• Type-specific HPV antibody development from the seronegative status at baseline to seropositive status a month after the completion of HPV vaccination series (Week 28) for HPV types 6, 11, 16, and 18 [ Time Frame: At Week 32 ] [ Designated as safety issue: No ]
  

• Occurrence of Grade 3 or greater adverse events [ Time Frame: Throughout study ] [ Designated as safety issue: Yes ]
  
• HPV antibody titers to types 6, 11, 16, 18 [ Time Frame: At baseline and Weeks 4, 12, 28, and 52 ] [ Designated as safety issue: No ]
  
• Longitudinal changes in HIV viral load and CD4 count from baseline [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  
• Nadir and baseline CD4 count [ Time Frame: Throughout study ] [ Designated as safety issue: No ]
  
• Baseline HIV viral load [ Time Frame: At Weeks 4, 8, 12, 24, 28, 52, and 72 ] [ Designated as safety issue: No ]
  
• Cellular immune response assay data from the subset of U.S. participants [ Time Frame: At Weeks 4, 8, 12, 24, 28, 52, and 72 ] [ Designated as safety issue: No ]
  

HPV is a DNA virus that affects both men and women. Approximately 90 types of HPV have been identified, 30 of which are sexually transmitted. The most common forms of HPV are types 6, 11, 16, and 18. The quadrivalent HPV vaccine that will be tested in this study has been shown in previous studies to be effective in preventing infection with HPV 6, 11, 16, and 18 in healthy young women. According to a report by the Centers for Disease Control and Prevention (CDC), 80% of women will have acquired HPV by the age of 50. HIV infected women have been reported to have a higher prevalence and persistence of HPV infection, as well as an increased risk for abnormal Pap smears and cervical cancer. HPV types 16 and 18 cause the majority of cervical cancers worldwide, and types 6 and 11 are responsible for the majority of cases of genital warts. Vaccinations for preventable infections are particularly important among HIV infected people because people with HIV have compromised immune systems; therefore, any infection is very serious and can potentially be fatal. However, standard vaccination series have not been very successful because a compromised immune system may not produce the desired immune response to a vaccine. The HPV vaccine is designed to protect against infection with HPV types 6, 11, 16, and 18 and has been approved by the FDA for use in women between the ages of 9 and 26. The purpose of this study is to determine whether the quadrivalent HPV vaccine is safe, tolerable, and effective in producing antibodies to HPV in HIV infected females.

This study will last 72 weeks. Participants will receive their first dose of the HPV vaccine by intramuscular injection. The HPV vaccine will be administered again at Weeks 8 and 24. Following each injection, participants will remain at the clinic for 30 minutes of observation for adverse events. A phone call from or a home visit by study staff will occur within 2 days following each injection.

Participants will return to the clinic for visits at Weeks 4, 8, 12, 24, 28, 52, and 72. Most study visits will include a physical exam, medication review, blood and urine collection, and answering questions about signs and symptoms since study screening. Some visits will include measurement of HIV viral load in the cervix, a cervical brush, an anal swab, and an oral exam. Some participants will be asked to provide additional blood samples.