More evidence for a mandate?: FDA approves Gardasil For Prevention Of Vulvar, Vaginal Cancers

We and other blogger friends have blogged about Gardasil before here and there -- and in a quick and dirty drive-by post, we thought we'd update you on the latest developments:

The AP press reports that federal health officials approved expanding the use of Gardasil, the cervical cancer vaccine, to prevent cancers of the vagina and vulva:

"The Food and Drug Administration first approved Gardasil in 2006 for the prevention of cervical cancer in girls and women ages 9 to 26. The vaccine works by protecting against strains of the human papillomavirus, or HPV, that cause about 70 percent of cervical cancers. The HPV virus, transmitted by sexual contact, causes genital warts that sometimes develop into cancer.

'There is now strong evidence showing that this vaccine can help prevent vulvar and vaginal cancers due to the same virus for which it also helps protect against cervical cancer' said Dr. Jesse Goodman, director of the FDA center that oversees vaccines."

Full Story can be accessed here.

A Quarter of Teenage Girls Test Positive For STDs

I'm just going to sit here and sip my coffee and let that title, and that statistic, sink in for a moment. A quarter of teenage girls test positive for sexually transmitted diseases. Go ahead and ponder it, I'll be here when you're done. Surely, you're thinking, it's not that bad! This must be sensationalistic reporting, or perhaps a matter of mistaking statistics or numbers or...

Okay, I admit. I stretched the truth a smidge to get the alarming title. In reality, the first national study of four common sexually transmitted diseases (chlamydia, HPV, trichomoniasis, and genital herpes) found that one in four teenage girls are infected with at least one of these diseases.

Oh. Clarifying that didn't really make it any better, did it?

Let's look at the numbers before we talk further, shall we? Always good to have those in front of us, whenever talking about straight up statistical analysis. According to the New York Times,

838 participants in the study were chosen at random with standard statistical techniques. Of the women asked, 96 percent agreed to submit vaginal swabs for testing. Extrapolating from the findings, 3.2 million teenage women were infected with at least one of the four diseases [emphasis added]. Because the new survey was based on direct testing, it was more reliable than analyses derived from data that doctors and clinics sent to the diseases center through state and local health departments.

To say that this suggests abstinence-only education is a complete and utter failure is, I think, a healthy understatement at best. And the numbers suggest something else, as well: abstinence-only education also hits minority communities harder, doing more damage, than the white communities. In this particular study, nearly half of the 14-19 year old black women had at least one of the four STDs being looked at, while only 20% of the white girls were similarly infected. Among these infected women, nearly 15% had multiple infections - of these four. Who knows what other infections were also piggybacked on top of the rest.

And of course, these infections all have the ability to present invisibly, for both men and women, meaning that not only is there a potential for continued widespread infection, but that it's very likely both women and men will end up with fertility problems down the line, thanks to the scarring that these diseases can cause (especially when they shift into pelvic inflammatory disease).

I'm not sure how people can look at these numbers and see anything other than earthshattering disaster for abstinence-only education. Something like a billion dollars has been spent on something that conclusively does not work. Not only does it not work, it is putting our teens, our children, at serious and significant health risk, not only for the immediate but for their future health, as well.

I've taught sex ed, and I know it can be uncomfortable. I've had to teach sex ed to my relatives, so I know how that can be even worse than sitting down with strangers. It can be embarrassing. Questions can be asked that you don't want to answer, or don't know how to answer - but we, socially, culturally, religiously, politically, need to get over it. Comprehensive sexuality education doesn't have to be about giving permission to have sex whenever; it's very much a whole body/being approach to teaching that doesn't just emphasize safe sex, but it also can (and should) emphasize things like waiting for what is morally right for the individual, cover things like protecting yourself from abuse, being comfortable in your own gendered skin, taking care of your plumbing; comprehensive sex ed is not about encouraging orgies, it's about encouraging responsibility and agency. We have to embrace this - and if we don't, then as a society, those infections are just as much our responsibility as it is the teenagers actually having the sex.

-Kelly


Oh, as a side note: the researchers in this particular situation did something I'd really love to see more often. While the survey was anonymous and they have no way of knowing which women were infected, they did inform all participants of the finding results and treatment recommendations via a password protected phone number, and they sent multiple reminders to the women who did not call in to the line. This keeps confidentiality, while still going well above and beyond what most researchers seem to do in these situations - it would be great if this could become the norm, rather than a pleasant surprise in a completely depressing article.

Embracing the HPV Vaccine -- Warts and All?

We've posted before here and here about the HPV vaccine and debated whether or not it should be 'mandated' for girls; today in the NY Times an article in the Fashion and Style section (??) asks whether or not the parents would encourage their boys to get the vaccine. Currently, Gardasil is only FDA approved for girls and is marketed as preventing cervical cancer; but boys could benefit too, because the vaccine also protects against genital warts. Currently the vaccine is already approved for boys in Australia, Mexico and countries in the European Union; Merck will seek FDA approval for boys later this year. The question is, will the parents of young boys and girls in the USA buy it? Full article accessible here.