young women in a public maternity. Methods: This cross-sectional study was carried out at Hospital Maternidade Leonor Mendes de Barros (HMLMB), one of the largest public maternity hospitals in Sao Paulo. During June 2006 to February 2007, 301 primiparous women aged 15-24 years, who gave birth at that hospital, were included in the study between 43 and 60 days after delivery. Detection of HPV DNA in cervical specimens was performed using a standardized polymerase chain reaction (PCR) protocol with PGMY09/11 primers. To estimate the association of HPV infection with selected risk factors, prevalence ratios (PR) and 95% confidence interval [CI] were estimated using a Generalized Linear Model (GLM) with binomial distribution and log link function. Results: Any HPV DNA was detected in 58.5% (95% CI 52.7%-64.0%) of the enrolled young women. Most common types of HPV found were: HPV16, HPV51, HPV52, HPV58 and HPV71. The overall prevalence of HPV types targeted by the HPV prophylactic vaccines was: HPV16 - 12.0%, HPV18 -2.3% and HPV 6+11- 4.3%. High-risk HPV types were found in 133 (44.2%) women, whereas 43 women (14.3%) had only low-risk HPV types. One hundred and two women (33.9%) were positive for one HPV type only; however, 43 (14.3%) had two types, and 31 (10.3%) had three or more types detected. The multivariate analysis revealed that only age (p for trend =0.020) and smoking habits (p <0.001) were risk factors independently associated with HPV infection. Conclusions: These adolescents and young primiparous women had high cervical HPV prevalence, suggesting that this is a high risk group for cervical cancer development. Nevertheless, 17.3% were positive to any of the four HPV types included in HPV vaccines (HPV6, 11, 16 or 18), with 13.3% positive for HPV 16 or 18, and only 1.0% of them had both vaccine related oncogenic HPV types. Thus, this study supports that the most part of young primiparous women could benefit from catch-up HPV vaccination, and represents a target group for effective primary and secondary cervical cancer prevention programs

OBJECTIVES To determine if health care workers are aware of the HPV vaccine and its availability, uptake of the vaccine and prescribing practices and reasons for non – uptake of the vaccine . METHODS Health care providers working in the private sector, in the Ethekweni health district in Kwazulu Natal, were interviewed. Health care workers included: 100 general practitioners, 50 gynaecologists, 50 paediatricians, 50 medical staff and 50 nursing staff. A questionnaire was designed for purpose of this study. Visits were be made to health care providers. All heath care providers who were willing to participate were interviewed. STATISTICS Comparisons of awareness among subgroups of health care providers was analysed using Chi-square tests. If significant, pairwise comparisons were made using a Bonferroni adjustment for multiple comparisons. Associations between awareness and other factors, such as demographic, uptake and beliefs were tested using a chi square test. Analysis was done by Stata v11 (StataCorp, 2009) i RESULTS Three hundred health care workers were interviewed - 50 gynecologists (16.7%), 52 pediatricians (17.3%), 99 general practitioners (33%), 49 other medical doctors (16.3%) and 50 (16.7%) nurses. Two hundred and sixty seven health care workers (89%) were aware of the HPV vaccine and one hundred and eighty eight health care workers (70.4%) informed patients of the availability of the HPV vaccine. Most (77.9%) practitioners have only prescribed the vaccine less than ten times. Gardasil® was prescribed by 46%, Cervarix® by 6.5% and prescription of either vaccine of health care workers was 50.2%. Practitioners were generally unaware that Gardasil® could be prescribed to males (62.9%). CONCLUSION Health care workers were aware of the HPV vaccine and prescribed the vaccine on request. However even though practitioners were aware of the vaccine, most have prescribed the vaccine less than ten times since licensing in 2008. Knowledge with regards to the licensed use of the HPV vaccines is deficient. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2012.

Thesis (D.P.H.)--University of Alabama at Birmingham, 2009. / Title from PDF title page (viewed on July 19, 2010). Includes bibliographical references (p. 73-79).

