Exploring the Connection between HPV and HIV - Essay Example

Jessica Ukandu ENGL 395 Case study assignment This paper looks at the life cycle of a biomedical idea, in this case, human papillomavirus (HPV) vaccines for of human immunodeficiency virus (HIV) infected individuals, and traces how the topic has been communicated to various audiences. It begins with a short description of the topic and continues with a compare-contrast essay utilizing rhetorical analysis tools to determine how the biomedical idea was framed in the four article explored. Exploring the connection between HPV and HIV Inspite of the stigma HIV national health institutions have been working to improve the well being of individuals who have contracted this communicable disease. Various researches have enabled individuals with HIV to live normal lives, as well as increased the lifespan of individuals suffering from this condition. But HPV changes all of this. Considered as the most common sexually transmitted infection, with 9-13% or 6 million people worldwide infected annually (Pandhi and Sonthalia), HPV is also the number one cause of death among young to middle aged women living in developing countries with high HIV prevalence (McNeil Jr.). The connection between the HPV and HIV has been firmly established following the publication of a number of researches (Mbulawa et al.; Heard et al.; Wang et al.). In response to the growing concern about HPV and HIV and the 2008 research (Engels et al.) showing that the highly active antiretroviral therapy (HAART), the HPV vaccine used since 1996 did not work for immunocompromised individuals. But three years after the release of the 2011 factsheet from the National Cancer Institute (that popularized the ineffectiveness of HAART for individuals with HIV), the New York Times is proud to announce that new vaccines against cervical cancer are now available, and these are proven effective even for sexually active women with HIV (McNeil Jr.).  Exploring the Various Methods of Propagating Scientific Ideas Written for a wider audience, the New York Times article uses a language that is readily understood by its readers. It summarizes the important points of the study (Kojic et al.), and uses numbers and percentages effectively. In just three hundred (300) words, the author was able to explain why this research was important by utilizing rhetorical tools that appeal to logic (logos), emotion (pathos), or authority (ethos). The major hook can be found in the second paragraph, where author began to appeal to both logic and emotion – after all, death is no laughing matter. Whenever death was concerned, people listened. And when this author says, many young women in areas with high HIV prevalence die of HPV, and this cancer vaccine is effective to HIV infected women, the immediate response is: “then the government should give them these vaccines!” To drive this point home, the author cites the effectiveness results of the study: “H.I.V. fairly recently developed antibodies in more than 90 percent of cases. Even women whose infection had progressed into AIDS developed antibodies more than 75 percent of the time” (McNeil Jr.). It was a logical – when one knows the solution to a problem, then one has to utilize that solution. To prevent anyone from availing of this “highly effective” vaccine, whatever the reason is (finances, access, etc.) is not only illogical; it was also inhuman since lives were at stake. To complete the emotional effect of this article, the author says, “Skeptics…argued that vaccinating those women [with HIV] would be a waste of money… We saw it differently…[they] bear the biggest burden, so if it worked, they would benefit the most from it” (McNeil Jr.). This quote from Dr. Erna Milunka Kojic, lead author of research, gave both a humanizing effect and credence to the article. To support the credibility of this report, the mentioned the number of subjects in the trial (319 – that is a lot, especially since researches typically involve only 30 subjects), the publisher of the report, and the name of the vaccine used in the trial and the name and affiliation of lead author for the research. One will note that the New York Times article was effective in communicating not only the results of the study by Dr. Kojic, it was also able to argue a strong case for HPV vaccination subsidies and HIV research funding. Yet, one has to remember that such article cannot be used as support to lobby for these advocacies. For one, the article was written for a general audience – its main goal was to educate and convince the general public, not to be accurate of its claims. If the New York Times article was submitted to a journal, its validity will