I hear about people who love to talk about condoms as an ultimate solution to everything. Yes, condoms might help to a degree. Studies even suggest that condoms can actually help people "clear" the virus once someone already has it (and note that clearing is defined in different ways within the mentioned studies).
But look at the numbers. The potential for protection that condoms provide is not good, statistically speaking, because condoms aren't designed for preventing the spread of HPV. They're designed for preventing pregnancy. The probability that you will still get HPV even if you use a condom every time you have sex is unacceptably high. If condoms failed that much at preventing pregnancy, people wouldn't use them for that purpose nearly as often as they currently do.
According to the CDC’s Report to Congress: Prevention of Genital Human Papillomavirus Infection:
The available scientific evidence is not sufficient to recommend condoms as a primary prevention strategy for the prevention of genital HPV infection.
And: Rep. Dave Weldon (R-FL) and family physician, said this at the hearing:
The scientific evidence is clear that condoms provide little protection from
infection by HPV. Yet agencies and organizations are fighting to keep that
fact from the public.
So hey there, this is reality speaking: Unless you wear a wetsuit as a condom, it's impossible for a condom to serve as a barrier for all the skin that can transmit HPV during sexual contact. Keep in mind that you don't have to have penetrative sex to get HPV, either. The virus can be transmitted through oral sex, use of sex toys, and any type of skin-to-skin contact, so even lesbians are at risk. And ask yourself this: do you wear a condom when you're intimate but not having intercourse?
This is Post #6 in the series, Debunking HPV Myths. For other parts of the series, click here.
I touched on it before, but I want to hit it harder. It's selfish, cruel, and/or stupid to say or think that you don't have to tell partners you have HPV. Oh yeah, and a legal risk. Although someone didn't develop symptoms (yet?), that doesn't necessarily mean they they won't develop symptoms, are 100% clear of HPV, can't transmit HPV, or that their partner won't develop a symptom upon contracting it. Yes, HPV can be transmitted even if you don't have symptoms. It's hard to predict whose HPV will progress, and there are a lot of risk factors. But just because you're asymptomatic doesn't mean your partner will be.
And if you're reading this thinking that no one could be so treacherous, have a look at this comment by matterofopinion, random kook:
I don't need to tell anyone I sleep with that I have it, I don't have to worry about anyone suing me, my names [sic] not plastered over the Internet, and don't have a million dollars sitting in the bank. And like I said it's a Domino [sic] effect, [sic] not too many virgins out there. And there's no test or cure for a male, they don't have a cervix, won't get cervical cancer, or should I say pre-cancerous cells. And, my ex's [sic] won't know whom they got it from, or have to worry about it unless their girlfriend/wife gets it.
Not only does matterofopinion have no idea how it affects men, she seems to be fully aware that she's risking the health of others. She even discusses the potential for future partners of her partners to contract the virus thanks to her. She seems to have no problem whatsoever hiding the fact that she's had HPV from the people she's with. So basically what she's saying is that she'll never get caught transmitting the virus, so she's not going to let the cat out of the bag, except online, anonymously. It would be funny if it wasn't so pathetic. matterofopinion also referred to surgery to remove pre-cancerous lesions as "the price a woman has to pay for having sex." With that kind of backwards thinking, the poor girl should hurry back to her time machine and hightail it to the 1950s before it's too late.
The bottom line is that it's not for one person to decide whether or not to put someone else's health at risk, especially when it comes to something as intimate and personal sexual health and cancer. Realize that if you're going to be intimate, the decision as to whether or not your partner gets exposed is not yours to make. It's theirs. This is called basic human decency. Have some.
This is Post #5 in the series, Debunking HPV Myths. For other parts of the series, click here.
All that stuff about HPV not affecting men and about them not being able to know they have it, ever? It's false. And people say stuff like it all the time:
From Anonymous:
There is also no test for men to detect whether or not they have HPV, so unfortunately it's pretty impossible for men to know...
