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Have you had sex? Do you intend to have sex in the future? Did you answer “yes” to either of these questions? If so, read on.

As we all know from our highly inefficient public school sex ed class, engaging in sexual intercourse bears a risk of contracting cooties sexually transmitted infections (STI). Unlike your sex ed teacher, I’m not going to show you numerous images of disease-ridden genitals[1] Today I want to talk about the importance of vaccination, condom use, and regular check-ups to the prevention of HPV.

HPV, human papillomavirus, is a sexually transmitted infection that has over 40 strains and is responsible for genital warts and certain kinds of cancer. It is extremely common. More than 50% of sexually active adults will have HPV at some point in their life. According to CDC, 79 million Americans are currently infected with HPV[2]. Fun fact: HPV is so common (how common is it?) that OB/GYNs do not recommend telling your partner(s) you have it. For a further discussion of HPV disclosure protocol, read this Jezebel article.

HPV prevalence among females aged 14-59

low-risk HPV causes genital warts, high-risk HPV can cause cancer

So What’s the Big Deal?

HPV is a huge public health issue. It is the leading cause of cervical cancer, with 70 percent of cases being linked to two high-risk strains. Eighty-five percent of cases of anal cancer are caused by HPV-16. HPV can infect the vulva, vagina, cervix, anus, rectum, penis or scrotum. It can also lead to cancers of those areas.[3].

What makes matters worse, not only is HPV very common, but the high-risk strains (the ones that cause cancer) often have no symptoms. There is NO CURE for HPV. Currently, there is no approved treatment for HPV. Anyone who has had sex can contract HPV. If you had sex once, or with only one partner and even if you practiced safer sex, if your partner was not a virgin, you can still get HPV. This is because, like herpes, what matters is a contact with the infected area, and transmission can happen through skin-to-skin contact.  Oh, and did I mention there is no HPV test for men?

So far, HPV sounds pretty serious: a lot of people have it, condoms are not 100 percent effective in preventing transmission, the “C” word is very scary, and your male partners do not know their status. However, the matters are not as hopeless as I made it seem so far, there is a very simple solution to this public health crisis – vaccination. Paired with consistent condom use and regular check ups for women, vaccination can help eradicate high-risk HPV strains.

The Good News

Women

Getting regular Pap smears is essential for HPV detection and cervical cancer prevention. HPV can cause cervical cells to undergo pre-cancerous changes. If these are detected early, the small patch of cells is easily removed, preventing larger problems and expensive treatment down the road. There are two approved HPV vaccines on the market: Gardasil and Cervarix. According to National Cancer Institute[4]:

Both vaccines are highly effective in preventing infections with HPV types 16 and 18, two high-risk HPVs that cause about 70 percent of cervical and anal cancers. Gardasil also prevents infection with HPV types 6 and 11, which cause 90 percent of genital warts

Vaccination is most effective when done before the first sexual encounter. The vaccine is covered by most insurance plans up to age 26. So, if you’re near that age cutoff and still haven’t been vaccinated, make the appointment with your doctor as soon as possible. Likewise, if you’re at risk of losing your health insurance, do not delay.

Men

There is no approved HPV test for men. That doesn’t mean, however, that HPV is undetectable. In women, HPV infects a relatively small area – the cervix, while any cell on the entire area of the penis can be affected, so there is no practical way to test men. One study of 1160 men from Brazil, Mexico, and the United States, found HPV prevalence to be 65 percent[5]. Sixty five percent of study participants carried some strain of HPV! So, if you’re a sexually active male living in one of these countries, there is a 65% chance you have HPV and there is no way for you to know for sure (aside from participating in a study).

So what can a man do to protect his partner(s)? Fortunately, Gardasil is approved for males ages 9-26. If you fall into that age bracket and you have not been vaccinated, please do so. Even if you are older than 26, consider getting the vaccine anyway, as older individuals have a higher risk of developing cancer and lower chance that the HPV will clear up on its own.

The Role of Condom Use

Condom use is essential to transmission prevention. According to a study in the New England Journal of Medicine, consistent condom use reduces the risk of infection by 70 percent[6].

Women whose partners used condoms for all instances of vaginal intercourse during the previous eight months were 70 percent less likely to acquire a new infection than were women whose partners used condoms less than 5 percent of the time, after adjustment for the number of new partners and the estimated number of previous partners of the male partner.

Women whose partners used condoms for all instances of vaginal intercourse during the previous eight months were 70 percent less likely to acquire a new infection than were women whose partners used condoms less than 5 percent of the time, after adjustment for the number of new partners and the estimated number of previous partners of the male partner.

Since men do not know their HPV status, and HPV has no symptoms, please consider using condoms even if you’re in a long-term monogamous relationship.  (This is especially true if you and/or your partner are not vaccinated against HPV.) Don’t be too quick to discount this advice as unnecessary or unrealistic, because not all monogamous relationships are as monogamous as you’d like to think (Surprise!!! Honey, I got you a gift that keeps on giving!).

*Note: condoms are not the only thing you can use to lower your risk of infection. Refer to articles by other editors here, here, here, and here.

What if I Already Have HPV?

If you had been diagnosed with HPV, fear not, it is not really that bad. Try to lead a healthier life style and avoid immune-suppressants. This might be a good time to stop smoking[3] and curb your alcohol use. There is a good chance your immune system will be able to deal with it. Get a Pap test once every 6 months to catch any cellular abnormalities early. Talk to your doctor about the things you can do to lower your cancer risk.

If you’re not vaccinated, get vaccinated. Remember, there are over 40 strains and you can get infected with more than one. The vaccine protects you from the most dangerous strains. It is still worth getting, even if you’re already infected.

Continue using condoms both for your and your partner’s protection. I cannot stress this enough.

Recap

  • HPV is very common
  • Both men and women can get vaccinated
  • Condom use significantly reduces the risk of transmission
  • Regular Pap and cerivcal exams help prevent cancer
Drawn by Katie Diamond http://www.katiediamond.com/

Click on the image to enlarge. Reminder that you don’t have to be straight or have penetrative sex to contract HPV. For a hot example of safer sex and glove use read this. Drawn by Katie Diamond.

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[1]For the love of everything you hold dear, do not, I repeat DO NOT google image HPV
[2] CDC HPV Fact Sheet http://www.cdc.gov/std/hpv/stdfact-hpv.htm
[3] NCI http://www.cancer.gov/cancertopics/factsheet/Risk/HPV
[4] NCI HPV Vaccine http://www.cancer.gov/cancertopics/factsheet/Prevention/HPV-vaccine
[5] Human papillomavirus infection in men residing in Brazil, Mexico, and the USA. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495064/
[6] Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women http://www.nejm.org/doi/full/10.1056/NEJMoa053284#t=articleResults

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