What She Said

Be a Stalwart

It’s STI Awareness Week (10th – 16 February 2016) so a spotlight must be shone on one of the most transmitted STIs in South Africa – Human Papillomavirus (HPV). HPV can have dangerous consequences for WSW (women who have sex with women) and/or anyone else lugging around a cervix.

It’s a sneaky, highly contagious DNA virus with 170 known strains able to infect humans. The virus establishes productive infections in certain cells of the skin or mucous membranes, and often when it does set up shop you may not even know it is there. Most HPV infections cause no physical symptoms; but in some people the infections do become clinical. These symptoms can range from genital warts to some strains of HPV that can cause cancers of the cervix, vagina, vulva, penis and anus.

HPV 16 and 18 are believed to be responsible for more than 70% of all cases of cervical cancer and because of this statistic and the ease, with which HPV is spread, it is considered a high-risk STI and should be on every woman or girl’s radar.

Transmission

HPV is contracted through skin contact, with more than 40 strains specific to the genital area. It was previously assumed that HPV was only contracted through sexual intercourse via heterosexual and MSM (men who have sex with men) interactions but studies have shown that there is a clear link between WSW, even those with no prior male sexual contact, and the transmission of HPV.

Symptoms

Because the infection is only obvious once clinical, the virus spreads easily and undetected via the majority of people who contract it. However, external genital warts may show around and inside the vagina and anus and should be seen to by a doctor immediately.

Limiting exposure to HPV and Cervical Cancer

Abstinence

Obviously a surefire way of reducing risk is by not engaging in any forms of sexual intercourse that might involve skin contact, but if cloistering yourself is not realistic you can focus on alternative forms of limiting contact.

Limited number of partners

Limiting the number of partners with whom you have any kind of intercourse lowers the possibility of exposure to HPV.  A frank discussion with potential partners about HPV and precautions needed to avoid transmission may be a good start.

Condoms and contraceptive with skin contact limitation

Although they do not entirely prevent transmission, all forms of skin limiting barriers decrease the chances of transmission. These may include male and female condoms, dental dams and surgical gloves (rather than the woolen kind).

Sex toys and paraphernalia

Barriers should be introduced into sex aids and toys as well, as toys that are shared have the potential of carrying the virus. Regularly disinfecting your toys will decrease the risk of exposure.

Pap Smear

Although warts around the genital area are relatively easy to spot, the abnormal cervical cell construction that leads to cancer requires a deeper, more thorough examination; namely a Pap smear. A gynecologist should administer the procedure and sexually active women should have a Pap smear every 3 years, regardless of sexual orientation.

Vaccination

The HPV vaccination is considered the most effective tool in the fight against HPV and cervical cancer. This vaccine trading under the names Gardasil and Cervarix vaccinate, primarily targets against HPV 16 and 18 (the big, bad cancer inducing strain). Previously the vaccination was recommended only to younger women, who were not yet sexually active, but this view is changing and nowadays anybody with a cervix of any age is encouraged to have one because women who are already sexually active may have been exposed to one or more of the HPV types but not necessarily with all HPV types prevented by the vaccines, so most would still get protection by being vaccinated.

The vaccinations may not protect against all strains of HPV but Gardasil has been approved to protect against 90% of genital wart infections.

Where to vaccinate

In early 2015 the Department of Health conducted a drive to protect young girls from getting cervical cancer caused by the human papillomavirus. All girls in grade 4 that were 9 years and older were to be vaccinated, provided that their parents signed a consent form. The aim was to vaccinate an estimated 500 000 girls in 18 000 public schools.

Both Gardasil and Cervarix are available at private pharmacies but require a prescription and administration by a registered practitioner. The vaccine is generally administered in 3 doses and the cost of the vaccine in the private sector is between R500 – R750 per dose. The vaccination is currently not available in public healthcare institutions.

In short, you may already be infected with one or two strains of HPV, but getting vaccinated may just prove to protect you from one of the more dangerous strains. Why not make an appointment for a pap smear this STI Awareness Week and put yourself in the know?

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