Introdução: A infecção genital pelo papilomavírus humano (HPV) é um fator necessário para o desenvolvimento do câncer cervical. Vacinas para prevenir a infecção pelos tipos de alto risco HPV 16 e 18 foram desenvolvidas e idealmente devem ser administradas antes da exposição ao HPV através do contato sexual. As variações na prevalência do HPV e na de seus tipos específicos em diferentes populações podem influenciar as recomendações da vacina contra o HPV em diferentes locais. A vacinação após o primeiro parto poderia ser uma estratégia em potencial para atingir mulheres jovens e saudáveis, dependendo da proporção de mulheres desse grupo ainda não infectadas pelos tipos de alto risco, HPV 16 e 18. Objetivos: O objetivo principal deste estudo foi determinar a prevalência genital do DNA de tipos específicos do HPV e avaliar a associação dessa infecção com fatores de risco selecionados em mulheres após o primeiro parto, usuárias de uma maternidade pública. Métodos: Esse estudo transversal foi realizado no Hospital Maternidade Leonor Mendes de Barros (HMLMB), uma das maiores maternidades públicas da cidade de São Paulo. Durante junho de 2006 até fevereiro de 2007, 301 primíparas de 15-24 anos, cujos partos ocorreram no referido Hospital, foram incluídas no estudo entre 43 e 60 dias após o parto. Na detecção de DNA do HPV extraído das células cervicais esfoliadas foi utilizado protocolo padrão da Reação em Cadeia por Polimerase (PCR), utilizando primers PGMY09/11. Para estimar a associação da infecção por HPV com fatores de risco selecionados, foi calculada a Razão de Prevalência (RP) e o intervalo de 95% de confiança [IC]; o ajuste foi realizado utilizando-se o Modelo Linear Generalizado (MLG) com distribuição binomial e função de ligação logarítmica. Resultados: O DNA do HPV foi detectado em 58,5% (IC 95% 52,7%-64,0%) das jovens mulheres. Os tipos de HPV mais comumente encontrados foram: HPV 16, HPV 51, HPV 52, HPV 58 e HPV 71. A prevalência dos tipos de HPV incluídos nas vacinas profiláticas foi: HPV 16 - 12,0%, HPV 18 - 2,3% e HPV 6+11 - 4,3%. Os tipos de alto risco de HPV foram encontrados em 133 (44,2%) mulheres, enquanto 43 delas (14,3%) apresentaram somente tipos de HPV de baixo risco. Cento e duas mulheres (33,9%) foram positivas para apenas um tipo de HPV; entretanto, 43 (14,3%) apresentaram dois tipos, e 31 (10,3%) apresentaram três ou mais tipos virais. A análise multivariada revelou que somente a idade (p=0,020) e o hábito de fumar (p <0,001) foram fatores de risco independentemente associados com a infecção por HPV. Conclusões: Essas adolescentes e jovens primíparas apresentaram elevada prevalência de infecção genital por tipos de alto risco do HPV, mostrando que constituem um grupo de risco para o desenvolvimento de câncer cervical. Contudo, apenas 17,3% apresentaram pelo menos um dos quatro tipos virais presentes na vacina quadrivalente (HPV 6, 11, 16 ou 18), 13,3% apresentaram infecção pelos tipos HPV 16 ou 18, e somente 1,0% apresentou concomitantemente infecção por esses dois tipos virais de alto risco presentes nas vacinas. Portanto, esse estudo indica que a grande maioria dessas jovens primíparas poderia ainda se beneficiar da imunização (catch-up) contra o HPV e constitui um grupo que deve ser alvo de programas efetivos de prevenção primária e secundária para o câncer cervical / Introdution: Genital infection by human papillomavirus (HPV) is a necessary factor in the development of cervical cancer. Vaccines to prevent infection by high risk HPV genotypes 16 and 18 were developed and ideally should be administered before exposure to HPV through sexual contact. Variations in HPV prevalence in different populations and of specific HPV types could affect vaccine recommendations in different settings. Vaccination after first delivery could be a potential strategy for reaching healthy young women depending on the baseline prevalence of high risk genotypes 16 and 18 in this target group. Objectives: The main objective of this study was to determine genital type specific HPV DNA prevalence and selected risk factors associated with HPV infection after the delivery of the first child among young women in a public maternity. Methods: This cross-sectional study was carried out at Hospital Maternidade Leonor Mendes de Barros (HMLMB), one of the largest public maternity hospitals in Sao Paulo. During June 2006 to February 2007, 301 primiparous women aged 15-24 years, who gave birth at that hospital, were included in the study between 43 and 60 days after delivery. Detection of HPV DNA in cervical specimens was performed using a standardized polymerase chain reaction (PCR) protocol with PGMY09/11 primers. To estimate the association of HPV infection with selected risk factors, prevalence ratios (PR) and 95% confidence interval [CI] were estimated using a Generalized Linear Model (GLM) with binomial distribution and log link