STD Awareness: Human Papillomavirus Grabs Headlines

Human papillomavirus, or HPV, is the most common STD out there — a fact made even more aggravating by the absence of a good test for it. Sure, Pap testing can detect cellular abnormalities triggered by HPV, and the HPV DNA test can find evidence of infection. But it’s not a definitive test — a negative Pap/HPV DNA co-test doesn’t rule out the possibility that you carry the virus. Ditto for the anal Pap test — which most people haven’t even heard of anyway!


There are more compelling reasons to vaccinate boys against HPV — and not-as-compelling reasons to think Gardasil could protect against skin cancer.


The lack of a good diagnostic test makes the HPV vaccine an even more valuable asset. If we can drive the virus to extinction through aggressive vaccination campaigns, our limited diagnostic abilities become a moot point. And recent headlines have given us reasons to love the HPV vaccine even more.

HPV and Men

Many people think of HPV as a women’s issue, as the virus causes cervical cancer, and for a long time, boys and men weren’t even targeted for vaccination. But HPV is everyone’s issue — genital warts don’t care what gender you are, and cancer-causing strains of HPV cause most cases of anal cancer, penile cancer, and oropharyngeal cancer. Recently, a large, first-of-its kind study published in JAMA Oncology analyzed penile swabs provided by 1,757 men to figure out how common HPV is in this population. (While there is no FDA-approved test for diagnosing male patients with HPV, scientists can still collect swabs for research purposes.)

The results: 45.2 percent of American men ages 18 to 59 carry genital HPV — for a total of nearly 35 million adult males. HPV carriers can transmit the virus to sexual partners through vaginal, anal, or oral sex — or even just rubbing genitals together, as the virus is spread by skin-to-skin contact. Furthermore, a quarter of men are infected with cancer-causing strains of HPV. And, while the female population sees a peak in HPV infections in their early 20s, men’s HPV prevalence increases with age. While 28.9 percent of men 18 to 22 years of age carried HPV, 50.8 percent of them carried it by the time they were 28 to 32 years of age, and 59.7 percent of 58- and 59-year-olds were carriers. Continue reading

STD Awareness: Gardasil and Males

menIt’s Men’s Health Month, and yesterday was the last day of Men’s Health Week, which means we’re going to look at a men’s health issue that is usually ignored: the impact of human papillomavirus (HPV) on the male population.

You’ve probably heard of HPV in discussions about cervical cancer and Pap testing. But HPV doesn’t care about gender, and is perfectly content to invade cells in anyone’s genital tract, mouth, throat, or anus. In males, HPV can cause genital warts as well as anal, oropharyngeal (mouth and throat), and penile cancers.


HPV will cause more oral cancer than cervical cancer by 2020.


The good news is that most HPV infections can be prevented by a vaccine called Gardasil, and you don’t need to be female to get it. However, few males are actually getting the HPV vaccine: In 2012, 20.8 percent of U.S. males 13 to 17 years of age had received at least one dose of the HPV vaccine, but only 6.8 percent completed the three-dose series.

Gardasil Is for Everybody: Good News from Australia

This huge disparity in promoting Gardasil to female patients rather than male patients has real-world consequences. In Australia, girls have been vaccinated with Gardasil since 2007, covered by their national health system. Four years into the program, genital wart rates fell by 93 percent in females less than 21 years of age. Even though males weren’t being routinely immunized, genital wart rates fell by 82 percent among heterosexual males in the same age group. That’s because their female partners had received the vaccine, which had the effect of protecting much of the male population. That might sound pretty nifty, but the female-only vaccination policy left out gay and bisexual males, whose genital wart rates saw no corresponding decline. Continue reading

Is Pap Testing Better Than HPV Vaccination?

Good news: The decision to be vaccinated for HPV or receive regular Pap testing isn't either/or. Image: Andy Newson

Good news: The decision to be vaccinated for HPV or receive regular Pap testing isn’t either/or. Image: Andy Newson

It’s January, which means that it’s Cervical Health Awareness Month! If you have a cervix, there are two big things you can do to protect its health: get vaccinated against human papillomavirus (HPV) before becoming sexually active, and receive regular Pap testing after becoming sexually active. When you take both of these steps, you can maximize what modern medicine has to offer. However, some people think you can just do one and ignore the other. Are they right?

