Question:
I was doing some reading on your site, regarding HPV. I was doing the reading, because, it has come to my attention, that my son had sex with a woman, who has told me she definately has HPV, and it is one of the ones, that can cause cervical cancer. Her pap test revealed this, and she is under a doctors care for the cervical cancer. My questions to you are: should I inform my son? SHould he be concerned that he has had sex with someone who definately has HPV, and she is also being treated for cervical cancer, that she got from HPV? Can he give this (cancer causing type) virus to his present girlfriend? AM i correct, in assumming, that over time this HPV will clear itself up (if it is not one of the kinds that causes cervical cancer)? If he passes this HPV along to his girlfriend, what are the chances she will get the cervical cancer? Should he be speaking to his girlfriend about this, and make sure she gets a regular pap test for it? I believe he had sex with the HPV infected women, up to a year ago. I think if he had symptoms, (warts etc) he would have seen a doctor, and had them treated. I am concerned, that he may have picked up the HPV, and given it to his present girlfriend, and the HPV he gave her, has caused cervical cancer in a women he previously slept with! Please help! I would appreciate some help on what advice I should give my son! thank you!

(Read my answer after the jump)

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This particular sex education PSA comes to us from Belgium. Check it out:

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Last night I learned that the HPV vaccine, Gardasil, was now being required of girls and women in order for them to be legal permanent residents of the United States. At the time, it was unclear to me who (as in, what age) the vaccine was being required for - it turns out, according to government documents, that the vaccine is being required of girls and women ages 11 through 26. I cannot believe that they are mandating this for CHILDREN - this has been a huge controversy in the United States for girls who are citizens (parent groups, conservative organizations, religious groups and feminist groups protested when states tried to mandate the vaccine to young girls in the US) - but now people immigrating into the US are being required to get this vaccine?

From what I am reading on health-related listservs today, several groups are planning to protest this requirement. Stay tuned.

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I find this hard to believe - that the US Citizen and Immigration Services (USCIS) is now requiring women to get the three-dose (and roughly $160) Gardasil vaccine that protects against 4 strains of HPV before they can become legal permanent residents of the US. This is an expensive vaccine! It is also not recommended for all women. Are they requiring all women to get this? What ages? What health statuses?

I can’t find detailed information about this change in vaccine requirements anywhere, even though it is important to consider. Yes, it is true that the vaccine may prevent cervical cancer or genital warts among many women, but this is not a vaccine that is required of other American women. Should women who are in monogamous relationships with uninfected partners be made to get the HPV vaccine? What about women in whom it may be contraindicated?

Given the lack of data among men, this requirement change affects only women - men are not required to get it (men can’t really get it anyway). What about young girls - are they being made to get Gardasil, too? Is this another way to fund Merck (the manufacturer or Gardasil), as has been suggested in other cases (like in Texas) where mandatory vaccines for young girls were being considered? What do you all think about this?

Read the USCIS press release on their web site and reports of this change in requirements on Feministing or this blog.

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In a recent report, the CDC has emphasized something that has plagued many public health professionals since the HIV epidemic - the disproportionate distribution of HIV infection. As most know, in the beginning of the HIV epidemic, white gay men had disproportionately higher rates of infection. As the years have passed, the face has changed a bit, but not entirely. White gay men in their 30s and 40s are at particularly high risk for HIV infection, as are young black men and young black women. That doesn’t, of course, mean that other groups are not at risk - in fact, anyone could be at risk for infection depending on their sexual behavior or drug use behavior. You can learn more about the CDC report from CNN.com and more about testing and prevention directly from the CDC web site.

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According to this study, not so much - the researchers found that after being diagnosed with herpes simplex virus 2 (HSV2, which most commonly causes genital herpes rather than oral herpes/cold sores), people didn’t really change their sexual behaviors. Granted, one wouldn’t necessarily expect people to have sex less often, particularly with a steady relationship partner (though that’s one behavior the researchers looked at) and condom use didn’t seem to differ much either… then again, considering that condoms cannot completely prevent herpes transmission, that may influence people’s condom use decisions too. Here’s the abstract from this web site:

Do Protective Behaviors Follow the Experience of Testing Positive for Herpes Simplex Type 2?
Note 
Sexually Transmitted Diseases. 35(9):787-790, September 2008.
Crosby, Richard A. PhD *; Head, Sara MPH +; DiClemente, Ralph J. PhD +; Meyerson, Beth PhD ++; Troutman, Adewale MD [S]

Abstract:
Objective: To test the hypothesis that individuals attending a sexually transmitted disease (STD) clinic would adopt sexual protective behaviors after receiving a positive test for herpes simplex virus 2 (HSV-2). 