function. Results: Any HPV DNA was detected in 58.5% (95% CI 52.7%-64.0%) of the enrolled young women. Most common types of HPV found were: HPV16, HPV51, HPV52, HPV58 and HPV71. The overall prevalence of HPV types targeted by the HPV prophylactic vaccines was: HPV16 - 12.0%, HPV18 -2.3% and HPV 6+11- 4.3%. High-risk HPV types were found in 133 (44.2%) women, whereas 43 women (14.3%) had only low-risk HPV types. One hundred and two women (33.9%) were positive for one HPV type only; however, 43 (14.3%) had two types, and 31 (10.3%) had three or more types detected. The multivariate analysis revealed that only age (p for trend =0.020) and smoking habits (p <0.001) were risk factors independently associated with HPV infection. Conclusions: These adolescents and young primiparous women had high cervical HPV prevalence, suggesting that this is a high risk group for cervical cancer development. Nevertheless, 17.3% were positive to any of the four HPV types included in HPV vaccines (HPV6, 11, 16 or 18), with 13.3% positive for HPV 16 or 18, and only 1.0% of them had both vaccine related oncogenic HPV types. Thus, this study supports that the most part of young primiparous women could benefit from catch-up HPV vaccination, and represents a target group for effective primary and secondary cervical cancer prevention programs

Objetivos. Determinar la relación costo-efectividad de la vacunación contra el (virus del papiloma humano) VPH y el tamiz de lesiones cervicales, frente a un programa de tamiz solo. Materiales y métodos. Se realizó una evaluación costo-efectividad y se empleó un modelo de Markov, con un horizonte temporal de 70 años y tres alternativas de prevención para el (cáncer del cuello uterino) CCU (tamiz solo, tamiz + vacuna bivalente, y tamiz + vacuna cuadrivalente), en una cohorte hipotética de niñas de diez años, desde la perspectiva del Ministerio de Salud. Resultados. La vacunación contra el VPH y tamiz es más costo-efectiva que el tamiz solo a partir de una voluntad de pago de S/ 2000 (USD 1 290,32). En el análisis determinístico, la vacuna bivalente es marginalmente más costo-efectiva que la vacuna cuadrivalente (S/ 48 [USD 30,97] frente a S/ 166 [USD 107,10] por AVAC, respectivamente). Sin embargo, en el análisis probabilístico ambas intervenciones generan nubes de puntos superpuestos, con una tendencia de la vacuna cuadrivalente a ser más costo-efectiva. Es decir, ambas son costo-efectivas y, por ende, intercambiables. El modelo fue especialmente sensible a variaciones de la cobertura y en la prevalencia de infección persistente por genotipos oncológicos no incluidos en la vacuna. Conclusiones. A partir de una disponibilidad de pago de S/ 2000 [USD 1 290,32] el tamiz y la vacunación son más costo-efectivos que el tamiz solo. La diferencia de costo-efectividad entre ambas vacunas carece de robustez probabilística y ambas vacunas pueden considerarse intercambiables desde la perspectiva costo-efectividad. / Objectives. To determine the cost-effectiveness of human papillomavirus (HPV) vaccination and cervical lesion screening versus screening alone for the prevention of uterine cervical cancer (UCC). Materials and methods. This cost-effectiveness evaluation from the perspective of the Ministry of Health employed a Markov model with a 70-year time horizon and three alternatives for UCC prevention (screening alone, screening + bivalent vaccine, and screening + quadrivalent vaccine) in a hypothetical cohort of 10-year-old girls. Results. Our model, which was particularly sensitive to variations in coverage and in the prevalence of persistent infection by oncologic genotypes not included in the vaccine, revealed that HPV vaccination and screening is more cost-effective than screening alone, assuming a payment availability from S/ 2 000 (US dollars (USD) 1 290.32) per subject. In the deterministic analysis, the bivalent vaccine was marginally more cost-effective than the quadrivalent vaccine (S/ 48 [USD 30.97] vs. S/ 166 [USD 107.10] per quality-adjusted life-year, respectively). However, in the probabilistic analysis, both interventions generated clouds of overlapping points and were thus cost-effective and interchangeable, although the quadrivalent vaccine tended to be more cost-effective. Conclusions. Assuming a payment availability from S/ 2000 [USD 1,290.32], screening and vaccination were more cost-effective than screening alone. The difference in cost-effectiveness between the two vaccines lacked probabilistic robustness, and therefore the vaccines can be considered interchangeable from a cost-effectiveness perspective.