While doing research for a new project, I was doing some reading about sexually transmitted infections and came across a couple of interesting articles about the HPV vaccine and Planned Parenthood. The article on the HPV vaccine deals with the concern over the vaccination increasing the sexual activity of young women. And the article on Planned Parenthood surrounds the controversy over whether or not the organization would remain part of the state-run Women’s Health Program in Texas. My interest in these articles stems from my research in the gendered aspects of healthcare, particularly in relation to sexual transmitted infections. Also, I am originally from Texas and I think it is inane to restrict access to affordable healthcare resources. So, in thinking about women’s access to healthcare, I decided to write about how important I believe it is for information, testing, and treatment of health issues to be available and accessible to everyone, regardless of income and insurance status because it actually affects more than just a single individual.HPV (Human papillomavirus) was first discovered in the 1950s. In 1972 a Polish physician, Stefania Ginsburg-Jabłońska, discovered there was a connection between HPV and skin cancer. In 1976 Harald zur Hausen, a German scientist and virologist, published his famous hypothesis on HPV. In his hypothesis, he explored the association of HPV with cervical cancer. He later went on to prove the authenticity of this hypothesis when he and his team discovered two strains of the virus, HPV16 and HPV18, and showed that these strains were the cause of cervical cancer—he won the Nobel Prize for his work in 2008.
One of the reasons that HPV interests me is because of the relatively low-impact, under-the-radarness (yes, I just made that word up) of the infection. I am wondering why that is. Is it because it doesn’t have the centuries-old roots of that old “social disease” syphilis? If this is the case, it could be a good thing that it was discovered relatively recently—no “cures” and “treatments” involving cloth-soaked wine, shavings of guaiac, flakes of copper, mercury, red coral, or burnt horn of deer. Is it because it doesn’t have the highly-public deadly association that goes along with HIV?
The fact is that HPV is the most common sexually transmitted infection. There is no cure and there is no treatment for the virus itself. There are more than 100 types of HPV and about 40 of those that can be transmitted through sexual contact. These can also infect the mouth and throat. A scary factor of HPV is that many people who become infected with HPV do not even know they have it because they don’t develop symptoms from it. The good news is that in the majority of cases (up to 90%), the body’s immune system clears out the infection within two years.
However, sometimes the infection is not cleared and can cause serious complications. These include genital warts, and in rare instances, warts in the throat (recurrent respiratory papillomatosis). In addition, HPV can lead to cervical cancer—the second most common cancer in women—as well as other, less common, but serious cancers, including cancers of the vulva, vagina, penis, anus, and oropharynx. Each year, about 12,000 women get cervical cancer in the United States. Almost all of these cancers are HPV-associated.  In rare cases, a pregnant woman with genital HPV can pass it to her baby during delivery. In these cases, the child can develop Recurrent Respiratory Papillomatosis (RRP).
What’s more, recent studies have shown that the virus can also cause head and neck cancers. Dr. Aimee R. Kreimer, of the National Cancer Institute, estimates that of the roughly 8,000 cancers of the oropharynx (tonsils and base of the tongue) seen in the United States in 2010, 65 percent were from HPV infection. Eighty percent of these are in men. The rates for HPV-associated cancers are rising (while rates are decreasing for sites like the mouth and larynx that are associated with tobacco and alcohol). In a 2009 article in The Journal of Infectious Diseases, Kreimer cites that while it has been theorized that oral infections are likely the result of oral-genital contact, there are current studies that confirm and expand on that theory by demonstrating that, not only are oral sexual behaviors important, but more common behaviors, such as kissing, may also transmit HPV infection to the oral region. Scary, right?
So, how to prevent HPV? Again, the good news is that two vaccines have been developed for women and one for men. For women, Gardasil and Cervarix have been recommended by the CDC and been proven effective against diseases caused by HPV types 16 and 18. These are the two types which cause most cervical cancers, as well as other HPV associated cancers. Gardasil also protects against most genital warts, as well as some cancers of the vulva, vagina and anus. For men, the CDC recommends Gardasil as well. However, for both women and men, the recommendations are for these vaccinations to be given between the ages of eleven and twenty-six, and are most effective when administered before first sexual contact.