That's just plain wrong. Not only does this encourage men to cast off conscientiousness when it comes to HPV, it encourages women to do the same, and it puts everyone's health on the line. It is a man's problem too.
Men can know they have HPV because they can show symptoms: Genital warts are the most common symptom in men, and they are somewhat common and highly, highly contagious. Wrap your head around these stats: Every minute in this country, there's a new case of genital warts. In the last decade, genital wart infections in the U.S. have increased at twice the rate of herpes. If someone has had warts in the past but don't presently, that doesn't mean they can't transmit them, and it doesn't mean they're free of HPV.
Men get cancers from HPV too. That includes penile cancer, anal cancer, oral cancer, and cancers of the head and nec. In fact, oral cancers disproportionally affect men, and by 2020, HPV will be causing more oral cancer in men than cervical cancer in women.
It's true that there is no test for HPV in men exactly as there is in women. Men can't go to the doctor and ask for an "HPV test" to detect the presence of the virus as women can - yet. Men do get tested for the purposes of scientific study all the time, but these tests are not generally available to the public. However, men should start asking their doctors about it though, in the hopes that this will create some pressure in the medical community to get a common test out there. I have heard of some doctors swabbing men for HPV and submitting the test, as well - so again, it doesn't hurt to ask.
How can men protect themselves? And how can they try to be aware that they have or might have HPV if they're not showing a symptom at the moment?
There are two things to bear in mind about the world around us, and I'm amazed at how many men openly identify with this first fact. And that fact is that a lot of women talk openly about their health to the men in their lives. That means there's a very real chance for men to have a clue that the women in their lives may have been exposed to HPV. Remember when she told you she went to her gynecologist that one time to get a biopsy, or treated for HPV/HSIL/LSIL/CIN/some other technical medical word you didn't bother inquiring about further? Yep guys, that might have been your tip-off that she's been exposed and has symptoms of HPV, and so have you. Men can't just ignore it, and men can't not think about the implications it has for them.
And the other big thing to think about: even if she never brought it up like that, just like it's a good idea for women to ask about a man's sexual health and history, men should ask women about their sexual history and health. Why?
Because it affects men too,and it's just one more thing men can do to protect themselves. Remember that laundry list of cancers earlier? That's serious. Even if a man never shows a symptom, never develops cancer, and is just a carrier, he should care enough about the women in his life to try to be aware of his exposure so he can give them a heads up. Ignorance is powerlessness for both sexes. Add into the mix the fact that women have been going to the gynecologist less frequently than they should be in recent years for things like cervical cancer screenings and paps, and you've got a recipe for disaster. The more you know about what's at stake, the better the decisions you can make with prevention (like the HPV vaccine, men and women) and screening (like annual paps for women and regular doctor visits for men). Men who ignore HPV because they think they can't know or because they think it won't hurt them are mistaken. And guys, don't forget that Gardasil is available for you too!
Make no mistake: this is not simply about the women that a man personally decides to be intimate with. It's bigger than that. It's about setting an example for other men — like the men that are intimate with the other people we care about in the world. These cancers affiliated with HPV disproportionately affect women. Your sisters, wives, daughters, friends, coworkers... all of them. But this is absolutely a two-way street. Ladies, be up front about your health. It involves him too. And in the off chance that you're not together forever, maybe you should think about the women in his future as well. You'd want them to do it for you.
This is Post #4 in the series, Debunking HPV Myths. For other parts of the series, click here.
This blog was updated on 6/23/2011.
In some cases HPV does stay dormant for a long time, but it absolutely doesn't have to. In younger females, it's been observed that precancerous lesions can come on aggressively and rapidly. I, for example, went from no HPV and years of back-to-back perfectly normal paps to HPV positivity and CIN3 in less than a year's time. (CIN3, and HSIL — which stand for grade 3 cervical intraepithelial neoplasia and high-grade squamous intraepithelial lesions, respectively — are precursors to cervical cancer.)
