The sexually transmitted human papillomavirus virus may be a taboo topic, but it is increasingly an issue for everyone. The Centers for Disease Control considers HPV to be the most common sexually transmitted sexual infection in the United States.

In fact, the disease is so prevalent that nearly every single sexually active male and female will be infected by it at one point in their lives. The CDC estimates that 79 million Americans have it with another 14 million newly infected individuals being reported annually.

Estimates also show that more than 80 percent of sexually active women will have been infected by HPV by age 50. Cervical cancer rates show steady increases, too, with 11,070 new cases and 3,870 deaths annually.

Other calculations shared by the Gardasil website — Gardisal is the only HPV vaccine available on the market — estimates that 33 women are diagnosed daily with cervical cancer. Most importantly, it has been determined that nearly 100 percent of the cervical cancer cases are connected to one of the 40 types of HPV.

In the Dan River Region, there is growing recognition that there is need for more conversation about HPV.

The Cancer Research Center of Southern Virginia — in association with several regional organizations — is arranging a series of workshops on HPV and its related cancers. The three workshops beginning in September will be targeted toward the health care industry members, teachers and parents and finally students.

Danville Regional Medical Center, Piedmont Access to Health Services, Danville Community College, Averett University, Pittsylvania/Danville Health Department and Danville and Pittsylvania County schools are participating. Most of the agencies seek to augment the training and skills held by doctor and nursing staff to emphasize the prevalence of the issue.

What is this disease?

There are 40 types of HPV. Generally it causes genital or throat warts and cancers. It can be passed to another person without any signs or symptoms and symptoms may develop years after infection.

While the disease can go away and you won’t even realize you had it, the most dangerous consequence is that it can cause fatal cancers such as cervical, vaginal or vulvar. Infected individuals may live for decades with HPV before they become aware of their condition.

Pittsylvania/Danville Health Department director Dr. Matthew Arroyo explained it’s often possible that “you can’t see the symptoms.” Particularly men are asymptomatic.

According to health department and CDC resources, infected individuals may realize their health status only when warts appear. The only screens or tests that exist for the disease are for cervical cancer.

Much of the conflict between information and results is related to communication issues. Arroyo commented that “anytime you talk things of a sexual nature, there’s sometimes a stigma of bringing it out in the open and talking about it. The view of it is ‘what did you do to get this?’”

Marsha Mendenhall, PATHS director of the continuing education program, has noted the same stigma.

“I think that some parents have a fear about it,” she said. “I think that they don’t correlate some of the cancers that are a result of the virus.”

Sherri Wright, coordinator of health services at the local public schools, stated “I really think that comfort level is a big thing. We need that trust level developed for all health care providers.”

Wright said that trust is only increased when the providers improve their understanding through such events as workshops.

“I think that school nurses are often the ones that receive those first questions, and we want any nurse wherever they are to be aware of all of the conditions and what people need to do to prevent it. This is a preventable cancer. So it’s really important for nursing to have all of the pertinent and correct information.”

Part of the challenge is emphasizing to parents how serious HPV is for the students who visit nurses. “It’s really the parents that we’re trying to reach much more than the students,” Wright said. “I think that parents just are not thinking about it. It’s really important that they do think about it.”

Some express apprehension because the recently developed vaccines are for children around the age 11 or 12. While most children are not sexually active at that age, the vaccine is preventative measure for when they do become sexually active.

Occasionally, Wright said the nurses need to use unusual tactics to paint the bigger picture for parents. “We really want to get parents emotionally involved,” she explained. “When we do talk to parents, we get them to actually visualize their child in their 30s with HPV and their child in their 30s asking the parents ‘why didn’t you get me that shot?’”

Treatment is available

Dr. Robert E. Broughton, one of PATHS’ pediatric doctors, handles some of the same types of conversations with patients and their parents. Broughton said the vaccine is needed at a young age “so your antibodies are built up.”

He said that some parents presume their young adult is not sexually active but find out after the fact that they are. Nonetheless, he and the staff diligently share the risks and benefits of the vaccination.

Others have persistent fears of the safety of the vaccine itself. PATHS’ Broughton saw this phobia of the vaccine in his work.

“What happened is it [the vaccine] got some bad press because the fact it was a new vaccine and the scare of the vaccine was still around,” Broughton said.

In 2006, the new vaccine Gardasil was approved by the Food and Drug Administration. The three shot series costs $150 plus administration fees. It protects recipients from four types of HPV that cause cervical cancer.

Side effects of the HPV vaccine are not especially unique. They include tenderness at the injection site, headache, fever, nausea, dizziness, vomiting or fainting. Many vaccines list similar or lengthier side effect warnings.

Though it is intended for children as young as 9 through the maximum age of 26, it is most effective if administered prior to sexual activity. However, sexually active young adults can potentially get protection from HPV through the vaccine.

During a special initiative about one year ago, the local health departments were provided with approximately 100 of the shot series to give to patients who met uninsured or underinsured criteria. The health department found that initiative assisted with raising awareness.

Beyond taking the vaccination, there are steps to help reduce or prevent the risk. At the top of the list is using condoms, limiting sexual partners or practicing abstinence. Women can get pap tests that will identify abnormal cells caused by the disease that indicate the potential of cancer. Unfortunately, men do not have a screen to know if they have HPV at this time.

Cancer Research and Resource Center program coordinator Kathy Hurt said “if we have a strong enough response we’ll do this again in the spring,” with the hope of bringing local vaccination rates to 100 percent.



(Posted: Friday, August 22, 2014 6:15 am at, Article by: Vicky Morrison )