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Thursday, July 6, 2006

On HPV & Gay Men

Posted by on July 6 at 10:51 AM

My vignette on HPV (and rock-star epidemiologist Dr. Laura Koutsky) focuses, like most of the recent press on the new vaccine, on women and girls. That’s because HPV infection is clearly linked with cervical cancer in women, and guys generally have an easier time of it.

But I know a lot of gay men are curious about the vaccine, too. HPV has been also been linked with (much rarer) anal and penile cancers in men. Gay and bisexual men, moreover, have a 17% higher rate of anal cancer than do heterosexuals. The rates are still very low, but they’re worrisome.

The new Merck vaccine is currently being tested on men and boys, for the same age range that it was confirmed safe and effective in women and girls (9-26). Eventually the company hopes to market the vaccine to the same target range of prepubescents (11 and 12-year-old boys). In men, it’s hoped that the vaccine would, as in women, prevent two common strains of HPV responsible for 80-90% of all cases of genital warts. In addition, vaccinated men would be less likely to pass the cervical cancer-related strains of the virus onto their female sex parters, and (hopefully) would develop anal and penile cancers at lower rates themselves. (A rival vaccine, currently being tested by GlaxoKlineSmith, only protects against the cervical-cancer strains and won’t be available to guys.)

So for people who are older than 26, the obvious question is, why isn’t the HPV vaccine recommended for us? Sadly, the answer seems to be, the older you get, the more likely you are to have already contracted one or more of the strains of HPV that the vaccine is meant to protect against. Getting kids early means they probably haven’t started having sex yet.

More questions? Here’s the CDC’s Q&A page. I can also try to tackle other stuff—or at least pass on the questions to the experts.

CommentsRSS icon

From a medical perspective, it should be mandatory for all grade 6 girls (since the proportion sexually active increases mostly after grade 6), and probably for all grade 9 boys (since it's hard to require of grade 6 boys, as it has a much lower personal risk factor, but a much higher societal risk factor).

I anticipate we'll see a move to make it mandatory for at least grade 9 girls in our state, then once that's been in place for a few years, they'll slip it to the grade 6 girls level and implement a grade 9 boys level mandatory requirement, with a recommendation that grade 6 boys get it earlier than grade 9.

Sorry, just looking it from a medical perspective.

Are you aware of the recent grant by the Gates Foundation to do research on HPV? The grant specified that there be immunization AND cure for those already infected as the goal of the funded research. I think there is, at least, some cause for hope for the older and infected inviduals.

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