immediately be questioned since there was no attempt to qualify what “effectiveness” meant, and there was no explanation whether the result of this study could be generalized to global population or if it true only for Brazilian women. Moreover, the statement, “The discovery is important because cervical cancer has emerged as a major killer of young and middle-aged women in poor countries with widespread AIDS” (McNeil Jr.) gave the effect that cervical cancer causes death, when in fact, it only exacerbates the situation. A journal article about a clinical trial would be lengthy and would utilize specialized language – one that would make no sense to individuals who have no medical background, but would communicate so much information to those who are familiar to the terms. For example, the title “Safety and Immunogenicity of the Quadrivalent Human Papillomavirus Vaccine in HIV-1–Infected Women”1(Wilkin et al.) is already a mouthful for the average reader, but for a medical researcher, it talks the intervention for the clinical trial, target subjects and expected results! But just like a news article, a journal article also utilizes rhetorical tools to appeal to the logos, ethos and pathos. Unlike a news article, however, a journal article needs to appear objective, devoid of emotion and must be unbiased. The appeal to ethos in a journal article would be typically found in section for stating the significance of study”, but it would commonly be phrased in a formal way. For example, “This vaccine prevented 93% of persistent anal infections with vaccine types in young HIV-1–uninfected men who have sex with men… This study was designed to test the hypothesis that the quadrivalent HPV vaccine is safe and immunogenic in HIV-1–infected men” (Wilkin et al.) is essentially saying “the HPV vaccine has prevented infection among men-at-risk for HIV, we want to know if it will do the same for infected men”. What remains unsaid is that these researchers do care for their subjects and that they truly want to help. Hence in a journal article, there is a lot of emphasis on the pathos and logos through the short review of literature relating to the topic, a simple explanation of the methodology utilized by the study (from the selection and categorization of subjects, to the procedure for analysis and counterchecking of results) and the presentation of results complete with charts, graphs and statistics. Whereas the New York Times article would say “The new study, done on 319 women in Brazil, South Africa and the United States” (McNeil Jr.), a journal article would say, “One hundred twelve participants were enrolled from 9 January 2008 through 24 November 2008. The flow of study participants who gave informed consent for study participation is shown in Figure 1” (Wilkin et al. 1249). Or “Women who were infected with H.I.V. fairly recently developed antibodies in more than 90 percent of cases” (McNeil Jr.) would be “In a post hoc analysis, we analyzed [that] higher baseline concentrations were significantly associated with higher concentrations at week 28” (Wilkin et al. 1250). The wordiness in a journal article is really an effort towards specificity. The author of a journal article has to make it absolutely clear to the reader that he/she has taken pains to ensure the accuracy of his/her claims, and that if the reader wishes to replicate the study and follow the same methodology he/she used, then the reader should come up with the same result. While news authors have to utilize proper positioning of words and phrases to make their stories interesting and readable, journal article writers have to be accurate and professional – where news writers have to appear credible, journal articles have to be reliable. Despite the credibility of journal articles, they are rarely used in public discussions with participants coming from different backgrounds. For example, in the Senate, lawmakers would rarely cite a formal study, but would often cite a book from a well-known author or publisher. In the case of HPV vaccines for HIV-infected individuals, a material from World Bank would be more popular among individuals who are interested to learn about the topic but would not want to study the specialized language of medical professionals. Such resources typically have straightforward, yet descriptive titles (in this case, The Global HIV Epidemics Among Men who Have Sex with Men); the language it uses is formal; the use of jargon is limited. These resources serves as a bridge between the academics and the laypeople, as illustrated in this paragraph: “More recent evidence has linked HPV infection with increased risk of HIV acquision... Specifically a study assessing the prevalent HPV