Improved HPV Vaccination Coverage May Help Prevent Noncervical Cancers in People with HIV

Increasing human papillomavirus (HPV) vaccination rates could significantly reduce the burden of noncervical cancers in people living with HIV (PLWHIV), according to new research presented at the 2025 Conference on Retroviruses and Opportunistic Infections (CROI).¹

“We did a global modeling analysis and found that thousands of people living with HIV could be protected from cancers related to HPV if we achieve the WHO target of vaccinating 90% of the population,” presenting author Namwa Wongkalasin, BSc, a medical student at University of Birmingham, said during a press conference. “However, with recent cuts to global funding ... these targets can now be really difficult to achieve.”²

HIV infection is known to increase the risk of HPV-related malignancies, with extensive documentation on cervical cancer. However, less is understood about noncervical HPV-associated cancers, including anal, oropharyngeal, vaginal, vulvar, and penile cancers. Current global HPV vaccination coverage remains low, with only 21% of girls and 7% of boys receiving the vaccine, particularly in regions with high HIV prevalence.¹

Using data from GLOBOCAN 2022 and UNAIDS 2022, Wongkalasin and colleagues assessed the burden of noncervical HPV-related cancers in PLWHIV across 185 countries. They estimated the proportion of cases attributable to HIV and modeled the potential impact of increased vaccine coverage.¹

The findings demonstrated substantial geographical variation in the burden of these cancers. In Africa, an estimated 29% of noncervical HPV-related cancers were attributable to HIV, compared with 5% globally. Anal cancer showed a particularly high variation, with 12.4% of cases worldwide attributable to HIV, ranging from 1.5% in Southeast Asia to 41.8% in Africa.¹

Among the 10 countries with the highest number of HIV-attributable cancers, only two had HPV vaccine coverage rates exceeding 50%. The modeling analysis projected that achieving the World Health Organization (WHO) target of 90% gender-neutral vaccine coverage could prevent 6854 cancer cases in PLWHIV—more than twice the current number prevented by existing vaccination rates.¹

The study underscores the need for targeted HPV prevention strategies in PLWHIV, particularly in regions such as Southern Africa, where a high burden of HIV-attributable cancers exists. Researchers highlighted the importance of further studies on vaccine efficacy in PLWHIV to refine future prevention strategies. Integrated efforts to improve HPV vaccination in high HIV-prevalence areas may help reduce global disparities in HPV-related cancer burden.¹

“This analysis adds to the consensus that people living with HIV warrant special consideration in HPV prevention,” investigators wrote. “More research is needed on vaccine efficacy in people living with HIV to inform future analyses.”¹

References:

1. Wongkalasin N, Pilkington V, Levi J, et al. Global Modelling Analysis: Impact of Improved HPV Vaccination on Noncervical Cancers in PLWHIV (abstract 165). Presented at: Conference on Retroviruses and Opportunistic Infections; March 9-12, 2025; San Francisco.

2. IAS–USA. Press conference at: Conference on Retroviruses and Opportunistic Infections (CROI). Published online March 11, 2025. Accessed March 19, 2025. https://www.youtube.com/watch?v=psvMPu4u9BU&ab_channel=IAS-USA