You’ve probably heard of HPV, which causes genital warts and certain cancers. This virus has the dubious honor of being the most common sexually transmitted pathogen — some call it “the common cold of STDs.” According to the Centers for Disease Control and Prevention, “HPV is so common that nearly all sexually-active men and women get it at some point in their lives. This is true even for people who only have sex with one person in their lifetime.”


HPV isn’t just the “cervical cancer virus” — it’s a jack of all trades that can trigger cellular abnormalities all over the body.


One of the cancers most commonly caused by HPV is cervical cancer. In fact, when Gardasil, the most popular HPV vaccine in the United States, made its debut, it was marketed as a “cervical cancer vaccine,” despite the fact that HPV can cause other types of cancer. Nevertheless, a vaccine that could protect against such a common and potentially dangerous virus was good news indeed. However, some critics were quick to point out that cervical cancer is rare in the United States, thanks to widespread access to Pap testing, an effective screening procedure that can catch cellular abnormalities when they are still in their “precancerous” stages, allowing them to be treated before progressing to cancer.

For those of us planning to receive regular Pap testing, is vaccination really necessary? Likewise, if we’ve been vaccinated against HPV, do we really need regular Pap tests? Let’s examine both questions separately. Continue reading

STD Awareness: Does Gardasil Have Side Effects?

Teen_GroupIn 2006, a vaccine called Gardasil made its debut. Its ability to protect against two of the most widespread strains of human papillomavirus (HPV) means that it doesn’t just protect against an infectious disease — it protects against cancer, too. A persistent HPV infection can trigger cell changes that could lead to cancers of the mouth, throat, cervix, vulva, anus, or penis. Gardasil also protects against two additional strains of HPV that cause most genital warts.


The most common Gardasil side effects are fainting, dizziness, nausea, headache, fever, and hives, as well as possible pain, redness, or swelling at the injection site.


Cervical cancer is not as common in the developed world as it once was, thanks to an effective screening test. The Pap test catches “precancerous” cell changes, allowing the precancer to be treated before it develops into full-fledged cancer. So, while HPV vaccines have the potential to save hundreds of thousands of lives if they can be distributed in countries without widespread access to Pap testing, they have utility in the United States, too. Gardasil has spurred declines in high-risk HPV infections and genital wart incidence among American girls — which means less “precancer” and all the invasive, possibly expensive or painful, treatments that they entail, and a lot fewer genital warts. What’s not to like about that?

Despite this, a lot of people are curious about Gardasil’s side effects. If you enter a few key search terms into Google, you can easily find all kinds of websites warning you of Gardasil’s alleged dangers. So, you might be wondering: Is Gardasil safe?

What are Gardasil’s side effects?

Despite Gardasil’s relatively recent debut, many studies have already been conducted to evaluate its safety — and research continues so that we can consistently reassess its risks and benefits. So far, the consensus is that Gardasil is safe, with very few side effects. According to the Centers for Disease Control and Prevention, the most common Gardasil side effects are fainting, dizziness, nausea, headache, fever, and hives, as well as possible pain, redness, or swelling at the injection site. These reactions are not considered to be serious, some people don’t experience any of them, and they are only temporary. Continue reading

STD Awareness: HPV and Smoking

cigaretteThursday, November 21, is the Great American Smokeout, a day to abstain from smoking — and, one hopes, to quit for good. “That’s great,” you say, “but what do cigarettes have to do with sexually transmitted diseases?”

Good question!

First, let’s talk about HPV. Human papillomavirus (HPV) is known as the “common cold of STDs” — because pretty much every sexually active person will contract it, even people with very few sex partners. Aside from complete abstinence, the best way to avoid an HPV infection is to be vaccinated with Gardasil, which protects against four common HPV strains — two that cause genital warts, and two that cause certain cancers, such as cervical cancer and oropharyngeal cancer. You can further reduce risk by using condoms and dental dams during all sexual activities, limiting sexual partners, and choosing partners who have had few or no previous partners — however, these risk-reduction methods don’t guarantee that you’ll remain HPV-free.


Harmful chemicals from cigarettes can end up in your cervical mucus!


