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Stress the 'Human' in HPV, One Man Suggests

FRIDAY, Sept. 23 -- Fred Wyand has been in a prime spot to watch the evolution of the public health response to human papillomavirus, or HPV.

Since 2003, Wyand has served as editor of HPV News, a bimonthly newsletter published by the American Social Health Association. The newsletter has been around since the 1990s.

HPV is a sexually transmitted disease that most people associate with genital warts, a temporary but somewhat repugnant condition. But the more dangerous potential side effects of HPV infection are not as well known, Wyand said.

"It's probably just within the last 30 or 40 years that science has begun to understand the connection between high-risk HPV types and cancers of the cervix, penis and anus," he said. "That's not even talking about the genital warts that aren't cancer-causing. So there's a lot of things to talk about."

An HPV vaccine has been on the market and recommended for girls and young women for several years now, but has been slow to catch on. Wyand said that studies have shown only about half of all girls now get the vaccine, although the numbers may have improved slightly in recent years.

Early on, there was some controversy when parents objected to having girls of 12 or 13 inoculated for a sexually transmitted disease, but those arguments have mostly faded, Wyand said.

"It's kind of hard to argue that by giving someone an HPV vaccine you're prompting them to go out and become sexually active," he said. "Not a lot of people are putting their attention on that issue these days."

He believes HPV vaccination rates are low because people either haven't heard about the vaccine or find it difficult to keep it in mind with all the other recommended childhood shots and checkups.

"There's still a lot of room for educating parents and educators," Wyand said. "It is a relatively new vaccine so it's sort of slow getting it into people's minds. This is now another among many vaccines that people have to remember to get their children."

Wyand also is well-versed in the ongoing debate over whether boys and young men should also receive the HPV vaccine.

"There has been a lot of back and forth about using the vaccine in men," he said. "There's a medical indication for using it in men, but when you look at it and consider that cervical cancer is probably the most prominent cancer linked with HPV, people say, 'Well, would we be better served taking those resources and using them to get more and more women vaccinated?'"

On the other hand, the emphasis on women can cause people to lose sight of the fact that both sexes contract and spread HPV. "By including men, you take HPV away from being a woman's condition and reinforce the idea that it is human papillomavirus, that it affects both sexes equally," Wyand said.

People should keep two things in mind when thinking about HPV and its vaccine, he said.

The first is that there is nothing wrong or shameful about having HPV.

"It's something that most every sexually active person will have," Wyand said. "It's just something that happens by doing what human beings are normally meant to do. By age 50, about 80 percent of women are estimated to have or have had an HPV infection."

In fact, the vast majority of HPV infections never show symptoms and heal on their own. "Their immune systems work behind the scenes to clear it up, and they never know they've had it," Wyand said.

The second is a point that's more subject to debate. Even though some people say condoms are not effective in preventing the spread of HPV, which is transmitted skin-to-skin, Wyand said that studies have shown that condoms are worth using.

"Condoms have been shown to work in lowering the risk of acquiring HPV," he said. "They aren't perfect, but they are pretty effective. One study showed condom use reduced risk by 70 percent. They shouldn't be dismissed because they aren't 100 percent effective."

More information

A companion article offers a broader look at the issue of HPV in men.

Posted: September 2011

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