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The HPV Vaccine Controversy: Sex, Cancer, God, and Politics: A Guide for Parents, Women, Men, and Teenagers Excerpt from The HPV Vaccine Controversy: Sex, Cancer, God, and Politics: A Guide for Parents, Women, Men, and Teenagers

by Dr. Shobha S. Krishnan

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All About HPV and Gardasil -- A College Girl's Guide
Article by Shobha S. Krishnan, M.D.,
Author of The HPV Vaccine Controversy

The introduction of the HPV vaccine, Gardasil, has been accompanied by healthy doses of both good and bad news. The good news is that the vaccine’s arrival has brought the virus into the spotlight by giving it the press it deserves. But the bad news is that myths and misconceptions about the virus and the vaccine abound, and these can and have caused considerable harm. For example, one prevalent myth is that promiscuity is the main reason why people get HPV infections. The fact is, it's possible to get an HPV infection even from a monogamous relationship. Here are some more common questions about HPV, the vaccine, and how they can affect teens' lives.

The Facts of HPV:

So what is HPV, really?

HPV is the human papilloma virus. It is the most common sexually transmitted virus. It isn't the same as HIV (Human Immunodeficiency Virus) or HSV (Herpes Simplex Virus), and it's not a new virus -- it's just often overlooked in discussions of common sexually transmitted diseases. There are more than a 100 types of HPV that can cause a variety of diseases, but we'll focus on its most significant manifestation -- genital HPV. Sexual contact is the most common way to transmit genital HPV, including not only sexual intercourse, but also sexual contact without intercourse and oral sex. HPV is a silent infection, meaning that many people are unaware that they are infected and can transmit the virus to their sexual partners without even knowing.

Who gets HPV?

Anyone can get HPV infections. It is estimated that at least 50 percent of sexually active men and women will acquire a genital HPV infection at some point in their lives. Most infections clear up on their own without any medical treatment in 12-24 months. People at the highest risk of getting HPV infections are those who engage in high-risk sexual behavior such as having multiple partners, having unprotected sex, and starting to have sex at an early age. Also, having a weak immune system due to poor nutrition, stress, and smoking can make existing HPV infections persist in the body for a longer period of time and cause HPV-related diseases.

Many of my patients have asked me if two people in a monogamous relationship can get HPV. The short answer is, unfortunately, yes. Even if you are currently in a monogamous relationship, you or your partner could have acquired HPV from a previous sexual relationship; the disease can lie dormant in the body for many years and can become active at any time. The only way to prevent HPV is for both partners in a monogamous relationship to have never had prior sexual partners or to abstain from sexual contact altogether.

What are the consequences of having HPV?

There are three possible results of HPV infection. First, it is possible to become a carrier of HPV and never show symptoms for the rest of your life. Second, you could develop genital warts, which are irritating, visually unpleasant, embarrassing, and often require repeated treatments to get rid of them. Third, you could develop a HPV related cancer, the most serious of which is cervical cancer. In addition, HPV can be a cause for tremendous emotional issues, such as feelings of guilt, blame and shame.

Should you get the vaccine?

There are now two vaccines available to prevent most HPV related diseases. Only one, Gardasil, is currently available in the United States. The vaccine is preventative in nature, meaning it can only prevent and not treat existing HPV infections. The vaccine protects against four different types of HPV, two of which cause 70% of cervical cancers, and the other two which cause most genital warts.

The CDC recommends the vaccine for girls at ages 11-12 years for maximum benefit. However, if you didn't receive the vaccine at this age, you can still get it up until the age of 26, even if you are sexually active. This is because even if you have already been exposed to some types of HPV, the vaccine will still prevent against any of the four types that you haven't. It is important to note that the vaccine does not prevent against pregnancy or other sexually transmitted diseases such as HIV/AIDS, Chlamydia or Gonorrhea. Therefore, it's crucial to continue to be abstinent or practice safer sex even after receiving the vaccine.

Should you get the Pap test?

A Pap test (also called a Pap smear) detects abnormal cell changes in the cervix, some of which if not treated, can progress to cancer. Therefore, once the abnormal changes are detected, they sometimes require close follow-ups and uncomfortable procedures. Pap tests, no doubt, have dramatically reduced the rates of cervical cancer in this country. But the vaccine, on the other hand, prevents these abnormal changes from occurring in the first place. Obviously, prevention is preferable to detection and treatment. But as the vaccine only protects against 70 percent of cervical cancer, it's important to keep getting Pap tests to detect the other 30 percent. Consult your health care provider to find out when you should start getting Pap tests.

What are the ways to prevent and fight HPV infections?

There are some basic tips to follow to keep healthy and avoid HPV infections.

Follow the "ABCDE" rules of prevention:
Abstinence, Being monogamous, Consistent condom use, Delayed sexual activity and Education.

Avoid drugs and excessive alcohol: These activities can lead to risky sexual behavior that make getting HPV more likely.

Get vaccinated: Getting the Gardasil vaccine before you become sexually active can protect you from HPV strains that cause 90% of genital warts and 70% of cervical cancers. If you are already sexually active and haven't been vaccinated, you should still consider getting vaccinated, as this can protect you from the vaccine strains that you may not have been exposed to.

Boost your immune system:

Quit smoking: Smoking weakens your immune system and makes HPV hang around longer in your body which can then cause disease.

Reduce stress: Look into techniques such as exercise that help you relax and make you feel good about yourself.

Add foods rich in Vitamins C and E such as fruits and vegetables that have cancer-fighting properties to your diet. In addition, it's a good idea to take a multivitamin daily.

HPV can be a potentially serious and chronic disease that can have tremendous medical, psychological and sexual consequences. It can turn your life upside down overnight. One chance encounter is all it takes to be potentially infected by the HPV virus. By seeking accurate information and taking productive steps, you can prevent the spread of HPV. Knowledge and education about HPV infections will help contain the spread of infection -- ignorance will not.

©2008 Shobha S. Krishnan, M.D.