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-08-09T18:26:50Z No. of bitstreams: 1 carolainebitencourtferreirafernandes.pdf: 1669281 bytes, checksum: 34f68a915c16a0c85f114101af871242 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-14T17:07:25Z (GMT) No. of bitstreams: 1 carolainebitencourtferreirafernandes.pdf: 1669281 bytes, checksum: 34f68a915c16a0c85f114101af871242 (MD5) / Made available in DSpace on 2017-08-14T17:07:25Z (GMT). No. of bitstreams: 1 carolainebitencourtferreirafernandes.pdf: 1669281 bytes, checksum: 34f68a915c16a0c85f114101af871242 (MD5) Previous issue date: 2013-08-28 / O câncer de colo do útero é o segundo tumor mais frequente na população feminina e a segunda causa de morte por neoplasia entre mulheres. A infecção persistente pelo vírus HPV é condição necessária para o aparecimento da doença, bem como de suas lesões precursoras. O uso da vacinação profilática contra o HPV tem se mostrado efetivo na prevenção da doença e, devido ao mecanismo de desenvolvimento do câncer a partir da infecção viral, novas partículas vacinais vêm sendo desenvolvidas com o objetivo de uso terapêutico, ou seja, na vigência de lesões. Este trabalho teve como objetivo realizar uma revisão sistemática da literatura sobre o uso de vacinas terapêuticas contra o HPV e sobre as novas partículas utilizadas com este fim. Foi feita uma consulta às bases de dados MEDLINE, PUBMED e LILACS, às coleções SciELO e à BIBLIOTECA COCHRANE, utilizando-se as palavras-chave “papillomavirus humano”, “”HPV”, “vacina”, “vacinação”, “terapêutico” e “imunoterapia” em diferentes combinações, sem limite de data. Dos 713 artigos encontrados inicialmente, 352 foram excluídos por estarem repetidos nas diferentes bases de dados, 217 por serem artigos de revisão, 86 por serem realizados em animais, 24 publicados em idiomas que não o inglês, português e espanhol, 15 de outras localizações anatômicas que não o colo do útero, 2 em pacientes HIV positivos, 1 em homens, 2 cujas pacientes possuíam apenas infecção pelo vírus, mas não lesão no colo e 1 realizado in vitro. Um último artigo foi excluído pois utilizava a vacina após a retirada da lesão do colo das pacientes. Desta forma foram selecionados 12 artigos para esta revisão sistemática. Estes são artigos de fase I e II, realizados com poucas pacientes e apenas 2 deles são randomizados e cegados. Não se pôde atribuir nenhuma medida estatística aos resultados, visto a heterogeneidade das publicações. Os estudos analisados utilizaram partículas vacinais baseadas nas proteínas E6, E7 e E2 do HPV, concluindo que a proteína E7 é a mais promissora para uso nas vacinas terapêuticas. Esta revisão concluiu que o uso das vacinas baseadas na proteína E7 de HPV é potencialmente benéfico no tratamento das lesões de colo uterino, sendo um campo de estudo promissor, mas esta conclusão deve ser analisada com cautela devido à ausência de estudos realizados com maior número de pacientes e com critérios metodológicos mais rígidos. / Cancer of the cervix is the second most common tumor in the female population and the second cause of death from cancer among women. Persistent infection by HPV is a necessary condition for the onset of the disease and its precursor lesions. The use of prophylactic vaccination against HPV has been shown to be effective in preventing disease and mechanism of cancer development from the viral infection, new particle vaccine have been developed with the aim of therapeutic use, in other words, in the presence of injuries. This study aimed to perform a systematic review of the literature on the use of therapeutic vaccines against HPV and the new particles used for this purpose. Was made a query to the databases MEDLINE, PUBMED and LILACS, SciELO and the collections COCHRANE LIBRARY, using the key words "human papillomavirus", "" HPV "," vaccine "," vaccination "," therapeutic " and "immunotherapy" in different combinations, without a time limit. Of the 713 articles found initially, 352 were excluded because they were repeated in different databases, 217 to be review articles, 86 were conducted in animals, 24 published in other languages than English, Portuguese and Spanish, 15 other anatomical locations than the cervix, 2 in HIV-positive patients, 1 in men, 2 whose patients had only infection, but not injury lap and 1 conducted in vitro. One last item was deleted because the vaccine used after removal of the lesion of the cervix patients. Thus 12 articles were selected for this systematic review. These articles are phase I and II, realized with few patients and only two of them are randomized and blinded. We were unable to assign any statistical measure the results, since the heterogeneity of publications. The analyzed studies used particle vaccine based on proteins E6 and E7 of HPV E2, concluding that the E7 protein is the most promising for use in therapeutic vaccines. This review concluded that the use of vaccines based on HPV E7 protein is potentially beneficial in the treatment of lesions of the cervix, being a promising field of study, but this finding should be considered with caution due to the lack of studies with larger numbers of patients and strict methodological criteria.