The STI You Already Have
Cancer-causing HPV infects millions of South Africans a year. Here’s how to protect yourself.
THE STI YOU ALREADY HAVE Cancer-causing HPV infects millions of South Africans. Here’s how to protect yourself.
Men like to categorise things. Even sexually transmitted infections: there’s the terrifying (HIV/ AIDS), and then there’s everything else, like the infections that produce a rash or a bruise to the ego but typically disappear with prompt treatment.
But human papillomavirus (HPV) deserves its own category. It’s different. For one thing, it’s shockingly common. You’ve probably had it at least once, and you may even have it right now. But perhaps the scariest thing about HPV is the side effect it leaves behind: an increased cancer risk. More South African men than ever are developing throat, tongue, and tonsil cancers thanks to HPV; and according to the latest estimates, the rates keep climbing. HPV can also cause penile or anal cancer, two diseases on our list of the worst ever.
How can you stay safe? It’s complicated. But we have some lifesaving advice.
A woman can be tested for HPV with her Pap smear, but there’s no approved HPV test for men. A study in JAMA Oncology suggests that nearly half of men are infected.
The virus can be detected in cells from the mouth, penis, or anus, but since collecting good samples from those areas isn’t easy, the results of these tests are often inaccurate, says Eric Buhi, of the Centre for Research on Sexuality and Sexual Health at San Diego State University. “There’s just no perfect place to test where cell changes occur regularly, like with the cervix,” he says. The rectum may be the best spot, but these tests aren’t routinely recommended.
Ask for a test if you have anal sex and/ or HIV, both of which raise HPV risk. “The main argument against screening has been that it’s not costeffective, but growing evidence is starting to suggest that it is,” says Buhi.
SET UP BARRIERS
When you discuss STI testing with your partner, ask about HPV. If she’s tested positive, don’t assume she’s had a huge number of sex partners or cheated; HPV infections are quite common and can show up on a test long after the exposure. When in doubt, use a condom. It’s not a perfect solution, since HPV is transmitted via skintoskin contact and you’ll rub up against plenty of flesh even with a rubber on. Still, condoms are helpful. In fact, research published in the Journal
of Infectious Diseases found that men with multiple sex partners who always used a condom had half the HPV risk of those who never wrapped up.
If you’re single, then you’ve already made condoms a nobigdeal routine, right? But what about giving oral sex? That’s where the dental dam comes in. You place this thin film of latex or polyurethane over her vagina before you get down to business. It’s not weird. It’s smart. In one study from
the University of Washington, only a small percentage of men used dental dams during oral sex, but not one of those men had oral HPV infections. Pick up a dental dam or latex sheet from your local pharmacist. A cut-up condom or even a piece of plastic wrap can also work, says Stephanie Marhefka, of the University of South Florida department of community and family health.
GET THE VACCINE
Even though the HPV vaccine is approved for all kids aged nine or older, lack of awareness and high cost mean very few have completed the three-dose series, according to recent numbers. Step it up, dads! What’s more, the vaccine, which boosts immunity to a variety of strains of HPV, isn’t just for kids. And some insurers may cover the HPV vaccine – check your policy.
Even if they don’t, the vaccine might be worth paying cash for. “If you can afford it, it’s worth it,” says Stephen Goldstone of the Icahn School of Medicine at Mount Sinai Hospital. Here’s why: if you’ve had only a few sex partners, there’s a good chance you aren’t infected with all the cancer-causing strains covered by the shot, he says. That makes the vaccine an especially smart choice for, say, newly divorced guys back on the dating scene. And for men who have sex with men, it’s a must-have, says Dr. Goldstone. After all, the cancer risk from HPV can multiply. In a study in the journal
Preventive Medicine, men who had a cancer suspected to be linked to HPV had an increased risk of a second HPV-associated cancer in the years that followed.
OPEN UP TO YOUR DENTIST
Four times as many men develop HPVrelated oropharyngeal cancers as women. That’s because men seem to have a harder time clearing oral HPV infections than women do, research shows. So make sure your dentist does a cancer screening at every visit. Dentists are trained to examine the soft tissues both inside and outside the mouth, and they can identify suspicious lesions and refer you for a biopsy if necessary, says Katharine Ciarrocca of the Dental College of Georgia. In addition, watch for signs on your own, like a persistent sore throat, trouble swallowing, hoarseness, ear pain, enlarged lymph nodes, or unexplained weight loss. HPV-related oral cancers have better survival rates than non-HPV oral cancers, especially if they’re caught early.