infection and HIV infection demonstrated an HR of 1.8...” (Beyrer et al.). Perhaps one important feature of these resources are that they report results of various studies and provide a meta-analysis of results. This way, it is able to provide answers to concerns from various fields that are connected in some way to the topic. Perhaps the least known method of promoting scientific ideas are the call to action from funding agencies and the corresponding winning grant proposal. For the purpose of this paper, the database of the National Institutes of Health was searched to find the grant award for the original article cited by New York Times (National Institutes of Health). Here was a funding proposal that sounded so much like the journal article – it summarized the importance of undertaking the study, as well as the proposed methodology for research, in a language that only medical practitioners and researchers could understand. Its main difference from the journal article is that the funding proposal explained specific elements of the research such as the choice of methodology, intervention and analytic procedure. The very language used as well as the different sections in the proposal was chosen in order to answer one question: why is this study worth funding? Unlike the journal article, the funding proposal had to demonstrate the operationability of the research in a limited space since most call to proposals are submitted on a pre-designed form. In the lower part of the grant award, one will see the spending category, “Clinical Research; Clinical Trials; Emerging Infectious Diseases; HIV/AIDS; Immunization; Infectious Diseases; Prevention; Sexually Transmitted Diseases/Herpes; Vaccine Related” (National Institutes of Health) which signifies the NIH budget allocation for research. One will notice that much of the discussions made in the funding proposal address these categories. In short, the project leader for the study did previous research about the available funding opportunities, and then framed their project proposal in terms that will fit the requirements of NIH. This way, assigned individuals who screen proposals will feel that this study is relevant (thanks to the short literature review), and is in line with the kind of researches the institution supports. A Conclusion Writing a biomedical idea is both easy and complicated. It is easy because there are only two rules to remember: Who is your audience? What message do you want to them to take home? When one knows the answer to these questions, other considerations such as the choice of words and rhetorical tools, among others will follow. Works Cited Beyrer, Chris et al. “Combination HIV Prevention Interventions for MSM: An Umbrella Review of the Evidence and Recommendations.” The Global HIV Epidemics Among Men Who Have Sex with Men. Washington: The World Bank, 2011. Findings. Print. Engels, Eric A et al. “Cancer Risk in People Infected with Human Immunodeficiency Virus in the United States.” International journal of cancer. Journal international du cancer 123.1 (2008): 187–94. Web. 29 Apr. 2014. Heard, I et al. “Characteristics of HPV Infection over Time in European Women Who Are HIV-1 Positive.” BJOG : an international journal of obstetrics and gynaecology 120.1 (2013): 41–9. Web. 29 Apr. 2014. Kojic, Erna Milunka et al. “Immunogenicity and Safety of a Quadrivalent Human Papillomavirus Vaccine in HIV-1-Infected Women.” Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2014): n. pag. Web. 29 Apr. 2014. Mbulawa, ZZ et al. “Genital Human Papillomavirus Prevalence and Human Papillomavirus Concordance in Heterosexual Couples Are Positively Associated with Human Immunodeficiency Virus Coinfection.” Journal of Infectious Diseases 199.10 (2009): 1514–24. Print. McNeil Jr., Donald G. “Cancer Vaccine Proves Effective in H.I.V. Patients.” New York Times 21 Apr. 2014. National Cancer Institute. HIV Infection and Cancer Risk. N. p., 2011. National Institutes of Health. A 5240 (Version 10) Immunogenicity and Safety of a Quadrivalent Human Papillomavirus Vaccine in HIV-1-Infected Women. N. p., 2011. Pandhi, Deepika, and Sidharth Sonthalia. “Human Papilloma Virus Vaccines: Current Scenario.” Indian journal of sexually transmitted diseases 32.2 (2011): 75–85. Web. 29 Apr. 2014. Wang, Chunhui et al. “Rapid Rise in Detection of Human Papillomavirus (HPV) Infection Soon after Incident HIV Infection among South African Women.” The Journal of infectious diseases 203.4 (2011): 479–86. Web. 29 Apr. 2014. Wilkin, Timothy et al. “Safety and Immunogenicity of the Quadrivalent Human Papillomavirus Vaccine in HIV-1-Infected Men.” The Journal of infectious diseases 202.8 (2010): 1246–53. Web. 29 Apr. 2014. Read More