Consequences of infection with HPV can be more serious and virus is more common than many realize
Up until now, the sexually transmitted disease human papillomavirus more commonly know as genital warts has been viewed by sexually active people as more of a nuisance than a serious health threat.
But that abruptly changed when the drug manufacturer Merck & Co. launched a campaign to promote widespread vaccinations of pre-teen girls with Gardasil, a vaccine designed to prevent cervical cancer. The new vaccine is believed to be 89 percent effective in preventing infection with HPV and 100 percent effective in preventing genital warts, precancerous lesions and cervical cancer.
Controversy surrounding Texas Gov. Rick Perry’s recent executive order requiring girls to be vaccinated, the drug company’s near simultaneous political contributions to Perry and state lawmakers and an outcry from conservative groups has heightened public awareness about the virus.
Now, the Texas Legislature is poised to pass a bill rescinding Perry’s executive order, which promises to bring even more attention to HPV.
Almost lost in the political debate about whether the danger of promoting promiscuity outweighs the benefit of protecting young people from the virus is the realization that HPV could pose a serious health threat to men as well. Some health professionals are calling for all boys and men to be vaccinated to help stop the spread of the virus to girls and women. But HPV has also been linked in smaller frequency to penile and rectal cancer in men.
It’s clear now that those pink, fleshy swellings, which can develop on the penis, around the anus and inside the rectum, can lead in some cases to far more serious consequences than just embarrassment and shame. Topical chemical treatments or, in the case of internal rectal warts, painful day surgery, could be the least of the suffering. For some, it could eventually mean chemotherapy and major surgery.
In London, the Freedomhealth Clinic on Harley Street has been acquiescing to gay men’s demands for the vaccine since January. Dozens of gay men have reportedly been immunized in recent weeks. The three-dose course of treatment costs the equivalent of $880.
Here in Dallas, it’s a different story.
Bret Camp, associate executive director for health and medical services for the Resource Center of Dallas, said neither male nor female clients are inquiring about HPV and vaccinations to prevent it.
“We’ve had virtually no response to the vaccine from the community,” Camp said.
Although there has been little discussion about HPV in connection with gay men’s health probably because of the attention AIDS, Herpes, syphilis and other diseases have demanded that may be about to change, Camp said. He noted that the Association of Nurses in AIDS Care has scheduled a speaker to discuss HPV at an upcoming meeting.
“I feel pretty comfortable saying that men with HIV and women with HIV are going to be more susceptible to HPV complications,” Camp said.
Camp said there probably is much more to be learned about the effect of HPV on HIV-negative people also. That’s critical because HPV exposure is so common that many sexually active people are already exposed to the virus. The Centers for Disease Control estimates that 50 percent of sexually active people are already infected.
“If you’ve had more than a couple of sex partners, you’ve been exposed to HPV whether you know it or not,” Camp said.
Not all infections of HPV result in genital warts, so some people have no idea they have been infected.
“Some people are just more susceptible, and it shows up in them,” Camp said.
HPV infections, of which there are four strains thought to cause genital warts and cancers, result from skin-to-skin contact during sexual activity. There is a test that can determine if HPV DNA is present in a woman’s pap smear. There presently is no test for HPV in men.
“I think they are starting to connect the dots, and they are noticing that there is a correlation between HPV and certain cancers,” Camp said. “It is evolving, and it does warrant some attention.”
Camp said that although none of the clinic’s clients have asked about the HPV vaccine, questions about genital warts are the most common ones he receives through the agency’s Web site. He advises people with external warts to contact a dermatologist or community doctor and those with internal warts to consult with a gastroenterologist.
“It is the number one request for treatment information that I get,” Camp said.
Camp said gay men appear to be uncomfortable talking about genital warts, and he suspects that is why he gets so many requests for information about them through the Internet.
In a roundabout way, maybe we have Gov. Perry and conservative legislators and their constituencies to thank for bringing this concern to the LGBT community’s attention. It should be easier to talk about now that it’s been debated on the floor of the Texas Legislature.
This article appeared in the Dallas Voice print edition, March 23, 2007.