The STI You Al­ready Have

Can­cer-caus­ing HPV in­fects mil­lions of South Africans a year. Here’s how to pro­tect your­self.

Men's Health (South Africa) - - CON­TENTS - BY JULIE STE­WART

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.

CON­SIDER TEST­ING

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.

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