Rates of cervical pre-cancer in women have been cut by more than half in British Columbia and the province’s school immunization program for the human papillomavirus is being given credit for the results.
A study published in the Journal of Infectious Diseases says those who took part in the program to prevent the sexually transmitted infection had a 57 per cent reduction in incidence of pre-cancer cells compared to unvaccinated women.
The program has been in place in public schools for 12 years and the first groups of women who were vaccinated in Grade 6 entered into the cervix screening program, allowing researchers to compare outcomes with those who hadn’t been vaccinated.
Dr. Gina Ogilvie, a senior research adviser at B.C. Women’s Hospital, says the study adds to the growing body of evidence highlighting the positive impact of the vaccine.
HPV is common in both men and women.
It can be easily spread through sexual contact and while most HPV infections clear up on their own, some pre-cancerous lesions can develop into cancer if not treated.
The Canadian Partnership Against Cancer says HPV immunization is offered to children in all provinces and territories, generally between grades 4 and 7.
B.C. Health Minister Adrian Dix says the lower rates of pre-cancer shows the importance of having children immunized early.
“The dramatic success — pre-cancer rates dropping by over half, shows us the importance of having children immunized early to protect their lives,” he said in a statement on Wednesday.
HPV has been identified as the cause of almost all cervical cancers.
The province implemented a voluntary publicly funded school-based HPV immunization program in 2008.
Education Minister Rob Fleming said the study reinforces the importance of such school-based programs.
“The decline we are seeing in HPV-related cancer rates highlights how strong partnerships between school districts and health authorities can significantly improve the well-being of B.C. students.”
B.C. Poverty Reduction Coalition organizer Trish Garner, pictured in 2012, calls the province’s $50 increase to monthly income and disability assistance rates ‘a drop in the ocean’ that still keeps rates ‘shockingly low.’ Arlen Redekop / PNG files
A boost to assistance rates are among the initiatives in Carole James’s latest budget intended to ease the financial burden faced by hundreds of thousands of B.C. residents who live in poverty.
But the financial measures, which come in advance of an anticipated poverty reduction plan slated for a March release, received muted reaction from some anti-poverty proponents.
In her budget speech, the finance minister said B.C. is thriving, with a balanced budget and a strong credit rating.
“But we will never have a truly prosperous province unless everyone in British Columbia can share in that prosperity,” James said. Often, all it takes to change a person’s life is an opportunity paired with a hand up, she said.
The most obvious hand up for those living in poverty that James’s government included in its latest financial plan is a $50 increase to monthly income and disability assistance rates. The government increased those same rates by $100 two years ago, bringing the total bump in the last three years to $150. Before that, a decade had passed without any increase at all.
Trish Garner, a community organizer with the B.C. Poverty Reduction Coalition, called the $50 increase “a drop in the ocean” that still keeps rates “shockingly low.” She said her organization was looking for an increase of at least $200 this year.
The latest increase places income assistance for a single employable person at $760 per month — less than 50 per cent of the poverty line, Garner said. Those on disability assistance will see their rates rise to $1,183. The increases come with a $44-million price tag over three years, according to the fiscal plan.
B.C. is the only province in Canada that does not have a poverty reduction plan, and it also has the highest rate of poverty for children in Canada, according to Shane Simpson, the minister of social development and poverty reduction.
No specific dollar figure for his anticipated poverty plan was included in the budget, but James said the budget did include some initiatives that would form part of the plan. She pointed in particular at a new “child opportunity benefit” that will put as much as $3,400 a year into the hands of parents who are raising children.
Garner said the child benefit gets B.C. caught up to other provinces by extending support for children up to their 18th year and will make “a huge difference.”
Meanwhile, James said more needs to be done to make income and disability assistance more accessible. Included in her budget is $26 million to remove barriers to financial support.
The budget includes $76 million to help put another 200 people in need into modular homes, and organizations that run rent banks will see funding for short-term, low-or-no interest loans to tenants who can’t pay their rent.
The government has said it wants to lift 140,000 people above the poverty line, including half of the 100,000 children who are impoverished, by 2024.
Prescribed pills to treat HIV. Jenelle Schneider Jenelle Schneider / PROVINCE
HIV-positive mothers with at least one child give birth to more babies than HIV-negative mothers, a new B.C. study spanning the years from 1997 to 2015 shows.
The analysis of live births published in a medical journal called PLOS One shows that among women who have already given birth, HIV-positive mothers have on average more children than a control group of HIV-negative mothers. The trend applies across all ages.
In the study span, there were a total of 669 live births among 270 HIV-positive women aged 15 to 49 and 1,577 births to 871 HIV-negative controls. The birth rate for HIV-positive women aged 15 to 24 was 1.88 live births per woman, while in the HIV-negative control group it was 1.52 per woman.
In the 25 to 34-year-old age group, the birthrate among women living with HIV was 2.62, compared to 1.76 in a HIV-negative control group. And in the 35 to 49-year-old category, the birthrate among HIV-positive mothers was 2.58, versus 2.11 in the HIV negative group.
The majority of HIV-positive women across Canada are in their reproductive years, and previous research has shown that motherhood is important to them.
There was an average of about 42,700 births annually to all women in the province during the study’s 1997 to 2015 time period. Babies born to HIV-positive women represented 0.05 per cent of all the births over the term of the study.
A study published in 2017 and based on a large group of Canadian women with HIV, showed that nearly a quarter of them between 2013 and 2016 got pregnant, but 60 per cent of such pregnancies were unintended. The new study did not look at whether pregnancies were planned.
There are about 1,200 women and 6,100 men living with HIV in B.C.
The Oak Tree Clinic at B.C. Women’s Hospital specializes in care for women and children with HIV, but the study’s authors say females with HIV need access to comprehensive reproductive health care, whether they live in urban areas like Vancouver or rural and remote areas.
Hélène Cote, a co-author, and researcher at the Women’s Health Research Institute at B.C. Women’s Hospital, said in an interview that the vast majority (over 80 per cent) of women living with HIV in Canada are receiving treatment, and most are attaining viral suppression success on such treatment. She said there has never been a baby born in B.C. to a woman aware of her HIV status and on such treatment during her pregnancy.
Cote said the fact that young women with HIV are having more babies would suggest they are conceiving at younger ages because of socio-cultural factors, in addition to feeling secure knowing that while on treatment, their risk of transmitting HIV to their baby is “almost zero.”
“Primary care physicians in communities across B.C. must not assume young woman are not having unprotected sex. And when they have HIV-positive patients, they must counsel them about sexual and reproductive health, including contraception, pregnancy plans, desires, and risks, among many other things. When a 17-year-old with HIV goes to a doctor and says, ‘I want to get pregnant,’ appropriate health care is required to ensure a safe pregnancy,” she said.
Women account for 18 per cent of all HIV cases in B.C., and since many have been on anti-retroviral treatment for a long time, researchers were keen to learn whether birth rates were going up over time for women in various age groups. Cote said for those aged 25 to 49, they found that as time went on, they did, suggesting women with HIV are “increasingly likely to feel confident about bearing children later in life.”
“The results of this study are an important step toward further understanding the reproductive health trends of women living with HIV, especially now that (they) can have pregnancies with little or no risk of … transmitting HIV to their child if engaged in care and appropriately treated,” says the study, funded by the Canadian Institutes of Health Research.
Previous research showed associations between HIV infection and lower childbirth rates in low- and middle-income countries, while the latest study is among the few done on women in high-income jurisdictions.