Not only are lesions like these aggressive, but they "are common early events among women with incident HPV infection" and, interestingly, "the interval between incident HPV-16 or HPV-18 infection and biopsy-confirmed CIN grade 2–3 appears to be relatively short."
How short? According to a study by Winer et al.,
Contrary to the theory that prolonged infection is necessary for progression to high-grade neoplasia [11–13], our results support the hypothesis that HSILs are often an early manifestation of HPV infection in young women. Half of the incident cases of biopsy-confirmed CIN grade 2–3 in our study occurred within 14 months of an incident HPV infection.
And what about warts? They show up even faster:
The median time between detection of incident HPV-6 or HPV-11 infection and detection of genital warts was 2.9 months (IQR, 0–5.7 months).
Something to think about, no?
This is Post #3 in the series, Debunking HPV Myths. For other parts of the series, click here.
Strains are a major source of confusion, even for some medical doctors and others in the health industry. Some basic questions for this blog: Are there different strains of HPV? (Yes! Many!) What do the strains do? (Depends on which strain.) Can you have more than one strain of HPV at once? (Absolutely.) Which strains are the most common? (High risk types 16 and 18.) Does Gardasil help if it only covers four strains? (Yup, and read on for explanation.)
Let's kick things off with the statements of a commenter going by the screen name Dr Williams, whose full name is probably Dr. Mark Williams, which we know thanks to another genius who replied to him by first name repeatedly. Do you think this is the guy? Anyway, it all began with Dr Williams proudly proclaiming his medical background:
First of all, let me start by saying I am not afraid to hide behind some screen name. My name is Dr. Williams, M.D.
Oh yes, and this is important:
Alan and I have been best friends since we met our freshman year in college.
While Dr Williams was discussing whether Dr. Alan Evans had warts, he went off on 
a bizarre tangent about "the cancer causing kind" of warts. Say what? This statement he made regarding the visual diagnosis of "cancer causing" warts versus "the bumpy strand" is something to behold:
He does not have warts. And even if he did, there is no way by looking at them to tell if they are the cancer causing kind. I guess a future conversation may be.. [sic] "so, do you have warts?", [sic] um [sic] yes." what [sic] genotyps [sic] are they, the cancer causing kind or just the bumpy strand?" ummmm... [sic] I don't know.
No, really. Is this a joke, in more ways than one?
It's common knowledge that the strains of HPV that cause genital warts do not cause cancer. This isn't information you have to dig for or have a medical degree to know; it's plastered everywhere. Cancer-causing strains and warts-causing strains are two different things. And you can definitely have more than one strain at a time.
Keep in mind that Dr Williams made these statements after directing everyone else to get as edumacated as he is on the subject of low risk strains by visiting CDC.gov.
I hope people took his advice on that one point and read the CDC website, because on a page labeled "basic information," the CDC comes right out and obliterates his nonsense about "cancer causing" warts in one sentence:
The types of HPV that can cause genital warts are not the same as the types that can cause cancer.
It's a good story, but I digress. It'd take a chapter of a book to fully explore the bitter, factually incorrect, facially inconsistent and puerile ravings contained within the comments and e-mail correspondence (oh yes, he sent me e-mails too - another time, perhaps?) from Dr Williams.
Here's a second commenter whose ignorance is worth learning from: rosiejr1. Notice that rosiejr1 also claims to know a thing or two about STIs thanks to her line of work with the CDC, so you had better listen up! Or not.
I am a CDC Rep at a local health department in TN, which is top ten for ALL STD's. [sic] Obvoiusly [sic] the courts had some medical experts in it, but [. . .] only one strain can cause cervical cancer.
Rosie is scary uninformed. HPV is a family of viruses. There are many strains — almost 200 that we know of so far — and like I said, different strains do different things. We're mainly talking about the ones transmitted via intimate contact. There are roughly 40 of those. This group can be divided into two types: high risk and low risk. As discussed before, high risk strains can cause cancer. Low risk strains can cause warts.
