HPV and Men: What You Might Not Know About Prevention


On the last weekend of June, I volunteered with Planned Parenthood of the St. Louis Region and Southwest Missouri for a three-hour shift at their booth at Pridefest.  Pridefest is the annual two-day outdoor festival celebrating the lesbian, gay, bisexual and transgender (LGBT) community.  I’ve volunteered with Planned Parenthood at Pridefest before and have always enjoyed the positive reception, but this year was different.  Because this year the Planned Parenthood booth included a large banner announcing the availability of the HPV vaccine for males between the ages of 9 and 26 years old, prompting a lot of interest and questions.

It is important to note that the human papillomavirus (HPV) does not discriminate – people are at risk regardless of their sexual orientation or gender identity.  There are also many forms of the virus, some of which are linked to cancers and others of which are not.

For men, HPV infection can increase the risk of genital cancers and/or cause genital warts.  It is estimated that more than half of sexually active men in the United States will have some form of HPV at some point during their lifetime. Although men will often clear HPV from their system with no health problems, it is important to understand the health risks associated with the virus.

Some types of HPV in men can lead to cancer of the anus or penis, although these types of cancer are rare in men with a healthy immune system.  Other types of the HPV virus cause genital warts. It is estimated that about one percent of sexually active men in the United States have genital warts at any given time.  The types of HPV that may cause cancers rarely present symptoms, but genital warts are a symptom of the type of HPV that causes warts but not cancer. 

Genital warts are usually diagnosed through a visual exam.  There currently is no routine test for men the types of HPV that cause cancers, although some doctors recommend anal PAP tests for gay and bisexual men who are at higher risk for anal cancer caused by HPV.  HPV may lay dormant in the human body for years without presenting any symptoms.

Condoms protect against transmission of HPV, but they are not 100 percent effective because HPV is primarily transmitted skin-to-skin.  Abstinence is the only sure way to prevent transmission of HPV. 

Planned Parenthood of the St. Louis Region and Southwest Missouri, and Planned Parenthood health care centers across the United States, now offer HPV vaccinations to males ages 9 to 26.  Planned Parenthood also offers HPV vaccines for girls beginning at 11 or 12 years old.  The three-shot regimen protects against strains of HPV and is most effective when started before sexual activity and before exposure to the HPV virus.  A Patient Assistance Program from Gardasil manufacturer Merck allows for health care centers to provide the vaccine at an affordable cost. Gardasil can protect against four types of HPV that cause warts.

Many of the young men who visited the Planned Parenthood booth at Pridefest in St. Louis said that they were interested in the vaccine to protect their future sexual partners as well as themselves.  The risk of transmission of HPV does not miraculously disappear when a person gets married or enters into a committed relationship.  Some of the men had questions about getting the vaccine even though they are over the age of 26 – all people should consult a trusted health care provider like Planned Parenthood to find information about testing, treatment and the HPV vaccine.

Throughout my volunteer shift at the Planned Parenthood booth at Pridefest 2010, I met people who wanted medically accurate information about HPV and the HPV vaccine.  A lot of folks said that they didn’t know that the HPV vaccine has been approved for males and I was grateful to be part of informing the public about an important health care opportunity.  I was impressed that so many parents came by the booth and were interested in getting more information about how the HPV vaccine could protect their sons and daughters and I was encouraged by the number of young men who visited the booth – gay, straight and bi-sexual – that were interested in taking proactive steps to protect themselves and their partners.  Knowledge is power – for more information about the HPV vaccine visit Planned Parenthood online.

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  • nycprochoicemd

    Yes, it’s good that the HPV vaccine has been approved for men by the FDA.  But remember that for FDA approval the company need only prove that the drug (in this case, the HPV vaccine) is safe and effective.  It does not need to prove that it’s cost effective or even that the majority of people using it will benefit.  The only thing the HPV vaccine has been proven to decrease in men is genital warts.  Those treated had a 0.2% (2 in 1000) chance of developing genital warts in the study period.  Those not given the vaccine had a 1.9% chance of developing genital warts in the study period.  It sounds pretty good, but shows us first of all that it is not 100% effective, and second of all that most young men will not get genital warts, so for them they’ll have spent on the order of $375 (plus the cost of administration fees and physician visit fees, which can get you over $1000) for no benefit.  It doesn’t mean we shouldn’t vaccinate, but when we have people dying because they can’t afford medications and women forgoing prenatal care due to cost we need to think about how to spend our health care dollar. (there is limited evidence that it may decrease the risk of certain kinds of anal cancer in men who have sex with men, but the jury is still out on that)

     

    You are careful to point out that the only thing the vaccine is approved for, and has proven to do, is decreased incidence of genital warts.  Many people are overselling the vaccine for men.  Although HPV appears to be the culprit behind many oral, anal, and genital cancers, we just don’t know if the vaccine will prevent it.  We will know years from now, and at that time we’ll be able to make an informed decision.  For now, I’m recommending it to men who have sex with men.

    For those interested, the CDC statement follows.

    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5920a5.htm?s_cid=mm5920a5_e

  • nycprochoicemd

    double post

  • halli620

    NYCprochoice, a very large part of the need to vaccinate men against HPV is so that they will not be carriers spreading it to women. Even if there were no proven benefits to the men themselves (which is not true, as even you indicate that there are small benefits), there are no risks, and the purpose of reducing transmission to the vulnerable population (in this case, women) is an extremely important reason for vaccination. 

  • halli620

    NYCprochoice, a very large part of the need to vaccinate men against HPV is so that they will not be carriers spreading it to women. Even if there were no proven benefits to the men themselves (which is not true, as even you indicate that there are small benefits), there are no risks, and the purpose of reducing transmission to the vulnerable population (in this case, women) is an extremely important reason for vaccination.