Category Archives: HPV

Sexual Activity and Reducing STD Risk

Health Risks of Noncoital Sexual Activity

Washington, DC — When counseling patients about preventing sexually transmitted diseases (STDs), it’s important for physicians to ask direct questions about both intercourse and noncoital sexual activity, according to a new Committee Opinion issued today by The American College of Obstetricians and Gynecologists (ACOG).

Noncoital sexual behavior includes mutual masturbation, and oral and anal sex and is common among adults and adolescents. Despite concerns expressed in the popular media about an increase in oral sex among adolescents and young adults, there is no evidence that this is the case. However, research does show that oral sex is much more common among adolescents who have already had vaginal intercourse, suggesting that these sexual activities occur at about the same time and with the same partner.

“Most people, including adolescents, are unlikely to use condoms during oral sex, which places them at risk for acquiring an STD,
” said Richard Guido, MD, chair of ACOG’s Committee on Adolescent Health Care, which issued the opinion along with ACOG’s Committee on Gynecologic Practice. “This unlikelihood is partly because of a greater perceived safety compared with intercourse. Although sexual behavior is a sensitive issue to address for both patients and physicians, it’s important to discuss sexuality frankly and without judgment so that we can help our patients fully protect themselves against STDs.”

Risk of getting certain STDs varies depending on the specific disease and the sexual behavior:

  • the risk of acquiring HIV through oral sex is less than through vaginal sex
  • with receptive anal sex having the highest risk
  • Herpes is commonly transmitted through kissing and through oral, vaginal, and anal sex.
  • Herpes simplex virus Type 1 (HSV-1), typically associated with oral herpes (ie, “cold sores”), can be transmitted to the genitals through oral sex.
  • Herpes simplex virus Type 2 (HSV-2), typically associated with genital herpes, can be transmitted to the mouth through oral sex.
  • Nonviral STDs, including gonorrhea, chlamydia, and syphilis, also can be transmitted through noncoital sexual activity.

“Our lesbian and bisexual patients also need be screened for STDs based on the same risk factors as other women,” Dr. Guido noted. “Most lesbians have been sexually active with men at some point. Even without this sexual history, there are some STDs that can be transmitted between two women during sexual activity.”

According to ACOG, physicians should ask more direct questions about a patient’s sexual behavior so that they can provide counseling on ways to lower the risk for STDs. Since most women who engage in noncoital sexual activity are also having intercourse, clinicians need to consider whether these noncoital behaviors add any additional risks to those already posed by intercourse.

Risk-reduction strategies:

  • limiting the number of sexual partners,
  • STD testing before engaging in sexual activity with a new partner
  • correct and consistent use of condoms
  • abstinence
  • and/or mutual monogamy.

Committee Opinion #417, “Addressing Health Risks of Noncoital Sexual Activity,” is published in the September 2008 issue of Obstetrics & Gynecology.

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Gardasil Information

Centers for Disease Control Gardasil reporting, here

A Homeopathic Perspective, here

Gardasil Human Papillomavirus (HPV) Vaccine

On June 8, 2006, the FDA licensed Gardasil®, the first vaccine developed to prevent cervical cancer caused by certain kinds of human papillomavirus (HPV). Since then, more than 12 million doses of Gardasil vaccine have been distributed. In 2006, a total of 2,151,000 doses were distributed and in 2007, another 11,317,902. At this time, the U.S. does not have a national registry for immunization and vaccination and therefore cannot report the total number of people who have received Gardasil.

The FDA has licensed the vaccine as safe and effective. This vaccine has been tested in thousands of females (9 to 26 years of age) around the world. These studies have shown no serious side effects. The most common side effect is brief soreness at the injection site. CDC, working with the FDA, will continue to monitor the safety of the vaccine after it is in general use.

CBS News story, here

Age for HPV vaccination.
Harper DM, Paavonen J.

Dartmouth College, Department of Women’s and Gender Studies, Obstetrics and Gynecology, Community and Family Medicine, Hanover, NH, USA. Diane.M.Harper@Dartmouth.edu

HPV vaccination of pre-pubescent girls will be effective for many girls. Vaccinating girls and women older than 12 years of age may accelerate the reduction in cervical cancer rates. Currently HPV vaccines are effective for at least 5 years in the prevention of HPV 16 and 18 associated precancerous lesions however the duration of vaccine protection is unknown. The need for booster shots must therefore be addressed with patients as unknown. Continued cervical cancer screening is necessary regardless of vaccination. Vaccination alone will not eliminate cervical cancer.