So let's get down to pointing out the incorrect information that this supposed 'CDC Rep' is carelessly broadcasting to the masses: Does just one strain cause cancer like rosiejr1 said? Um, no. To simplify things to the point of seroius inaccuracy is unacceptable — especially after bragging about how she's in the medical field, so that people will buy what she's saying.
HPV isn't simple, so don't try to make it simple. To give you an idea of how many strains of HPV can cause cancer, the Hybrid Capture II High Risk HPV test looks for 13 different high risk (e.g. cancer-causing) types — 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. It tests for the most common types, but that's not all of them. For example, there are at least two more well-known high risk types not included in that test: 73 and 82. There's also a test for low risk types, which looks for 5 different strains : 6, 11, 42, 43, and 44. And once again, that's not all. Examples of other low risk types not included in the test are 54, 61, 70, 72, and 81.
The HPV vaccine known as Gardasil protects against four distinct strains: two high risk strains (strains 16 and 18, which together cause 70% of all cervical cancers), and two low risk strains (strains 6 and 11, which together cause 90% of all genital warts). Those four strains cause the vast majority of the most common health problems caused by HPV, which is why it makes sense to get the vaccine. You'd think someone who works as a "CDC Rep" would know that much simply from experience, maybe while talking to people about Gardasil or something in her day-to-day work. But you'd be wrong. Maybe you should be worried, too.
UPDATE: The FDA approved Gardasil to help prevent anal cancer caused by HPV, the vast majority of which is, in fact, caused by HPV.
This is Post #2 in the series, Debunking HPV Myths. For other parts of the series, click here.
Believe it or not, people really do say this kind of thing. Let's kick this one off with a snippet of a comment by pdx97216:
Despite how The Talk made it sound, HPV is not life threatening. [sic]
They said it so matter-of-factly. And yet, they're so factually wrong.
Cervical cancer. Vulvar cancer. Vaginal cancer. Penile cancer. Anal cancer. Bladder cancer. Head, neck, mouth, and throat cancers.
What do these things all have in common? Meh, they're all cancer, and cancer kills people. No big deal, right? Notice anything else? Oh yeah, those cancers can all be caused by HPV.
Almost all cervical cancer is caused by HPV. This year, 11,000 women will develop cervical cancer in the United States, and about 4,000 of them will die. Worldwide, cervical cancer is the #2 cause of death among women. In a year's time, on this planet, over a quarter of a million women will die from cervical cancer. What about the number that develop it and don't die? Double the number to a half a million worldwide. What about the number, in this country alone, that develop CIN (cervical intraepithelial neoplasia, or cervical dysplasia, a potential precursor to cervical cancer)? About 400,000 in the US every year. That's a lot.
But there's more cause for concern, for men and women alike. HPV causes
• between 50 and 80% of vulvar cancer
• at least 70% of vaginal cancer
• 50% of penile cancer
•85% of anal cancer
• 39% of oral cancers
• and bladder cancer.
This isn't hard to figure out. HPV can be life-threatening and people die because of it.
Put aside the medical problems for a second. What about the financial side of HPV? This isn't something you see talked about much, but it should be. How much does it cost to treat cervical cancer? In 2000, it cost an individual over $20,000 to treat cervical cancer in the early stages, and $37,000 to treat a late stage case. What if they don't have insurance? What if their insurance drops them from coverage for the very type of cancer they have? What if their insurance drops them from all cancer coverage, like mine did? In 1996, the direct medical care costs of treating cervical cancer in this country were estimated at $1.7 billion. That's an old number. What do you think it is now?
We probably haven't reached the limit of our knowledge regarding the damage that HPV can do, but we do know that death is a possible result. To downplay its severity is to deny reality.
This is Post #1 in the series, Debunking HPV Myths. For other parts of the series, click here.
