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  • Lounette Els

Smiling is infectious…. So is HPV


Hello Mindful Connectors,


As part of my Masters dissertation, I have been conducting research on the Human Papilloma Virus (HPV) and the current vaccines that are available. I have also come to realise that most people I have discussed this topic with, do not generally know what HPV is, how it gets transmitted, what it does to the human body, or how important the vaccine is (insert anti-vaxxer eye-roll here). With such an abundance of information at our fingertips, as well as recent clinical trials and campaigns advocating for HPV vaccinations, is there any reason as to why individuals are left ill-informed about such a serious global health issue? And should we all be jumping on the HPV vaccine band-wagon?


Truth be told, I was not as aware of HPV when my mother stuck a needle in my arm a few years ago. Trusting my mother who knew what was best for me, I was just praying that I would not get some weird side-effect like becoming a HPV fighting super hero with the ability to destroy warts. But I am happy to say that I am HPV free and fully vaccinated! Not sure what this all means? Well, let me share my own research with you as to what I have found and what I would have liked to know, regardless of being vaccinated or not. We all know the saying knowledge is power so, the more you know, the better-informed decisions you will be able to make.



WHAT IS HPV?

HPV is a double-stranded, nonenveloped DNA virus that belongs to a group of over 150 viruses. About 79 million Americans - that’s about 24% of the US population - [JE1] are currently infected with HPV, making it the most common sexually transmitted infection among humans with 14 million new infections each year. Various strains of the virus have been found to infect the anogenital (cervix, vulva, vagina, penis, anus, rectum) and oropharyngeal tract of men and women, but only a high-risk subgroup of the virus is carcinogenic (meaning cancer-related). Other strains of the virus are known to cause “papillomas” - more commonly referred to as warts. Hence the name Human “papilloma” virus. You would think they would have considered naming it the Human Anal, Cervical, Head and Neck Cancer Virus for bigger emphasis? I mean, a wart virus seems mild compared to the possible havoc the carcinogenic strains may cause.


CERVICAL CANCER & HPV

Although HPV affects both men and women, my study focuses primarily on females. Here are some terrifying statistics. Over 275, 000 women lose their lives to cervical cancer each year with more than 500, 000 new diagnoses being reported annually on a global scale. Cervical cancer is the fourth most common cancer and the second biggest cause of cancer-related mortality in women worldwide. Reportedly, 70-80% of all HPV related cancers are found in the cervix and are solely caused by high-risk strains - HPV 16 and 18. Carcinomas can be detected through routine Pap Smears. But let’s be honest – we as women are the WORST at prioritising ourselves and actually going for a gynae visit each year. So once patients have been diagnosed, treatment options are available. However, the management of cervical carcinomas and lesions are costly. Therefore, prevention remains the most viable option to date as continued routine Pap smears within the private health sector of South Africa have resulted in a significant decline in cervical cancer diagnoses among women.


PREVENTION

HPV is the ONLY preventable sexually transmitted infection. It is transmitted through sexual contact. You can get HPV by having vaginal, anal, or oral sex with someone who is a carrier of the virus (mainly men). However, it is most commonly spread during vaginal or anal sex. The scariest bit about the virus is that it can lay dormant inside a person without that person showing any signs or symptoms of the virus. Symptoms can develop years after infection occurs, making people unaware and spreading the virus to multiple sexual partners. If that does not terrify you enough, new research has potentially found that HPV can be contracted using unsterilized gynaecological equipment (speculums) and through the use of public bathrooms. Last year, I was surprised to find out that pharmaceutical nurses provided Pap Smears to women. This is certainly not the ideal environment and I would strongly advise having a Pap Smear done by your trusted gynaecologist, or ensure that the disposable speculum is opened in front of you before the exam. With that being said, the aforementioned bathroom also needs to be extremely dirty and contain evidence of a sexual act for you to be able to contract HPV. Condoms are not looking so bad, now are they? More like a full-on bodysuit if you ask me.



HPV VACCINE

Currently, two prophylactic vaccines are commercially available which target the high-risk HPV strains. The immune responses of Gardasil (quadrivalent) and Cervarix (bivalent) are reported to be the most effective when administered before an individual’s sexual debut. The vaccine was first introduced and licensed across many overseas countries in 2006. Subsequently, most countries recommend the vaccine to be taken up by girls between the ages of 11 and 14. Gardasil and Cervarix are registered vaccines in South Africa and have been available within the private sector since 2008. Moreover, the national HPV vaccine campaign that was launched in the South African public-school systems of April 2014, reported that of the 353,000 girls (age 9 and above) that were vaccinated, only 10 cases of mild to minor side effects were reported. These included abdominal pain, nausea, fever, rash and dizziness - NO DEATHS. Yet, despite the continued success rate and safety of administering the HPV vaccine within the private sector, uptake rates remain poor among most developing countries.


VACCINE RESISTANCE AND HESITANCY

Vaccine hesitancy can be defined as the refusal or delayed acceptance of a vaccine, despite its availability. Vaccine confidence among parents are likely to decrease due to beliefs that the vaccine can cause harm to their children, is costly, and is not easily accessible. In the United States, 30% of parents reported that they were unwilling to vaccinate their daughters against HPV due to concerns about safety and efficacy. Moreover, studies have reported that mothers are less willing to vaccinate their daughters against HPV as it will increase promiscuity and sexual risk-taking. To date, no correlation exists between sexual risk-taking and adolescent vaccination. The reality that exists is the possibility of saving your daughter’s life instead of hopefully preventing the possibility of her having sex. Because guess what? If a young person decides to have sex… they are likely going to have sex - vaccinated or not. The best we can do as parents and healthcare professionals is to be the best source of credible information for children to make knowledgeable decisions. And for parents to know the good… and the bad - in order to make informed decisions about the welfare of their children.


From what I have researched, these are the facts:

  • A person infected with HPV may not know it.

  • Anyone who is sexually active can get HPV, even if you have had sex with only one person. Then there is also unsterilized speculums and dodgy bathrooms (sies!).

  • HPV 16 and 18 is the main cause of cervical cancer in women.

  • Cancer often takes years, even decades, to develop after a person contracts HPV. Without regular screening, the diagnosis is often fatal.

  • There is no swab or blood test to find out a person’s “HPV status.” A person may not know they have HPV until they get genital warts or receive an abnormal Pap Smear.

  • HPV is preventable through vaccination, you can ask your healthcare provider next time you visit.

  • The use of latex condoms can lower your chances of getting HPV. However, HPV can infect areas not covered by a condom (e.g. oral sex). Thus, condoms do not guarantee full protection from HPV. Unless you want to go full latex and avoid skin to skin contact completely.

  • The most optimum age to receive the vaccination is during adolescence (10-19 years of age) as most individuals in their late teens and early twenties will reportedly contract the virus.

  • Two vaccines are available in South Africa and can be prescribed by your gynaecologist.

  • The vaccines are safe and effective, the data suggest minor to mild side effects.

  • Due to the sexual nature of HPV, the disease is mainly surrounded by stigma. I would personally choose to be vaccinated over genital warts and cancer any day.


And so, while Mindful Connections speaks mostly to fun and pleasure it’s also about being mindful about your sexual health! So, lets feel free to explore our sexuality and educate ourselves around living full, healthy sexual lives. But most importantly, let’s be responsible about it.



Happy connecting!

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