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September 5th, 2010 | | Make me happy! More than 100 HPV types have been identified with more than 30 being sexually transmitted (7). Anogenital HPV types have been classified into low-risk types (non-oncogenic), which are associated with anogenital warts (condyloma acuminata), oral and conjunctival papillomas, recurrent respiratory papillomatosis (in infants and young children), and mild dysplasia (8). High-risk types (oncogenic) are associated with high-grade dysplasia and various cancers. Current estimates of the attributable fraction, the proportion of cancer cases preventable by the elimination of HPV, are very high (9): 100% for cervical, 90% for anal, 40% for vulvar and vaginal, 50% for cancer of the penis, and between 33 and 72% of oropharyngeal cancers (10). Although there has been increasing interest in understanding the burden of HPV infection and related comorbidities in men (11), studies in this group are still quite limited (12), particularly among Hispanics. Research and surveillance data have indicated that Hispanics have been disproportionately affected by HIV/ AIDS (13), Other STIs (14) and may engage disproportionately in high-risk sexual behaviors (15). In addition, a higher incidence of cervical cancer is observed in Puerto Rico and Hispanic women in the US compared with non-Hispanic whites (Figure 1). These factors could reflect a potential higher prevalence of HPV infection in these populations, as well as disparities in screening rates in these groups (16) suggesting that Hispanic and Puerto Rican men might also be at higher risk for HPV infection and related health outcomes. This high incidence might also lead to a significant economic burden. In Puerto Rico for example, it was estimated that the economic impact of HPV related cancers in 2004 was approximately 7.5% (close to 5 million dollars) of the total cancer costs (17). Even though HPV infection is highly prevalent in sexually active men, (18), most research studies have focused only in women. Studies in men are of particular relevance because, as with other STIs, men play a key role in the transmission dynamics to both male and female sexual partners. It is also clear that HPV infection in men is a serious clinical issue, given the association of HPV infection with a variety of cancers in men, including anal cancer and a subset of penile and oral cancers (19). With the world-wide introduction of two new prophylactic vaccines (bivalent vaccine protecting against HPV 16 and 18, and the quadrivalent vaccine protecting against HPV 16, 18, 6 and 11) against oncogenic HPVs causing cervical cancer in women (20), and the recent FDA approval of the quadrivalent vaccine to prevent genital warts also in men, there is an urgency to determine the burden of HPV in Hispanic populations before vaccination programs are implemented on a widespread basis. Knowledge of the burden of the disease and its related morbidities prior to implementation of these programs will allow a better assessment and understanding of the short-term and long-term effectiveness of this primary prevention strategy for cervical neoplasia and genital warts. In addition, it will permit exploring the prevalence of type-specific HPVs in these populations, not currently included in the HPV vaccines available in the market.
Women in Kenya remain disadvantaged, with opportunities for educational, social, and economic advancement inferior to those of men. Women are underrepresented in modern sector wage employment, political and judicial decision making, and all major public service appointments. Numerous social, economic, and cultural barriers limit womens participation in these areas. But womens underrepresentation in education is a primary factor. The benefits of womens education to women and to society in general are immense. In the workplace, education increases skills needed for job entry, improves chances of vertical mobility, and enhances overall labor market productivity. It also has positive consequences at home, including improved health, increased child survival rates, reduced fertility rates, lower infant mortality rates, and better protection against HIV and AIDS (Tembon and Fort 2008). Education of women and girls is therefore not only a moral and human rights issue, but also an economic and development issue. Given the significant benefits of womens education, equity in education is essential to improving circumstances for all Kenyans. As the leading provider of education, the government should acknowledge that compensatory mechanisms may be required to level the playing field for disadvantaged girls, and it should adopt an approach that uses these mechanisms. Making education equitable means adopting policies and initiatives that support equal provisions across genders. Female Education in Kenya Education in Kenya has four basic levels: preschool (ages 4-6), primary (ages 7-14), secondary (ages 15-18), and tertiary. Since attaining political independence from Great Britain in 1963, the Kenyan government has emphasized educations importance to economic development. It has also increased the number of schools at all levels, from about six thousand primary and 150 secondary schools in 1963 to almost twenty thousand primary and four thousand secondary schools in 2004. As a result, the student population has increased substantially, with over 700 percent growth at the primary level and almost 3,000 percent growth at the secondary level (Ministry of Education 2007). But this total expansion in education hides disparities by gender and region.