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SLU Researcher Receives $2.83 Million NIH Grant to Increase HPV Prevention Strategies in Nigeria

by Maggie Rotermund
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Maggie Rotermund
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ST. LOUIS – When designing strategies to create lasting impact in a particular community, there is no better resource than the strength and intelligence of the community members themselves, and in this case, girls and women. Using crowdsourcing as a framework, a Saint Louis University researcher aims to increase HPV vaccination and HPV screening to lower incidents of cervical cancer among girls and women in Nigeria.

Juliet Iwelunmor, Ph.D.
Juliet Iwelunmor, Ph.D. is a professor of global health and behavioral science and health education at Saint Louis University’s College for Public Health and Social Justice. Photo by Sarah Conroy.

Juliet Iwelunmor, Ph.D., professor of global health and behavioral science and health education at Saint Louis University’s College for Public Health and Social Justice, was awarded a five-year $2.83 million grant from the National Cancer Institute to enhance the understanding of HPV prevention in resource-constrained settings, building upon the strength of the girls and women within these settings.

“Actions for Collaborative Community Engaged Strategies for HPV,” or ACCESS-HPV, will engage girls and women to come up with innovative, sustainable, and feasible ideas to increase the uptake of essential human papillomavirus (HPV) prevention services in Nigeria. The grant, locally known as 4 Girls and Women in Nigeria, will expand HPV vaccination amongst young girls and women between the ages of 9 and 26 years old and improve cervical cancer screenings for women aged 30-49 years old. 

“Cervical cancer is a significant cause of morbidity and mortality in many sub-Saharan countries. The Nigerian government recommends HPV vaccination and the self-collection of cervical cancer screenings, but uptake is poor,” Iwelunmor said. “Every day, 28 women die of cervical cancer in Nigeria. My sister-in-law was one of them.”

Currently, in Nigeria, only 10% of eligible women have been screened and 14% of girls are vaccinated for HPV. Iwelunmor and her multifaceted team will use participatory crowdsourcing methods, that have been previously implemented in her I-TEST grant in Nigeria, to drive HPV prevention among girls and women in attempt to increase these numbers. 

Open crowdsourcing calls will allow Iwelunmor’s research team to identify locally relevant messages and dissemination techniques to increase the uptake of HPV prevention. Once the innovative ideas and strategies are identified through participatory activities including a three-day design-a-thon, similar to hack-a-thon, and a four-week innovation bootcamps, participatory learning communities will build capacity for community-led implementation of the strategies. 

“Specifically, mother-daughter relationships in Nigeria can be leveraged to increase HPV vaccination uptake among young girls and HPV self-collection among mothers,” she said. “Mothers or female caregivers profoundly influence decisions and preferences about young girls’ vaccine uptake in the Nigerian cultural context. At the same time, maternal choices about HPV self-collection can be reinforced in discussions with their daughters.” 

“The primary outcome will be vaccine uptake among young girls and HPV self-collection among their mothers,” Iwelunmor said. “The strong support of the Nigerian Institute for Medical Research (NIMR) alongside national HPV programs creates a rich research infrastructure and increases the likelihood of successful implementation.”

Through this study, Iwelunmor and her team will determine the effectiveness of a final combined campaign on the uptake of HPV vaccination among young girls and women and HPV self-collection among their mothers and caregivers.

“For girls and women is a shared feeling of hope that when girls and women come together to inform and to inspire each other, change, by way of ending cervical cancer, will occur. We are a mirror of our society, and together, we can eliminate cervical cancer.”

The co-principal investigators are Oliver Chukwujekwu Ezechi, M.D., Ph.D., director of research at the Nigerian Institute of Medical Research Lagos and Professor of maternal, reproductive and child health at the Lead City University Ibadan, Nigeria, and Joseph D. Tucker, M.D., Ph.D., professor of medicine at the University of North Carolina, Chapel Hill.

This work was supported by grant number R01CA271033-01 from the National Cancer Institute.

College for Public Health and Social Justice

The Saint Louis University College for Public Health and Social Justice is the only academic unit of its kind, studying social, environmental and physical influences that together determine the health and well-being of people and communities. It also is the only accredited school or college of public health among nearly 250 Catholic institutions of higher education in the United States. Guided by a mission of social justice and focus on finding innovative and collaborative solutions for complex health problems, the college offers nationally recognized programs in public health and health administration.