WHAT IS HPV?
HPV, the Human Papillomavirus, is a very common sexually transmitted infection that has been linked to the development of genital warts as well as oral and genital cancer (such as anal and penile cancer). HPV can be transmitted easily by oral, anal, and/or genital sexual contact and is widespread among all adults, including gay and bisexual men.
HPV is widespread among all adults. At least 60% of gay and bisexual men have HPV, and almost 80% among HIV+ men.
HARMS ASSOCIATED WITH HPV
HPV strains 16 and 18 are considered the more dangerous strains as they are known to cause cancer, including anal, oral, and penile cancer among men. Among cancers affecting men, it is estimated that HPV infection is associated with 80-90% of anal cancers, 40-50% of penile cancers, 35% of throat cancers, and 25% of mouth cancers.
Gay and bisexual men are more likely to get anal HPV than men who only have sex with women. According to the Centers for Disease Control and Prevention (CDC), we’re about 17 times more likely to develop anal cancer than men who only have sex with women. In comparison with the general population, gay and bisexual men are about 20 times more likely to develop anal cancer.
Anal cancer is a particular concern for HIV+ gay and bisexual men, who are over 100 times more likely to develop anal cancer that the general population. About a third of gay and bisexual men who are living with HIV have been shown to have HPV type 16, and are significantly more likely to develop anal cancer compared to men who are not HIV+.
PROTECTING YOURSELF FROM HPV
Condoms offer some protection from HPV, but don’t eliminate the risk of HPV infection, as transmission can occur from contact outside the area protected by condoms – even hands and mouths can facilitate transmission. The most effective way of protecting yourself from HPV is through Gardasil® vaccination.
Condoms can reduce but won’t eliminate the risk of HPV infection, as transmission can occur from contact outside the area protected by condoms – even hands and mouths can facilitate transmission. Talk to your doctor or visit a pharmacy to get started with your Gardasil® 9 vaccination.
Currently, in Canada, there is no approved test to determine HPV in Canadian men. As part of your routine health care, you should seek the attention of a medical practitioner if you experience any unusual signs or symptoms in the anus, such as unexplained pain or bleeding, regardless of whether or not you have received the HPV vaccination. Speak with your doctor about getting a digital ano-rectal examination (DARE) done as part of your regular check-up or when getting tested for HIV or sexually transmitted infections (STI’s).
WHAT IS GARDASIL?®
Gardasil® provides protection from the four most common strains of HPV infection, two of which (types 6 and 11) are commonly associated with benign genital warts. The others two common strains (types 16 and 18) are considered high-risk and are linked to some forms of cancer including anal, oral, and penile cancers. HPV types 6 and 11 are responsible for over 90% of genital warts, while HPV types 16 and 18 are responsible for about 70% of anal cancers.
ELIGIBILITY AND AVAILABILITY
Canada’s leading authoring on vaccination policy, the National Advisory Committee on Immunization (NACI), has recommended Gardasil® for gay and bisexual men of all ages. It is expected that a NACI recommendation regarding Gardasil® 9 will be issued before the end of 2015.
PHARMACIES, COST AND PAYMENT
Gardasil4® is publically funded to males in grade 7 and for gay and bisexual men up to the age of 26 – administered in two doses. Durham Region Sexual Health Clinics are approved to provide Gardasil9® (at cost) to gay and bisexual men up to the age of 26 years old. However, the cost for Gardasil9® is paid out of pocket for individuals’ seeking the vaccine. Gardasil9® is a three dose vaccine at $155.25 a dose for a total of $465.75 and is administered over a six month period.
At this time the Gardasil® vaccine is intended for use up to the age of 26. However, a health care provider may prescribe an off label vaccine to individuals seeking the vaccine who have exceeded this age.
Please see the publically funded Ontario vaccination website for more details - http://www.health.gov.on.ca/en/ms/hpv/
Please contact Durham Region Sexual Health Clinics at http://www.durham.ca/
It’s important to note that neither Gardasil® nor Gardasil® 9 are a treatment or cure for existing HPV infection. However, even if you have been infected with HPV, getting vaccinated will protect you from getting the other commonly identified HPV types that you have not been infected with.
There’s some encouraging evidence from a small study that Gardasil® vaccination may also have some benefit in preventing the recurrence of pre-cancerous lesions in the anus. In this study looking at these recurrence rates, men who have been vaccinated had about half the rates of recurrence than those who had not been vaccinated.
Health Canada and many other regulatory bodies around the world have approved Gardasil® and Gardasil® 9 for the prevention of HPV infection among males. These decisions have been based on many clinical trials and studies demonstrating the safety of the vaccine.
Very few side effects of the vaccine have been reported, and the most common is temporary soreness at the sire of injection, which is a common side effect of most vaccinations. If you have questions about possible side effects from Gardasil® or Gardasil® 9 please speak with you health care practitioner.
Gardasil® protects individuals against 100+ HPV strains. Most importantly strains 6, 11, 16, and 18.
Low-risk HPVs, which do not cause cancer but can cause skin warts (technically known as condylomata acuminate) on or around genitals, anus, mouth, or throat. For example, HPV types 6 and 11 also cause recurrent respiratory papillomatosis, a less common disease in which benign tumors grow in the air passages leading from the nose and mouth into the lungs.
High-risk genital strains of HPVs, which cause cancer – types 16 and 18. About a dozen high-risk HPV types have been identified. Two of these, HPV types 16 and 18, are responsible for most HPV-caused cancers. Most high-risk HPV infections occur without any symptoms, go away within 1 to 2 years, and do not cause cancer. Some HPV infections, however, can persist for many years. Persistent infections with high-risk HPV types can lead to cell changes that, if untreated, may progress to cancer.