Girls may not have riskier sex after HPV vaccination
Omer’s team didn’t have any data on how many of the girls were sexually active during the study period. The researchers also couldn’t tell if the STI and pregnancy tests were part of standard clinical procedures or if girls were tested because they were sexually active or had symptoms.
Divya Patel, an ob-gyn researcher from the University of Michigan in Ann Arbor, called the study a “really good first stab” at looking at the behavioral effects of HPV vaccination.
“But I felt that it didn’t convey the full picture,” she added.
For example, it’s possible girls as young as 11 and 12 aren’t even told what the vaccine is for, or only hear about it in the context of cervical cancer.
MYTH: The Pap test tells you whether you have HPV or other STIs
FACT: The Pap test detects cell changes in the cervix (located at the end of the vagina). It doesn’t tell you if you have an STI, including HPV. Your health-care professional can test for sexually transmitted infections as part of a pelvic exam or separately, but you need to ask for it.
Right now, in Canada, there is an HPV test that can be used to detect high-risk types of HPV (the ones that can cause cancer). A doctor might decide you should have an HPV DNA test after a Pap test comes back showing abnormal cells. This test is not available in all parts of Canada and the cost is not generally covered by public health insurance. The HPV test is usually recommended for women over 30 whose Pap results show specific abnormalities. The test is not recommended for women under 30 because some strains of HPV are likely to clear up on their own within 2 years.
MYTH: HPV vaccination can protect me from HPV and other STIs
FACT: There are more than 100 different types of HPV. At least 40 of these types are spread through sexual contact and can infect the genital area.
Four types of HPV cause the majority of genital warts (types 6 and 11) and most cases of cervical cancer (types 16 and 18). Two vaccines are now available in Canada; one protects againsst types 16 and 18 and the other against all four types.
These vaccines do not protect against the other types of HPV or any other STI.
MYTH: I don’t need the HPV vaccine because I am not having sex
FACT: Vaccination works best if you have not been exposed to any types of HPV preventable by the vaccines. If a young woman gets vaccinated early, before she is sexually active, she could be protected from up to 4 types of HPV that she could be exposed to when she does have sexual contact with a partner. Studies on the vaccines have shown that it is most effective for girls aged 9 to 13, and it protects young women for a minimum of 5 years. It may protect for much longer, but more research is needed to confirm this.
MYTH: HPV vaccination can prevent pregnancy
FACT: HPV vaccination is not a contraceptive. You still need to protect yourself from unplanned pregnancy by using some form of birth control.
MYTH: HPV vaccination infects you with the virus, so you can become immune to it
FACT: These vaccines do not contain any live or dead virus and cannot infect you with HPV.
MYTH: After being vaccinated, you no longer need Pap tests
FACT: HPV vaccination does not replace the need for regular Pap tests. The Pap test does not diagnose an HPV infection. It is used to detect cell changes in a woman’s cervix before they develop into cancer. Regular Pap tests are a key part of a healthy woman’s life, whether or not she has had the HPV vaccination. These vaccines do not protect you from all types of HPV, so there is still a risk of developing cervical cancer if you are infected with one of these other types.
“I’d be really surprised if kids this age are knowing that, ‘I got a vaccine for HPV and it’s a sexually transmitted disease,’” Patel, who wasn’t involved in the new study, told Reuters Health.
Looking at pregnancy tests from primary care doctors’ offices is also limiting, she said, because girls might be more likely to go to school health clinics, or buy a test off the shelves, in those situations.
She said future studies like this one, but in different locations and in older girls, will be needed to help piece together what’s going on.
The researchers agreed that there are other issues limiting the popularity of the HPV vaccine besides concerns about a spike in sexual risk-taking.
“I think that perception of risk (with HPV) is not quite there. People don’t really consider themselves at risk, or they’re not concerned,” maybe because it’s so common, Patel said.
“We need to be aware of how to prevent it, and vaccination is the best way to do that.”
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SOURCE: Pediatrics, online October 15, 2012