Science of Sex: HPV and the HPV Vaccines

June 17th, 2017

Welcome to the fourth installment in a new feature on Of Sex and Love: Science of Sex. In this feature, I plan to discuss the science of sexuality in an easy-to-digest format that’s accessible to the casual reader. I will also follow up with some extended reading material for people who want to know more about the subject of each post.

Enjoy!

Science of Sex HPV

Human Papilloma Virus in a Nutshell

HPV is the virus that causes genital warts, but just because you don’t have any symptoms doesn’t mean you don’t have HPV. It’s one of the most common sexually-transmitted infections with over 200 strains (strains 16 and 18 cause over two-thirds of all cervical cancer while low-risk strains 6 and 11 cause most warts). Over 80 million people or about 1 in 4 people have it. It’s easy to transmit through skin-to-skin contact, so even using condoms may not prevent HPV. The CDC advises that ‘nearly all’ men and women will contract HPV in your life, and it’s likely that many people don’t even know they have it.

HPV doesn’t just cause warts. It can lead to irregular PAP smear results for women and cause cervical cancer (HPV can also be the culprit for other cancers, including that of the throat and anus). Those results can lead to a woman getting tested for HPV, but there is currently no test for HPV in men who have an asymptomatic strain (some sources indicate that a test does exist but it’s expensive and invasive).

Treatment of HPV may mean doing nothing at all. Most cases clear up within two years, but this isn’t always the case.

The HPV Vaccine

A vaccine for several of the most common strains of HPV, including some that cause cervical cancer, Gardasil, became available about 10 years ago. There are now three different vaccines for HPV available (Cervarix, quadrivalent Gardasil, and 9-valent Gardasil-9), the latter of which cover more strains of HPV than the original. One study concludes that HPV vaccines can prevent “most” invasive cervical cancers (around 70% of cervical cancer for the 9-valent vaccine and 66% for original Gardasil) as well as some oral cavity, penile, laryngeal and vulvar cancers. These vaccines are at least 90% effective at blocking those strains.

The vaccines consist of three doses that you can take between ages of  11 and 27 (for women) or 21 (for men). Younger patients may only need two doses. Even if you can’t take all shots within this time frame, you’ll still benefit from at least one dose. Similarly, the vaccine is still beneficial if you’ve already become sexually active, but it’s more beneficial if administered before sexual activity. In this case, the younger the better.

Although at first recommended for girls, HPV vaccines are beneficial for boys who can contract and transmit HPV. But it’s less likely that a male will no if he’s HPV-positive, which means he’s more likely to transmit it to a partner.

Still, fewer boys than girls are being vaccinated (12% of boys had received all three doses compared to 36% of girls in 2013), and vaccination occurs at a later age. Fortunately, vaccination rates have increased through the years, perhaps as no serious side effects have arisen over the years and the efficacy of the vaccines have been proven. For girls, infections by strains of HPV that the vaccine prevents has dropped 64% since 2006.

Let’s hope that vaccination rates rise, gaps close and strides can be made to cover more strains of HPV in future vaccines!

Further Reading

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Prostitution

June 12th, 2009

Sleeping Dreamer recent posted a thread/poll on the EF forums about whether prostitution should be legalized or not. Not so long ago, I was old-fashioned enough to argue against it based on moral reasons. Then I realized how silly that was because I don’t see what’s morally wrong for a working girl to provide a service to a customer. I just thing it’s easy for people to use a prostitute for immoral reasons (cheating) or immorally (abusive interactions) and, really, that’s not the fault of a working girl or even the industry. I’ve never known a prostitute to force someone to use her services at gun point (I’m sure it’s happened, though, and am not making light of that situation). Most customers have a choice.

Prostitutes don’t have much of a choice when it comes to health and safety though. I watch a lot of Law and Order: SVU and I think it realistically portrays the resistance prostitutes have when it comes to talking to the police even if it might be for their benefit. In that sense, I think that legalization may help sex workers who are otherwise (legally) helpless when it comes to protection against abusive customers and possible even murderers. Right now, there’s definitely fear of going to the authorities and this may mean illegal means of protection (weapons) or seeking protection of an individual or group but protection can be just as costly.

Proponents also suggest that regulation of the sex industry means keeping a closer track of health. Healthier conditions and access to health care is undoubtedly valuable. In places like Nevada where there are legal brothels, STD screening is commonplace and condom use is prevalent. Safe practices certainly lead to a safer industry.

Of course, legalizing the industry means being able to tax it. It’s certainly prosperous in some ways and the funds from taxation could benefit worthy causes like, hey, health programs for the sex industry? OR education. Or rehab programs. You name it.

Still, it’s a tricky situation. Just because prostitution is legalized doesn’t mean sex workers will all of a sudden trust authorities and it could even spur human trafficking as one poster commented. Just because it’s a regulated industry and health care can be made available doesn’t mean that it will be or that sex workers would take advantage of it. Some will but some certainly don’t care. Drug use and prostitution go hand in hand, in some areas, and results in many bad decisions. It would be virtually impossible to try to force safer sex practices or use of health care services, even if they were universally available. I mean, it would be unethical to keep a list of sex workers and even if you tried, you could never succeed.

I’m sure some would want to take advantage of health care and it would make a difference but I would still be a cautious customer. Escort services and brothels which are well organized would probably be the best solution for providers and customers alike. They already exist and tend to be safer than your typical street-corner girl. I see these groups as the ones which would most take advantage of health care and promote safer sex. Many of the current brothels would be able to come out of the sex industry closet and new ones would certainly form.

