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Preventing HPV Infection

Monday, December 23rd, 2013

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI). HPV can lead to a number of serious health problems, such as genital warts and some types of cancer. Many people who have HPV do not know it, because it often causes no symptoms. HPV should not be confused with either herpes or HIV. While these can all be transmitted through sex, they cause different problems and produce different symptoms.

Anyone who has ever had sex has potentially been exposed to HPV. Remember – not everyone who has it is even aware they have it. At least half of all people who are sexually active will get HPV at some point. This statistic remains constant even in the case of people who have only one sexual partner in their entire lifetime.

Most commonly, HPV is transmitted through vaginal and anal sex. It does not discriminate between straight and homosexual couples. Furthermore, even if years have passed since contact with an infected person, HPV infection can still be present. In rare instances, HPV can be passed from a pregnant woman to her baby during delivery. In addition, one person can contract more than one type of HPV.

In most cases, HPV will go away on its own without causing any serious problems. Sometimes, however, the infection will stick around and cause serious issues such as genital warts, cervical cancer, or other types of cancer.

According to the CDC (Centers for Disease Control), HPV is the main cause of cervical cancer in women. There are about 12,000 new cervical cancer cases each year in the United States. Cervical cancer causes about 4,000 deaths in women each year in the United States. There are about 15,000 HPV-associated cancers in the United States that may be prevented by vaccines each year in women, including cervical, anal, vaginal, vulvar and oropharyngeal cancers.  In addition, about 7,000 HPV-associated cancers in the United States may be prevented by vaccine each year in men.  Approximately 1 in 100 sexually active adults in the United States have genital warts at any given time.

 

Should You or Your Daughter Get an HPV Vaccine?

Individuals can reduce their risk of getting HPV by getting vaccinated. As with any newer vaccine, there have been rumors regarding dangerous side effects. However, the fact is that the HPV vaccine has been shown to be safe and effective, and since at least 70% of all cervical cancers are caused by HPV, it is absolutely recommended that people who are able to get the vaccine do so. Gardasil is one vaccine that should be given to girls and young women between 11 and 26 years of age. Another available vaccine is Cervarix. The vaccines are given in the form of three doses (injections) administered over a period of six months; for the best protection, it is important to receive all of the doses (injections).

Sexually active individuals can also choose to lower their risk by using condoms. It is possible for HPV to affect areas that the condom does not cover, so realize that condoms are not 100% effective against the transmission of HPV. A vaccination is recommended even for people who always use condoms and plan to continue to do so.

Gardasil is also licensed, safe, and effective for males ages 9 through 26 years. CDC recommends Gardasil for all boys aged 11 or 12 years, and for males aged 13 through 21 years, who did not get any or all of the three recommended doses when they were younger. All men may receive the vaccine through age 26, and should speak with their doctor to find out if getting vaccinated is right for them.

 

The vaccine is also recommended for gay and bisexual men (or any man who has sex with men) and men with compromised immune systems (including HIV) through age 26, if they did not get fully vaccinated when they were younger.

 

Finally, limiting the number of sexual partners a person has can reduce their risk of being exposed to HPV; so can choosing a partner with few or no previous partners. But again, even if only have one sexual partner ever, you still have at least a 50% chance of contracting HPV – so, in you are in the appropriate age range, you should still receive the vaccine if possible.

– Yvonne S. Thornton, M. D., M. P. H.

Why getting the HPV vaccine (Gardasil®) makes sense

Friday, October 30th, 2009

Too often, the Internet is filled with rumors about the dangers of vaccines. And those rumors are typically based on misinformation, disinformation and fear.

That’s been the case with Gardasil® (Quadrivalent Human Papillomavirus  (Types 6, 11, 16, 18) Recombinant Vaccine), the vaccine that protects girls and young women from the human papilloma virus (HPV).  Many people who have HPV may not show any signs or symptoms.  This means that they can pass on the virus to others and not know it. A male or female of any age who takes part in any kind of sexual activity that involves genital contact is at risk.

While all medicines carry some risk, the benefits of being vaccinated against HPV far outweigh the small potential dangers.

A large part of the backlash against this vaccine may be due to an effort by the drug’s manufacturer to make vaccination mandatory.

Do I believe that young girls and women should be forced to get the vaccine? Absolutely not. Coercion would be a mistake. And that attempt by the drug maker appeared, in this physician’s opinion, to place profits above the right to make a personal choice.

But, getting past the bad decisions of pharmaceutical companies, let’s look at the benefits for our daughters and ourselves. We know for a fact that HPV is connected to cervical cancer. And we know for a fact that cervical cancer is a horrible disease.

So, if you can get a vaccine that will largely protect you against HPV, then getting vaccinated is an absolute no-brainer. Gardasil® protects against four types of HPV: two types (Types 16, 18) that cause about 70 percent of cervical cancer cases, and two more types (Types 6, 11) that cause about 90 percent of genital warts.

The HPV vaccine is typically offered to girls and women between the ages of 9 and 26.  Given in a series of three injections (initial vaccine, another in two months and the last in six months).   For adolescents and younger, I would recommend discussing the vaccine with your gynecologist when your daughter comes in for her first gynecologic visit, which should be between 11 and 12 years of age. That first visit is only for an introduction to a gynecologist and a pelvic examination is not performed. It is a “get acquainted” visit and it is then that the benefits of the vaccine should be discussed.  Gardasil® is most effective if you can vaccinate before a woman risks being exposed to HPV … in other words, before she becomes sexually active.

As a woman gets older, her body isn’t as susceptible to the damage of HPV, so vaccinating isn’t recommended.

– Yvonne S. Thornton, MD, MPH