If you’re sexually active, you could have contracted HPV without ever knowing about it. Most infections are asymptomatic (meaning that you never develop symptoms) and transient (meaning that they go away on their own after a year or two). When symptoms do appear, they can manifest as genital warts, penile skin lesions, cervical abnormalities, and signs of cancer elsewhere on the body. And, sometimes, an HPV infection can become persistent, meaning that it doesn’t go away. Luckily, there are steps you can take to decrease risk of developing HPV symptoms, and to increase your chances of fighting off an HPV infection. And one of those things is to quit smoking! Continue reading

Arm Yourself Against Genital Warts and Cancer!

RosieVaccineBWVaccines are pretty nifty: Injecting a few tiny particles stimulates your immune system to build antibodies, which can bind to and help destroy harmful pathogens. A well-oiled immune system can neutralize these invaders before they have a chance to make you sick! In the war against infectious disease, we should be boosting our immune systems at every opportunity, and vaccines are one of the best weapons in our arsenal.

You’ve probably heard of HPV, or human papillomavirus, which causes genital warts and certain cancers. HPV has the dubious honor of being the most common sexually transmitted pathogen — some call it “the common cold of STDs.” According to the Centers for Disease Control and Prevention, “HPV is so common that nearly all sexually-active men and women get it at some point in their lives. This is true even for people who only have sex with one person in their lifetime.”


You might not know how easy it is to contract HPV — vaccination allows you to take charge of your health.


There are many strains of HPV. “Low-risk” strains can cause genital warts, which aren’t usually harmful but might be upsetting. “High-risk” strains can cause cancers of the cervix, anus, vagina, vulva, penis, mouth, and throat. The good news is that a vaccine called Gardasil protects against HPV-6 and HPV-11, which cause 90 percent of genital warts, and HPV-16 and HPV-18, which cause 70 percent of cervical cancers and 90 percent of anal cancers.

With protection available against a common virus that can cause upsetting warts or fatal cancer, you’d think that everyone would be lining up for Gardasil shots — but, unfortunately, vaccination rates are very low in the United States. Many of us opt out of vaccination for ourselves or our children because we don’t realize how easily HPV is acquired, or we minimize its potential to harm.

HPV is easier to contract than you might think, so if you think the risk is too small to outweigh other justifications against immunization, read on — you might not be aware of just how easy it is to acquire this wily virus. Vaccination is an empowering option for those of us who want to do all we can to take our health into our own hands. And, by being immunized, we can play a role in driving cancer-causing viruses into extinction, which would be feasible with sufficiently improved vaccination rates. Continue reading

STD Awareness: Can Oral Sex Cause Throat Cancer?

mouthLast month, actor Michael Douglas gave a frank interview in which he revealed that human papillomavirus (HPV) caused his throat cancer. And, he continued, he got the virus from performing oral sex — specifically, cunnilingus (oral contact with female genitalia). It’s unusual for celebrities to be open about their STD status — and Douglas’ spokesperson has since backpedaled on his comment — so Douglas is to be commended for bringing light to a taboo and little-understood topic. But there were a few things he got wrong, too.


No matter your gender or sexual orientation, performing unprotected oral sex can increase cancer risk.


HPV is a common virus that can be spread by most sexual activities — including vaginal, anal, and oral sex, as well as rubbing genitals together. There are many strains of HPV, which come in two main categories: low-risk HPV, which can cause genital warts; and high-risk HPV, which can cause cancers of the cervix, anus, vagina, vulva, penis, mouth, and throat. The majority of HPV-related cancers are caused by two strains of HPV: HPV-16 and HPV-18.

The good news is that there is a vaccine that can protect you from infection by HPV-16 and HPV-18. Furthermore, most people clear an HPV infection within two years. HPV-related throat cancer is rare, affecting just 2.6 out of 100,000 people.

Can oral sex really lead to throat cancer?

Unfortunately, it is absolutely true that oral sex can transmit HPV, and a chronic infection can cause cancer. Oral sex is indeed sex. It’s not “third base,” it’s not “almost sex,” it’s plain old, straight-up sex, carrying with it the potential for both pleasure and disease transmission. Unfortunately, because so many of us have a lax attitude toward it, fewer people take precautions when engaging in oral sex, and are less likely to use condoms or dental dams. Combined with low vaccination rates for HPV in the United States, the virus is even easier to acquire than it needs to be. Continue reading