Vaccine. 2008 Mar 14;26 Suppl 1:A7-11

EMEA Statement On The Safety Of Gardasil, Europe

Article Date: 25 Jan 2008

The European Medicines Agency (EMEA) has received reports of deaths in women who had previously received Gardasil, including two reports concerning the sudden and unexpected deaths of two young women in the European Union (EU). Gardasil is a vaccine approved in the EU for the prevention of cervical cancer and other diseases caused by human papillomavirus (HPV) types 6, 11, 16 and 18. It is estimated that about 1.5 million patients have been vaccinated with this HPV vaccine in Europe.

The two European cases were reported as part of the continuous monitoring of the safety of medicines. One of the cases occurred in Austria and the other in Germany. In both cases, the cause of death could not be identified. No causal relationship has been established between the deaths of the young women and the administration of Gardasil.

On the basis of the currently available evidence, the EMEA’s Committee for Medicinal Products for Human Use (CHMP) is of the opinion that the benefits of Gardasil continue to outweigh its risks and that no changes to its product information are necessary.

The EMEA will continue to closely monitor the safety of Gardasil and take appropriate actions should new information emerge that has an impact on the benefit-risk profile of Gardasil.

Notes:

1. The approved indication in the EU for Gardasil is: “Gardasil is a vaccine for the prevention of high-grade cervical dysplasia (CIN 2/3), cervical carcinoma, high-grade vulvar dysplastic lesions (VIN 2/3), and external genital warts (condyloma acuminata) causally related to Human Papillomavirus (HPV) types 6, 11, 16 and 18. The indication is based on the demonstration of efficacy of Gardasil in adult females 16 to 26 years of age and on the demonstration of immunogenicity of Gardasil in 9- to 15-year old children and adolescents. Protective efficacy has not been evaluated in males. The use of Gardasil should be in accordance with official recommendations.” For more information on Gardasil, please see here.

2. HPV types 6, 11, 16 and 18 vaccine is also marketed in the EU as Silgard. For more information on Silgard, please see here.

The Gardasil Vaccination, A Study in Tragedy?

The info posted below is from this young lady’s blog. In an attempt to pass the word about what she is currently dealing with. Visit her blog (here), medical professionals should check it out also and of course teens, young women and their mothers.

Her blog has additional information on other cases in where Gardasil is implicated. We can keep her in our prayers.

Welcome to the Family Blog for Jenny.

Jenny is a 14 year-old girl who lives in Northern California.

Over the last year, she has gone from being a fully healthy 13 year-old to being nearly completely paralyzed. She retains movement only in her neck and mouth and faintly in her left hand.This rapid decline in motor ability has understandably shocked and concerned us [her family]. We have responded by working with the best doctors in the field, fighting continuously to reach a diagnosis and find treatments.

Despite the best efforts of an extremely talented array of medical professionals, we have not been able to stop her decline. Doctors don’t know for sure why Jenny got so sick but some think it may be connected to the Gardasil vaccinations she got (last one in March, 2007) and the weakening that seemed to start in spring and gradually built up. One sign was in April 2007 when everyone in her PE class laughed at her because she couldn’t jump a hurdle they considered really puny. It is hard to say when the weakening started but by summer she had a terrible limp.

One of the major things that would help her doctors figure out what to do is to find other people like Jenny (called “comparables”)–people that share her medical condition and perhaps have had luck with certain treatments.

We are creating this blog to aid us in our search for comparables. If you think you may know a comparable, we urge you to check out the comparable traits in the sidebar and email us at jenjensfamily@gmail.com. Even if you do not know a comparable, feel free to leave a comment of support or link to any information you think might be helpful for us.

HPV vaccine mandates

Viruses are not the cause per se of cervical cancer. There has to be exposure to the virus and their has to a susceptibility to it. Their are many factors involved and by changing those inputs (behavior, diet,nutrition, life focus, spiritual focus of an individual, teaching wise choices vs. risky behaviors, etc.) outcomes can be changed. There are healthier approaches beyond vaccination.

A Research Study

HPV vaccine mandates: just say ‘no’ to the “great big public health experiment”

While many states are seriously considering requiring vaccination of pre-teen girls as a condition of middle school admission, the case for mandatory human papillomavirus (HPV) vaccine is very weak. Such a requirement lacks the traditional justification for vaccine mandates and therefore represents an unjustified usurpation of parental authority. Moreover, serious questions remain as to whether the vaccine is effective in preventing cervical cancer. The vaccine is the most expensive pediatric vaccine in history. Given the uncertainties surrounding the vaccine, Missouri lawmakers and taxpayers should reject this expensive and intrusive “public health experiment”.

Washington University School of Medicine, St. Louis, USA. Bob.Onder@house.mo.gov

American Teenage Girls, One in Four May Have an Sexually Transmitted Disease

“What we found is alarming,” Dr. Sara Forhan, from the U.S. Centers for Disease Control and Prevention, said during a teleconference Tuesday. “One in four female adolescents in the U.S. has at least one of the four most common STDs that affects women.”"These numbers translate into 3.2 million young women nationwide who are infected with an STD,” Forhan said. “This means that far too many young women are at risk of the serious health effects of untreated STDs, including infertility and cervical cancer.”