I don’t know how close we are to legalization prostitution. and I also think it won’t be a magic cure for the ails of society but it certainly could be a step in the right direction.

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Importance of Sex Education

February 23rd, 2009

I have always believed in sex education. Coming from a liberal, midwest state I know the sex education I got (which started in second or third grade and last, on and off, until my sophomore year) was much better than the sex ed others were getting which ranged from “Don’t do it” to “Masturbation is a sin” to none at all. Still, the focus was on not engaging in sex; although I felt my teachers gave me good reasons why (and I was listening), more information about safer sex would be preferred.

I know I’m not the only one who values sex education that is actually, well, educational but not everyone does. There are some people who feel that educating our nation’s youth about sexuality isn’t the way to go (is it any wonder that these people have unsatisfactory sex, got pregnant in their teens, caught a multitude of STDs because of risky behaviour or have never known how to please themselves or their lovers?) and to them I say “Listen up!”

I think most of us agree that the purpose parenting and teaching is to communicate to our children the risks they will have to deal with once they leave the walls of home or school and set them up to make the best decisions when it comes to these risks. We certainly exert more control over theirs lives when children are younger; no one is going to let a toddler cross the road by himself but as children grow, we impart on them more responsibility regarding life’s risks and trust that we have reared a child or a generation of children who will choose the best course of action for them. Notice, I don’t say “right” because what is right for one individual may not be for another.

I believe it’s important for us to recognize that life is full of risks but we can’t simply shelter our children; this almost always leads to more harm than good. By allowing them to make their own decisions and mistakes, we help them grow and give them a sense of confidence. So why is it that so many people think the best way to teach about sexuality is to say “Don’t do it” and leave it at that – the equivalent of “Because I say so,” another cheap cop out that no responsible person should use?

Although I’m not a parent, I can tell you that when I was given a solid “No” without meaning, it only made me want to rebel against my mother. However, if she took the time to explain why she said no, I was more wiling to consider her side and listen to her advice. When we tell our young children not to cross the road (without looking both ways), we explain to them that cars sometimes drive very fast and drivers may not see them when they’re doing so. Not looking could result in a painful or even deadly accident. And when we tell them not to talk to strangers because strangers may want to hurt them, they learn not to talk to strangers.

Of course, even as we try to teach these life lessons, we must recognize that, at some time, our youth will cross the road without a trusting hand to hold and that everyone begins a stranger so we must be somewhat trusting. We take as active a role as possible: we tell them some strangers are helpful like police officers, doctors or teachers and we send them into the world, armed with knowledge. We teach them how to drive, explain that a car is a powerful machine and they must be observant and obey laws and rules of the road. And then we let them go.

So why should sex be the exception? Why should something, without which none of us would exist, be glossed over, tucked in the back of the book or ignored altogether? It shouldn’t. Sex is a part of life and will always be a part of life. It has the potential to be riskier than other activities, certainly, which makes it even more important that we educate youth about it.

Of course, it also makes us want to protect them from it even more and it’s certainly understandable but if we don’t give them the information they need to make the best decisions, doesn’t this endanger them even more? By withholding information about the risks of sex, teens may be walking into a dangerous situation blindly. In fact, I would call this very irresponsible in terms of parenting and educating. Furthermore, by not educating how sex can be a positive, healthy and pleasurable thing (within and outside of a relationship), we could be setting up the next generation to a life of mediocrity.

I don’t think we should be bringing porn starts into our class rooms or waking up our kids with skin mags but I think that a level of responsible parenting and teaching is necessary. And, no, I don’t think that illustrating why waiting to have sex but outliningg ways to engage in safer sex at the same time will prompt teens to engage in sex earlier. I think that, by nature of our species, adolescents will be curious and some will have sex, yes. I also think that if we show them the potential risks including pregnancy, STDs, physical discomfort and emotional tolls, we allow them to make the most educated decision and, should they decide to have sex, they know to protect themselves from all the possible negative consequences. Hopefully, teaching about the risks will also deter some teens from having sex at a young age.

But if we don’t teach them and they race to the sack with the first person who is open to advances, they may not know to use condoms to protect from STDs and prevent pregnancy. How many know someone who thinks “pulling out” is an effective form of birth control? Or who wonder if you can get pregnant from oral sex? Or who think that you cannot get pregnant while a female has her period? How many people are aware that condoms don’t protect against all STDs, should only be worn for 30 minutes at a time, should have room at the tip for semen to accumulate and should never be worn doubled up? Not everyone and that is a problem.

Yet, it’s not the only problem. I think it’s important to recognize that not teaching today’s youth about their bodies can limit the pleasure they will experience during their life on Earth. This is especially true with the female half of the population, some of whom do not even know what the clitoris is or that female cans masturbate or that it’s okay to communicate what they like during sex. Comprehensive sex education not only leads to safer sex but leads to more meaningful, positive sex which enhances, not harms, relationships.

Although I discuss mostly young people and their ignorance when it comes to sex, I think that most young people are better educated than some adults. Do our parent’s and grandparents’ generation even know a fraction of what we do? How many grown women engage in dangerous vaginal douching to be “fresh” and clean? Would some hard learned lessons have made sex and relationships better had someone care enough to take the time to explain the basics? Absolutely.

There is no need to drill into youth that “Sex is bad! Sex is bad! Sex is bad! Don’t talk about it.” However, there is every need to explain that the best sex can be physically and emotionally fulfilling by knowing the risks and preparing for the consequences. And that is no different from every other lesson we teach at home or school.

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