Monday, 5 May 2008

Your daughter will probably have sex one day, kindly deal with it

Human papilloma virus (HPV) is a leading cause of cervical cancer, and can also cause other types of woman-only cancers (vulvar, vaginal), a male-only cancer (penile), and several non-gender specific cancers (anus, oropharyngeal [mouth and throat]). Rates of cervical cancer have fallen dramatically in NZ in recent years, due to the screening programme, 180 women a year are diagnosed with the disease and around 60 die of it annually.

HPV is present in up to two thirds of women, three years after they become sexually active, regardless of the number of sexual partners they have had. It is quite simply rife in the general population, men and women. While condom use can reduce the likelihood of transmission it cannot completely protect anyone, as it can also be caught through other forms of sexual contact than straight forward genital-genital.

It's important to remember that this is not just about the 60 who don't make it each year, this is also about those who survive, and the invasive medical procedures they have to undergo. Further, cervical cancer rates are expected to increase fourfold worldwide by 2020. Treatment for cancer is not pleasant, and not cheap, and if we could diminish the need for treatment, by preventing cancers from developing in the first place, then surely that is a good thing? Here we have an opportunity to make a big difference to a large number of people - not just the women who will not develop cervical cancer as a result of the vaccine, but also their families. And if we are spending less on treating cervical cancer then that frees up more of the health budget for other matters.

Yet some are opposing the vaccine on the grounds that HPV infections could be eliminated if we stopped the "liberal promotion of promiscuity as a valid lifestyle" (as I saw one particularly vile blogger put it.) Family First is also of this view, absurdly comparing vaccinating a 12 year old girl against an infection that could kill her with giving her a condom "just in case". Hmm, the Catholics don't seem to see any link between the vaccine and promoting loose sexual morals, and aren't they supposed to be the Christians who are most uptight about these matters?

Others are agin any immunisation at all, which always seems to me to be a viewpoint they are able to take only because most of us do get jabbed. I don't think immunisations should be compulsory and I respect their right to choose, for themselves and their children. But in general I will be getting Wriggly poked with any vaccine I am satisfied is safe.

A few are opposing the vaccine because there is no plan to vaccinate men for prostate cancer. Sadly there is no vaccine for prostate cancer. If there was I would definitely be thumping the table to get it rolled out (even if it was based on preventing an infection spread by sexual contact!).

Ultimately I think a lot of the opposition to HPV is because it is going to be given to pre-teen girls and many people don't want to face the fact that their daughters are going to be sexually active one day. Vaccines are given to children because their immune systems are in the best condition to respond in a manner than confers immunity for the longest possible period. In the case of HPV it needs to be given prior to the beginning of sexual activity, even non-penetrative touching and petting. How would you feel if your daughter developed cervical cancer later in life because you couldn't deal with the fact she was going to have sex one day?


Anna said...

It bothers me that some parents believe that keeping children ignorant about sexuality somehow safeguards them - and that any discussion promotes sex. That's led to so many shocking outcomes for women and men alike. And it's not as if HPV can't be passed on within the confines of traditional marriage, after all. I understand that sex-talks can be difficult, but coming to terms with cancer or infertility isn't a barrel of laughs either as you point out. Besides, a candid talk about genital warts doesn't exactly get most people in the mood. It's funny - AIDS came to prominence when I was was 11 or 12, and the public health campaigns about condom use really stuck with me into adulthood. The whole HPV vaccination would be better viewed as a chance to teach children than as an encouragement to underage sex. Good on ya Julie!

Anonymous said...

"... - and that any discussion promotes sex..."

Quite! Clearly worried parents should be trying to ban conversation before marriage :)

Great site, look forward to reading more of your interesting articles and comments.

- Luke

Julie said...

Thanks A and Luke. I just find it so frustrating that the debate about the HPV vaccine is centred around sexual mores, when actually this is a health issue.

Anonymous said...

Great post.

Regarding your comment on The Standard. Yeah, probably not many of the commentors on that post could develop cervical cancer, and it is an issue we concerned about. We would love to get more women involved commenting and reading (several of our writers are women) but we're fighting against the fact that both politics and the internet are traditionally male-dominated spheres. If you've any advice, I'd be glad to hear it.

Steve Pierson

Anonymous said...

Julie- excellent as always, I wanted to say something very similar while my computer was dead and I get back and find you've covered the important stuff better than I could. :)

Anna- I'm completely with you, in fact I'm rather aghast at the idea that some parents seem to think they can hold off talking about sex with their children until an age where they're becoming independent of their parents and sexually informed/active, and thus have two new motivations not to listen to their parents. I'd imagine it must be... intimidating to have that kind of talk, but surely you talk to kids about road safety before you first take them out when they can walk independently? The same principle would seem to apply here.

Besides, with some good third-party information on the seriousness of the consequences of sex, you can probably scare them off making the decision lightly. I know it worked on me! ;)

And you're right, Anna- HPV can be transmitted vertically from mother to child, meaning that even if a couple are both virgins when they meet and only have sex with each other, one of them could infect the other. Not to mention that odds are good any given person you have sex with will already have HPV if they've ever been sexually active before, so any woman who sleeps with a man who's ever had another partner is potentially doubling her risk of cancer without this vaccine. Even if you believe that casual sex is deeply wrong, I think you still have very good reasons to support this vaccine, as there is probably a heterosexual girl you care about somewhere in your life, maybe a daughter, a niece, a cousin, or a friend- and I doubt you'd want her to double her risk of cancer just by getting into a relationship with a man who's broken up with a previous partner.

Steve- just being open to female perspectives on your writing and treating them seriously is the biggest step to make, in my own experience, and it sounds like you've done that already. :) Post more issues that are pertinent to women, (which is not the same as posting more issues that men aren't interested in) and you'll be read by more women.

Anonymous said...

You know, on second thoughts, lesbians are at risk too. Duh. I'm apparently not on the top of my game today.

Julie said...

@Steve - didn't mean my comment as a criticism of The Standard, at all, more as a barb at some of your trollish commenters who were pissing me off in that thread ;-) Will shift The Standard to the women's part of our blogroll, I wasn't sure if you had any XXers on board, glad to hear you do!

In general, I think it's important to note that HPV is not just spread by penetrative sex, it is also spread by other forms of sexual contact that involve touching the genitals, even with the hands or mouth. I would say that it would be a pretty rare 20 year old who hasn't engaged in that kind of activity, even if they are a virgin.

Thanks for the feedback on this post folks.

Lyn said...

Further to Steve and Ari's comments re the standard and attracting more women commenters - writing about issues that are pertinent to women is a good one but two other things spring to mind - try to get more women you know to start commenting and be open about being female while doing so. I reckon women don't often want to engage in flame-wars (I don't mind it but it can get really reductive) so if you get more women commenting you might be able to break up the commenting behaviour that is currently exhibited and allow different commenting behaviours to grow which are maybe less confronting/a waste of time for women. This will necessarily change the flavour of the standard and may alienate some readers. The other thing to do is to make it more obvious that women are writing on the blog. In my experience we tend to assume someone is male unless they identify otherwise. I speculate that women will feel more included as readers and writers if they know there are women writing for the standard, and the rest of what you want may in fact roll out from there. I did a few posts about the gendering of the net which might be of interest: