all women surveyed, but black women were one-and-a-half times more likely to test positive for strains of HPV that can lead to cancer. The study indicates the infection typically lasts about 12 months in white women and 18 months in Afri- can-American women. To read the Carolina Women’s Care
Study, visit
www.ncbi.nlm.nih.gov/pmc/ articles/PMC3704405. A study reported in the October 2011
issue of AJPM showed white women also were more likely to complete the three-dose series than their Hispanic and African-American counterparts. Vincent Fonseca, MD, a San Antonio
preventive medicine specialist and mem- ber of the TMA Council on Science and Public Health, says he sees an ethnic disparity in HPV vaccination firsthand, especially in women aged 19 to 26. Dr. Fonseca says no one knows exactly why the ethnic disparity exists. “But it does seem to be related to so- ciodemographic factors that help to ex- plain other health disparities,” he said. At-home testing kits, which could tar- get uninsured patients or women who don’t receive regular Pap tests, are avail- able in the United Kingdom but not in the United States. A study from the Unit of Cancer Epi-
demiology at the Scientific Institute of Public Health in Brussels shows at-home tests were only about 11-percent less sensitive in identifying precancerous growth than a test administered by a health care professional. But Dr. Fonseca says at-home tests are not the answer to reduce HPV-related health disparities. “This would just add additional bur- den to the patient and an additional cost to society,” he said. “Let’s first try to put as much effort in adolescent and young adult immunization as we do for infants.” Dr. Fonseca says it’s every physician’s
C M Y CM MY CY CMY K
duty to recommend the vaccine to pa- tients to help reduce health disparities and prevent HPV-related cancers. “The risk for teenagers and young adults is extremely high. That is why there is a universal recommendation for both boys and girls, women and men,” he said.
April 2014 TEXAS MEDICINE 39
Texas awards $45M for women’s health
Most Texas women will receive health services thanks to new state funding from the Texas Department of State Health Services (DSHS). In February, the department awarded $45.4 million to 55 agencies across the state to expand access to health services for women, including immunizations, birth control, and breast exams. With $100 million in additional funds from the legislature for the next two years, DSHS launched the Expanded Primary Health Care (EPHC) program to increase access to essential comprehensive care for women in 2014 and 2015. Lawmakers created the EPHC pro- gram and appropriated state money
AVI_TxMedicine_030514_PRINT01.pdf 1
after the state opted to forgo federal funding for the now-defunct Women’s Health Program so that it could exclude Planned Parenthood and affiliates of abortion providers. “We’re providing women greater ac- cess to a broader range of health ser- vices in Texas,” said David Lakey, MD, DSHS commissioner. “These dollars will help women receive the family planning and screening services they need to be healthy.”
DSHS estimates more than 60 percent of the women served will receive fam- ily planning services. The funding will go to local health departments, hospital districts, and health clinics. Awards range from $53,800 for South
Texas Rural Health Services in La Salle County to $4.2 million for The Universi- ty of Texas Medical Branch at Galveston. Parkland Memorial Hospital in Dallas re- ceived $3.8 million; Centro Med in Bexar County, Harris County Hospital District,
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