What about men? HPV’s effects aren't limited to cervicalcancerit can also cause genital warts and anal cancer in both men and women,and although anal cancer is rare, incidence has been increasing over the pastseveral decades. In the past, I've talked to straight men who were upset thatthey may have unwittingly given their girlfriends a virus that causes cervicalcancer (there are no routine tests to detect HPV in men), and I've talked togay and bisexual men who were frustrated that they didn't have the same accessto HPV vaccines that women did.
In October 2009, Gardasil was approved for administration inyoung men, but its effects were seen as largely altruistic. Yes, the vaccinewould protect men against genital warts, but in the public health field, wartsare not perceived to be as serious a problem as cervical cancer (although manyindividuals who have had to deal with warts would probably say that theireffect is not negligible!). Yes, the vaccine would protect against analinfection among men who have receptive anal sex, but most scientists wouldconsider this a small slice of the population, and since the vaccine issupposed to be given around age 11, before sexual activity has begun, it'sunlikely that parents are going to be factoring this into theirdecision-making. "Hey, just in case your son turns out to be queer, wouldyou like to give him this vaccine?" We're talking about a country wheresome parents don't even want to give girls the vaccine lest it encourage themto have pre-marital sex.
However, a new study published last month in the Journal of Infectious Diseasesdemonstrates that anal HPV infection is much more common among heterosexual menthan previously thought. While gay and bisexual men are estimated to be 17times more likely to develop HPV-related anal cancer, there haven't been anygood estimates of how many heterosexual men might be at risk.
The study found that 12% of heterosexual men in the US, Braziland Mexicohad an anal HPV infection, and 7% of those with an infection carried a strainrelated to cancer. By comparison, less than 1% of men in the U.S. areinfected with Chlamydia at any given time, and Chlamydia is considered quitecommon. Some of the men in the study had previously had male sex partners, butthe majority had not. Study researchers speculated that HPV could have beentransmitted anally to men via their female partner's hands or could have movedfrom the men's genitals to the anus.
An October 2009 study in the British Medical Journal found that vaccinating men with Gardasilwas not a cost-effective public health measure, meaning that the benefitsobtained in preventing disease were not greater than the costs incurred inadministering the vaccine. However, this study looked only at preventingcervical cancer and genital warts, not at anal cancer. Our knowledge of HPVchanges almost daily and this latest study is more evidence of how much we donot know about sexually transmitted infections and how many assumptions we makebased on a person's sexual orientation. HPV vaccination for men may be moreviable than it appears.
