McMaster University
Human Papilloma Virus (HPV) is a sexually transmitted disease which is the major cause of cervical cancer. The World Health Organization estimates that 500 000 women suffer from cervical cancer annually. HPV vaccines are available and have proven to be safe and effective for both sexes as a viable means of intervention. Given that the main burden of HPV-related diseases is attributed to women because of cervical cancer, why does the public health vaccination policies target the opposite sex?
Although HPV infection in males does not lead to cervical cancer, it can still act as a transmission vector. Academics Zimet and Rosenthal have argued for the inclusion of males in HPV vaccination programs. Summarized in their review, the support of male HPV vaccination cites six fundamental reasons:
(1) Female-only vaccination will not protect men who have sex with men from HPV and HPV-related diseases; (2) the fastest way to achieve the greatest protection for females from cervical cancer and its precursors is to vaccinate males as well as females; (3) vaccinating males is a more equitable public health policy and recognizes that both genders contribute to the transmission of HPV; (4) vaccination of males may be more acceptable to some cultural groups than vaccinating females; (5) genital warts and HPV-related cancers in males represent costly and emotionally burdensome conditions that can be prevented more expediently by vaccinating both males and females; and (6) historically, implementation of risk-based (or gender-based) vaccination policies have been less effective and more confusing to the public.
These reasons create a logical argument towards expanding and encouraging public health policy to target male HPV vaccination. However, money is most often a central consideration when making changes to health systems. Current literature proposes that HPV vaccination in males is less cost-effective than large-scale HPV vaccinations campaigns for females. Other studies, however, rebut that current methodologies used to calculate cost-effectiveness calculations do not capture the best measure of health outcomes. Consequently, the supporting data is not conclusive enough to dismiss male HPV vaccination as neither economically viable nor advantageous for public health.
Unless consensus is achieved within the research community regarding the cost-effectiveness of male HPV vaccination, an economic argument will remain elusive. Keeping some of Zimet and Rosenthal ‘s aforementioned ideas in mind, let’s take another look at the situation.
The transmission of HPV requires at least one infectious partner in a sexual relationship between two or more people. If two people are entering into a relationship, they have a mutual responsibility to protect their partner and themselves. The current media does not appropriately communicate the idea of a shared burden to the public, but rather publicizes HPV as a female disease because of its high correlation to cervical cancer. As a consequence, women not only bear a high proportion of the physical burden but bear the brunt of the social burden as well. It is troubling to see health systems take such a narrow-minded stance towards HPV vaccination and control. I want to draw a comparison between the achievements of gender equality with HPV vaccination policy. Issues of gender equality, similar to HPV, often disproportionately affect females.
The recognition that males have an equal role to play in reducing gender equality has influenced a fundamental change in the way society perceives this problem. Why shouldn’t we extend that same collaborative atmosphere, found in gender equality, towards HPV prevention and control through the promotion of an equitable public health policy that encourages the vaccination of both sexes? At the end of the day, HPV affects both men and women. Neglecting to vaccinate males ignores one side of the problem and creates a bias towards women in society’s perception of HPV.
The recognition that males have an equal role to play in reducing gender equality has influenced a fundamental change in the way society perceives this problem. Why shouldn’t we extend that same collaborative atmosphere, found in gender equality, towards HPV prevention and control through the promotion of an equitable public health policy that encourages the vaccination of both sexes? At the end of the day, HPV affects both men and women. Neglecting to vaccinate males ignores one side of the problem and creates a bias towards women in society’s perception of HPV.
And so, if you love the person you’re with or you anticipate to be with, whether you are male or female in a heterosexual, homosexual, or other type of relationship, perhaps it’s time to shift the paradigm and face HPV as a collective entity.
After reading this article, a recent public advertisement that's been on the television came to mind: one in which a male and female are eating dinner at a fine restaurant. During their date, text informs the viewer that he has HPV and is putting her at risk of contracting it. Ads like this are a step in the right direction, and illustrate that there is a gradually shifting societal understanding of this infectious disease. Paired with the fact that incidence of HPV-related throat cancer in men has been predicted to surpass that of HPV-related cervical cancer in women by 2020 (see: "Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States"), we can see that the idea of male vaccination programs can not be ignored.
ReplyDelete