The vaccine has not been without controversy. Aside from the “to vaccinate” or “not to vaccinate” debate, there arose a clamor from some about whether or not this was yet another free ticket for women to expand their promiscuous repertoire–because yes, the concern here was focused on the increased promiscuity of young women. So much so that a study was conducted to disprove this notion. After all, remember what happened when women emerged from the “private sphere,” shortened their skirts, frequented dance halls, and got access to The Pill?
What about those who haven’t been vaccinated or who are already infected? For those who choose to be sexually active, it is crucial to have accurate information. It is also important to know your sexual partners and to be honest with them. According to the CDC, condoms may lower the risk of HPV infection. To be most effective, they should be used with every sex act—from start to finish. Condoms may also lower the risk of developing HPV-related diseases, such as genital warts and cervical cancer. But HPV can infect areas that are not covered by a condom – so condoms may not fully protect against HPV (remember the “kissing study”?) The CDC recommends limiting the number of sex partners and choosing a partner who has had no or few prior sex partners. However, even people with only one lifetime sex partner can get HPV. And of course, when in doubt, the only sure way to prevent HPV is to avoid all sexual activity.
Have you been waiting for the tie-in between HPV and Planned Parenthood? Well, here it is. HPV rates are continuing to rise and it is a serious problem. It is imperative not only to test for the disease, but to also provide information about the causes and prevention of spreading it. It is also important to know the possible consequences of contracting it. This is where Planned Parenthood comes in. I’m not going to get into the controversial abortion issue involved with Planned Parenthood. First, I just don’t have enough allotted space here, and second and most important to my point, Planned Parenthood offers so many much-needed health services. These services include STI information, testing, monitoring, and treatment. As I stated earlier, HPV is the most common sexually transmitted infection, and this comes from the statistics of known cases. Some people may not even know they have it OR they may know something is wrong, but may not have the resources to be tested. Planned Parenthood offers these tests, and the threat of the loss of funding could have real consequences and that is something that everyone should be concerned about.
In addition to STI testing, Planned Parenthood offers important information on sexual and reproductive health. This information is essential in the prevention of STIs and the promotion of safe sex. And while sex education ideally should be provided by parents, many young people simply don’t have that option— perhaps because of the reluctance of kids or parents to discuss such delicate matters or because the home environment just isn’t a safe one for this discussion. Resources such as Planned Parenthood provide a site for information about sexual and reproductive health that is important for individuals. This, in turn, serves the health of society as a whole. Planned Parenthood provides testing, monitoring, treatment, and referrals for sexually transmitted infections—including HPV. They also provide information on preventing the spread of the infection, as well as prophylactics. Like the CDC, Planned Parenthood also recommends using condoms every time engaging in sexual activity. However, condoms are not as effective against HPV as they are against other infections such as chlamydia and HIV. In addition to condoms, Planned Parenthood also recommends using Sheer Glyde dams, dental dams, or plastic wrap during oral sex to further reduce the risk.
Cutting the funding and access for such a valuable resource is an important issue for everyone. It would be detrimental in the delivery of essential health care services. When states like Texas attempt to restrict access to these resources it has implications beyond individuals. While access to affordable healthcare services, such as those provided by Planned Parenthood, enhances the health of individuals, it also improves the overall health of the population. This should be a goal that we are all striving to achieve. In addition, information about sexually transmitted diseases and birth control, along with affordable access to contraception, is an important step in the prevention of STIs and unwanted pregnancies. In the debate surrounding Planned Parenthood, these valuable health services should be seriously considered. So, pro-life? Pro-choice? How about pro-prevention? Or how about pro-health?
 “Human Papilloma Viruses (HPV)-Causative Agent of Cervical Cancer.” http://explorable.com/human-papilloma-viruses.html
 Deborah Hayden, Pox: Genius, Madness, and the Mysteries of Syphilis (New York: Basic Books, 2003).
 Aimée R. Kreimer, “Oral Sexual Behaviors and the Prevalence of Oral Human Papillomavirus,” The Journal of Infectious Diseases 199 (May 2009): 1253-1254.