Methods: Recruitment (N = 360) occurred in a publicly funded STD clinic located in a metropolitan area of the southern United States. Participants were tested for HSV-2 using a rapid test manufactured by Biokit (Lexington, MA) and they completed a self-administered questionnaire before and 3 months after being tested for HSV-2. Follow-up questionnaires were completed by 256 participants (71.1%).

Results: Of those completing follow-up, 43.4% (n = 111) tested positive for HSV-2 at enrollment. Significant differences between participants testing positive and those testing negative (at baseline) for HSV-2 over the follow-up period were not observed for frequency of sex, frequency of condom use, avoiding sex, and number of sex partners. Controlling for statistically identified covariates did not alter the null findings for these between group analyses. When analyzing change (baseline to follow-up) among only those testing positive, significant differences were not found with the exception of reporting greater frequency of condom use with steady (P = 0.037) and nonsteady partners at follow-up (P = 0.017). However, repeated measures analyses yielded only 1 significant group x time interaction; this indicated a greater increase in condom use frequency with steady partners among persons testing negative compared with those testing positive. 

Conclusions: Among STD clinic attendees, diagnosis of HSV-2 was unrelated to the adoption of sexual behaviors protective against further acquisition and transmission of STDs. In the absence of education beyond posttest counseling, becoming aware of HSV-2 positive serostatus may not be sufficient to motivate the adoption of safer sex behaviors among this population.
(C) Copyright 2008 American Sexually Transmitted Diseases Association

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For the sake of context, it may be worth noting that Alaska historically is frequently ranked as one of the states (and sometimes THE state) with the highest rates of chlamydia infection and also typically has astronomical rates of sexual assault and rape. In addition, this state of 600,000+ tends to have substantial rates of health disparities, as do other states, that deserve attention and funding. Then again, it seems that Alaska does provide fairly good sexuality education in some places as well as access to family planning services, and they seem to have had a decline in teen pregnancies in recent years (source: Guttmacher Institute).

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Sometimes I think people don’t believe me when I tell them that they should consider getting tested for sexually transmissible infections (STI) such as chlamydia, gonorrhea, syphilis, and HIV even if they have never noticed any symptoms. Chlamydia, for example, is the most common bacterial STI in the country - and is particularly common among young women and men ages 15-24 - and yet many young women and men failt to get tested for it, even though it is one of the most "silent" STIs of them all (meaning, it often shows no noticeable symptoms at all).

In a recent study, researchers tested men who have sex with other men for chlamydia and gonorrhea, even though none of these men had any symptoms of either infection. Over a period of one month, 114 men were tested. Guess how many came back positive for at least one (if not both) of these two STIs, chlamydia and gonorrhea? ELEVEN PER CENT! (Yes, that’s a lot). 

If you are now or have in the past been sexually active with another person (oral sex, vaginal sex or anal sex), please consider getting tested for chlamydia and gonorrhea, as both of these infections - if left untreated - can cause problems with fertility. It’s part of being an adult, and part of being a sexually responsible person - plus, it shows care and kindness for your partner. Deciding to NOT get tested - even though you could be putting your partner at risk - is neither kind nor responsible. To learn more about STIs, testing and treatment, visit the CDC web site or Planned Parenthood, or talk to your healthcare provider. I have seen far too many students of mine, and clinic patients, test positive for infections that they never knew they had (and often that they then spread to a partner) so please take your health (and your partner’s health) seriously and with care.

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Oh, the conundrums of modern society. To wax or not to wax? What about health issues? Listen to my response to a question about this very topic of whether one can get chlamydia from a bikini wax on this recent Kinsey Confidential podcast.