I honestly have no idea why Kim Kardashian is famous and can’t name her sisters. To me, Farrah was the second hottest Angel (after Kate Jackson of course) and Demi is still married to Bruce Willis. Ok, I’m not being honest on the last one – I know Demi moved on to Ashton and I read an old People Magazine in my dentist’s office only to discover that they split up. Which makes me feel sad. I’m also sad to learn that Jean Stapleton (Edith Bunker) died over the weekend.
The other celebrity news flash that got my attention this weekend was about Michael Douglas. See, apparently MD clarified in a media interview that his throat cancer was caused by the sexually transmitted inflection Human Papilloma Virus (HPV) which he contracted by performing oral sex.
Michael Douglas’ sexual proclivities have never been on my mind nor a topic of conversation but right now I’m kind of glad that MD has uttered the word ‘cunnilingus’. Why? Well, because the strains of HPV that are associated with cancer are nasty and the way HPV impacts men is rarely discussed. MD has provided a great opportunity to the cunnilingus-loving among us and those who will likely be fans at a future date.
First, a little beta on HPV:
- Human Papilloma Virus is spread by skin to skin contact. That means vaginal, oral and anal sex, and any other genital to genital contact like a good non-penetrative hump. You can’t pick up the infection from toilet seats because the virus likes to live in warm and moist places.
- About 75% of sexually active adults will acquire HPV before the age of 50. Usually it is contracted between the ages of 15 and 25.
- Condoms help but do not provide complete protection from HPV infection because condoms do not cover all exposed genital skin (ie. scrotum, labia). While heaps of people aged 15-25 use condoms for vaginal and anal penetrative sex, many of those same people skip condoms for oral sex.
- Most infected people have no signs or symptoms but where there are signs or symptoms, they can show up 3 months to years after exposure which can make tracking the spread really challenging. Worts are the most common sign and they usually do not hurt.
- Although there are about 100 strains of HPV, researchers divide the virus into two types. Most strains are considered the low risk type because they are not linked with cancer. That covers about 90% of genital worts.
- Persistent viral infection with high risk HPV strains are seen in virtually all cancers of the cervix. Pap tests are critical for that reason. The test will show abnormal cells on the cervix, increases detection of high risk strains of HPV and so supports early detection of cervical cancer.
- HPV is linked to a bunch of other cancers, including anal cancer, and cancers of the penis, vulva, mouth and throat.
- Chronic outbreaks of HPV, by the way, can be incredibly uncomfortable and like other STIs, carry with them a whole lot of stigma. And stigma hurts.
There are two authorized vaccines in North America to prevent infections from the most common types of high risk HPV. Gardasil™ (for females and males) and Cervarix™ (for females only). In Canada and in the US, the powers that be (the National Committee on Immunization and the Center for Disease Control respectively) recommend the HPV vaccine for both females and males somewhere between ages 9 and 13. The intention is to vaccinate people before they are at risk. but if people miss that window, it’s still recommended for females (until age 26) and males (until age 21).
In the March publication of the journal Pediatrics, researchers concluded that parents mistakenly perceive that this vaccine is related to and necessary only if there is current sexual activity. That’s flat out wrong. Parents also mistakenly perceive their children to be not sexually active. Surely we can all agree that we don’t always know what our (pre)teens are up to in this department. Finally, many parents have safety concerns about the vaccines.
Some parents think all vaccines are dangerous. I’m not in a position to challenge those beliefs. What I would like to do is make a case for the HPV vaccine for those who are basically adhering to immunization guidelines offered by their state, province or country. To begin, the HPV vaccines do not contain any preservative or antibiotics, including thimerosal or mercury. The vaccines can have side effects but they are the same as the ones we’ve seen when our children were inoculated before: redness, tenderness and swelling at the injection site and, less commonly, dizziness, nausea, headache and fever.
Because HPV is very common we can assume it likely that our children will come in contact with it. For most people, the body can clear the infection by itself. Sometimes however, the infection does not go away and becomes chronic. Chronic infection with high risk HPV types might eventually lead to certain cancers.
This brings me to our sons.
We might as well assume our male children will come in contact with HPV. Those who contract HPV will clear the infection without challenge. A few might have chronic infections of low risk strains, a fraction still might have chronic infections of high risk strains, and a tiny portion of those males may end up with penile, anal or throat cancers. Nasty for those few but all told, the risk to our male children may seem negligible.
Personally, I’m game to do what I can to avoid my sons getting cancer. But even if you think a vaccine is not warranted to protect our male children from these cancers, boys ought to be vaccinated to protect the female population from acquiring high risk HPV strains that are much more likely to be precursors to cervical cancer. In other words, if I vaccinate my daughters, why not my sons?
Well there is one good reason why parents don’t vaccinate their sons. Gardasil for males is not covered by the health care system in Canada and is rarely covered by medical insurance in the US. That means if you want it for your male children, it’s a personal expense. And it’s not cheap. The vaccination costs approximately $500.00 for the three required shots which makes it an unviable option for lower-income families.
I’ll be honest with you again - I’m prepared to pinch funds from our established RESP (the educational trust for our kids) to finance this vaccination and when my boys turn 11, they’ll roll up their sleeves and I’ll explain exactly what the shot is, why they are getting it and why we are paying for it out of pocket. And it will likely be a better education than their first semester at college. And worth every penny.
Like the Pediatrics research found, loads of parents balk at vaccinating to prevent a sexually transmitted infection when their kids are 9, 11 or 13. Truth is, whether we like it or not, some of our children will be sexually active earlier than we would like and most likely before we know they are active. Vaccinating them early will help protected them. Michael Douglas didn’t say that initially, but his love of oral has got the rest of us talking.
Here are some links to recent articles on the issue of HPV vaccination generally and HPV vaccination for boys
http://www.cbc.ca/news/health/story/2012/04/13/hpv-vaccine-boys.html This one happens to feature my pediatrician from 35 years ago.
http://rhrealitycheck.org/article/2012/01/03/vaccinating-children-against-diseases-including-hpv-is-one-our-societal-responsib/ Martha Kempner also wrote a peice following the Michael Douglas news.
http://www.guardian.co.uk/science/2011/may/27/boys-vaccinated-hpv-human-papilloma-virus In part, a look at HPV vaccinations to protect gay men
http://www.bbc.co.uk/news/health-21282382S Shout out to Australia for universal vaccination of females and males.
*** By the way, when my kids are being vaccinated for HPV, I’ll be asking for the Hepatitis B vaccine too since Hep B is about 100 times more infectious than HIV but transmitted in the same way – via blood or body fluids.
Update: in October 2014, I was on Global TV talking about HPV and the value of innoculating boys.