These common STDs include human papillomavirus (HPV), chlamydia, herpes simplex virus and trichomoniasis, Forhan said.

Forhan announced the results as part of the CDC’s 2008 National STD Prevention Conference, in Chicago.

“These findings are really giving us a lot of pause about how we provide care to adolescent girls who are sexually active,” said Dr. Elizabeth Alderman, an adolescent medicine specialist at Children’s Hospital at Montefiore in New York City and chairperson of the Executive Committee of the Section of Adolescent Health of the American Academy of Pediatrics. “The numbers are really astonishing.”

Forhan noted that most of the burden of STDs falls on young African-American women. “Among African-American teenagers, about one in two were affected compared to one in five white teens,” she said.

In terms of the racial disparity, “it’s what we’ve always seen, which is very unfortunate,” Alderman said.

In the study, Forhan’s team collected data on 838 girls aged 14 to 19 who took part in the 2003-2004 National Health and Nutrition Examination Survey. The study did not include syphilis, gonorrhea or HIV, as earlier studies found very low prevalence of these diseases in this age group.

HPV and chlamydia are the most common STDs found among teenage girls, Forhan said. “Almost one in five overall had a strain of HPV associated with cervical cancer or genital warts,” she said.

“We need to be screening adolescent girls who are sexually active and providing them with HPV vaccine,” Alderman said. “The recommendations are to screen sexually active girls, but many girls don’t disclose to their health-care provider that they are sexually active, even when asked,” she said.

As for chlamydia, 4 percent of teenaged girls had this STD, Forhan said. “The majority of chlamydia infections do not have symptoms. If left untreated, it can lead to pelvic inflammatory disease, which leaves these young women at risk for atopic pregnancy, chronic pelvic pain or infertility,” she said.

In addition, the study found that 2.9 percent of young women had trichomoniasis, and 2 percent were infected with genital herpes, Forhan said.

According to Forhan, about 50 percent of the teens reported having sex, and the prevalence of STDs in this group was 40 percent. “Even for young women with only one reported lifetime sexual partner, one in five had an STD,” she noted.

“If you choose to be sexually active, you need to protect yourself and be screened for these infections,” Alderman said. “And all girls between the ages of 11 and 26 should get vaccinated for HPV.”

Among women with an STD, 15 percent had more than one infection, Forhan added.

“These data provide a clearest picture to date of the overall burden of STDs in adolescent women in the United States,” Forhan said. “The study also underscores the importance of addressing racial disparities in STD rates among young women.”

Race itself is not a risk factor for STDs, Forhan said. However, factors such as limited access to health care, poverty, community prevalence of STDs, and misperceptions about individual risk are some of the reasons that STD rates are particularly high among African-Americans, she said.

Comments:

The female population in the United States ages 0-19 is estimated to be 40,328,895. This sample consisted of slightly over 800 girls. Who were they? What is their way of life? Based on this sample, it is recommended to vaccinate all girls. There are less risky ways to foster the health (if that is the goal) of young girls.

Women risk HPV infection from first sex partner

Information to share, not out of fear, but to encourage judiciousness.

NEW YORK (Reuters Health) – Women run a significant risk of acquiring human papillomavirus (HPV) from their very first sex partner, according to a new report.

Human papillomavirus or HPV is the cause of genital warts, as well as most cases of cervical cancer.

“HPV infections are common among newly sexually active young women, even in those reporting only one partner,” Dr. Rachel L. Winer told Reuters Health. Therefore, she pointed out, the new HPV vaccines will have the greatest impact when they’re given before young women become sexually active.

Winer, from the University of Washington in Seattle, and colleagues attempted to determine the risk of HPV infection in 244 young women enrolled in a study before or within 3 months of their first intercourse. They were followed for up to three years. Women who acquired a second sex partner during follow-up were excluded from the analysis.

Within 12 months of intercourse with their first sex partner, 29% of the women tested positive for HPV, the researchers report in the Journal of Infectious Diseases. After 24 months, the cumulative rate of HPV infection increased to 39%, and at 36 months it was 49%.

The investigators found that the only factor associated with risk of HPV infection was the male partner’s number of previous partners.

“Our previous work has shown high rates of female HPV infection following sexual debut,” Winer said. “Therefore, it is not surprising to see a high risk of infection from a first male partner.”

She added, “It is important to encourage condom use with all new partners, and regular Pap smear screening.”

SOURCE: Journal of Infectious Diseases, January 15, 2008.