Here’s what you need to know about preventing and managing human papillomavirus
One of the many things the pandemic has taught people is risk assessment. Whether it’s crowds to hang out with friends or going home for the holidays, people are more aware of the risk these activities pose in the context of COVID-19.
The same mindset applies to sex and the risk of sexually transmitted infections (STIs), especially as restrictions are lifted — just in time for Valentine’s Day. One such sexually transmitted disease that you should know about is Human Papilloma Virus or HPV.
HPV is one of the most common STIs in Canada. It’s so common that three out of four sexually active adults will contract it at least once in their lives. In addition to being transmitted during oral, vaginal, and anal sex, it can also be transmitted without penetration through skin-to-skin genital contact and through the sharing of sex toys. HPV can also be transmitted when a barrier, such as a B. a condom, does not cover the entire area.
There are two main types of HPV infection to look out for: low-risk and high-risk infections. Low-risk HPV doesn’t cause long-term problems for the body, and the immune system can deal with eliminating it.
“Most people don’t even know they have it [low-risk HPV]said Jennifer Gibson, the community education services coordinator at Island Sexual Health. “It clears up within 24 months. If it shows genital warts we can treat the symptoms with things like liquid nitrogen or topical creams, but we don’t have to, it’s a choice. People can literally live with the symptoms and the body is still doing the work on the virus.” When HPV shows symptoms, they are genital warts.
Gibson also clarified that in her 18-year association with Island Sexual Health, the majority of people who find out they have an infection are completely surprised by the news because they have very few, if any, symptoms of an STI . They also never identified themselves as someone at risk of infection.
On the other hand, high-risk HPV can cause cervical, throat, vaginal, penile, and anal cancers if and only if left alone for long periods of time. Although HPV can cause cancer, this is a worst-case scenario, and despite the daunting cancer threat, HPV on its own is treatable and manageable.
To avoid the worst-case scenario, there are several strategies a person can employ. One of them is regular performances.
For people with a cervix, the recommended screening for HPV and cervical cancer is a Pap test. It is recommended that regular Pap exams begin when a person becomes sexually active or turns 25. The Pap test is repeated every three years. If you’re sexually active, it’s probably a good idea to get tested regularly.
If anything is discovered during the Pap exam, regular screenings are escalated to a six-month schedule to monitor the irregularity and see if it improves on its own. A high percentage of people will have normal cells again after six months. There are occasionally people where it progresses much faster, but this is where the increased screening schedule comes in. When people get cervical cancer, the majority of them haven’t had a Pap exam in more than a decade. It’s important to note that the Pap exam doesn’t cover all STIs.
For people without a cervix, there is no direct equivalent of a Pap exam for HPV testing. There are anal swabs for people who engage in anal sex, but nothing quite like a penile swab. In these cases, self-monitoring of your body is a very important preventive step. In this case, it’s important to get in the habit of getting tested regularly for STIs and HPV.
How regular is regular? That is very person dependent. Gibson says factors can include relationship status and practices. When someone becomes sexually active, about three months after having sex for the first time is a good time to get screened. And that depends on the needs of the individual person, which can be one every year or several times a year. For example, if someone has many sexual partners, Gibson says it’s good practice to get screened about every three months to keep track. If someone is in a long-term relationship with the same partner or partners, this may be once a year.
If you get tested, be sure to tell your doctor which body parts you use for sex. And always remember to ask your doctor, “What am I going to be tested for today?” Never assume you’ll be screened for every STI.
In addition to regular screening, two HPV vaccines are currently available in Canada. The first is Gardasil 4/HPV4. It protects against four types of HPV: HPV 6, 11, 16 and 18. The HPV4 vaccine consists of a series of three injections given at zero, two and six months. HPV 16 and 18 cause most cases of cervical and anal cancer and cause 90 percent of genital warts.
The second vaccine is Gardasil 9/HPV9. It protects against HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58. These nine HPV types are known to cause about 90 percent of cervical cancers, 80 percent of pre-cervical cancers, 75 percent of HPV related vulva, vaginal and anal cancer and precancerous lesions as well as over 90 percent of genital warts.
While the vaccine is preventative, it doesn’t eliminate the need for future screening, so continue to get screened and practice safe sex in addition to getting vaccinated. Getting vaccinated reduces a person’s risk of developing cervical cancer by 87 percent.
If you haven’t been vaccinated and have been exposed to HPV, the vaccine doesn’t provide a treatment, but it does provide prevention for what you haven’t been exposed to.
Despite being such a necessary vaccine, it is not free for everyone. All provinces and territories have publicly funded, school-based HPV vaccination programs for girls, and most have them for boys ages 9 to 13 (grades 4 to 8). The HPV9 vaccine is also available free of charge for HIV-positive people (9-26), transgender people (9-26), men (9-26) who have had sex with other men, men (9-26) who are not sexually active but question their sexuality or are out on the streets.
If you don’t belong to these groups, you can purchase the vaccine at a pharmacy, public health center, or travel clinic, but note that they can cost up to $500. Some of the cost may be covered by your health insurance plan, so be sure to check your coverage.
“What we’re basically doing is harm reduction strategies,” Gibson said. “There’s always going to be some level of risk, and with it knowledge, and our knowledge of HPV — low risk, high risk, how it’s transmitted, how we manage it, how we prevent it — is really key to understanding situations and yours Assess well-being.”
HPV is not a life sentence. It’s manageable. Just because someone is infected with HPV doesn’t mean it will progress to cancer, and it doesn’t mean the person has “failed.”
“[Viruses] are sneaky, tricky, dodgy!” said Gibson. “They just know where to go and how to get there and will do whatever they can.”
Gibson realizes that sexuality is more than just sex. It is an ever-changing experience that contains duality, diversity and so much more. People deserve to be healthy while exploring this part of themselves. It comes down to knowledge and risk assessment.