So, you’re in love. I understand. And s/he’s amazing, I know, we’ve most of us been there. You share an indescribable connection of the heart and soul, a connection you’d soon like to develop into heart, body, and soul. Yes, most of us have been there, too. First, though, you have the “talk,” and then s/he tells you those three little words… I have HPV.
Unfortunately, more and more of us are, or will be, similarly situated yet again. Human papillomavirus (HPV) is the most common sexually transmitted virus in the United States. According to the CDC, 80% of American women will be infected with HPV by age 50. There are over 100 types of HPV, thusly named because some types can cause warts (a.k.a. papillomas) on different areas of the body, including the sexy parts. Speaking of which, according to the CDC, at least 50% of sexually active people will be infected with genital HPV, over 6 million new cases per year. Over 30 types of HPV can be transmitted through some kind of sexual contact (including all your best moves, original recipe to extra spicy). Two types of HPV cause 90% of genital warts cases, and another two cause 75% of cervical cancer cases.
There are likely to be just as many reasons HPV is so prolific as there are terrifying statistics I just threw at you. For example, there is no test for men, no treatment which eliminates it, and most infections go undetected because there are often no symptoms. Vaccines are only (so far) FDA-approved for young people (under 26), and most effective when given prior to any sexual contact. The virus is transmitted through skin-to-skin contact, meaning condoms are effective, but not as effective as with other viruses (i.e., HIV). A person’s body can usually fight the infection, mostly within a year or two; however, the persistent virus can cause cancer. With that in mind, let’s get back to your intractable situation.
So, your much desired partner has HPV. That’s a tough one, and you won’t find any advice here, only compassion and, hopefully, perspective. I know that, in a way, you’d probably feel the same hopelessness no matter what STI was at issue; but, as you can see above, HPV is a little special. The fact your prospective partner knows is encouraging, because obviously s/he cares enough to get checked. Although, what makes your partner my hero is that s/he told you.
See, I happen to believe there is another reason HPV is so prolific and, what’s better, we may be able to do something about it. Because, let’s face it, we’re not going to develop a test for men in our basement, we can’t pop over to the pharmacy and pick up a pill, and presently many of us are not eligible for vaccination. The prevailing guidance for “avoiding” HPV is to not have sex. Wow, what an insight. I’m sure the best way to avoid a car accident is to live on the moon but, realistically, that’s not a proactive game plan. More and more people each year are going to be in your or your partner’s position. In my view, silence and misunderstanding are fueling this virus just as much as the reasons mentioned earlier, and we can do something to help – get people talking. At the very least, HPV may still be hard to avoid, but cancer much less so, and having the talk means precautions and early detection. In order to get this conversation started, we need to address the stigma currently stifling frank discourse.
But how, you ask, can we do that? Stigma is defined as having a characteristic which directly accompanies a devalued social identity in a particular context. I am not an expert, but I think attacking stigma might just be a matter of severing the attribute from the devaluation by eliminating the context in which it attaches.
Let’s do a little experiment. Suppose the following are true:
- I got chicken pox from my neighbor when I was 3.
- Both my parents get cold sores, and I do, too.
- After lots of safe and awesome sex, my gyno told me I have HPV.
The predominant similarity here is, of course, that I have contracted a virus. And, as we often do, I made sure to note wherever possible that I did not make unrealistic choices which led to transmission. Think of the following phrase: “She died of lung cancer, she never smoked a day in her life.” The latter absolution feels necessary for stigma avoidance (as if having smoked 4 packs a day for 40 years makes her death less tragic). People who contract STIs often feel overwhelmingly guilty and dirty, responsible. These emotions do not typically accompany chicken pox and cold sores, which are viewed as “blameless.” To eliminate stigma, we need to change the view. Instead of proffering exculpating details, though, I say own it!
Unfortunately, no detail involving sex is going to help others view your condition as blameless. This is an entrenched landmine, so side-step it. I think you have nothing to be ashamed of but, for now, this sentiment is just too rare. I know – what, exactly, is so shameful? The 6 billion individuals on this planet are a pretty sizeable living testament to the fact that more than a few people have sex. But, the truth is, stick a group of three things in a bulleted list and the one that involves sex invariably stands out. Sex, as it has been for-seemingly-ever, is a go-to stigma context. So shun it. You had sex. It happens. You got HPV. It happens. That is, in fact, how it happens, making it an unnecessary detail. Pointing fingers, wherever you point them, isn’t going to make it un-happen, it’s just assigning blame – to others or yourself – which, in turn, attaches stigma. Remember that, because who wants to talk when they feel ashamed?
With that in mind, let’s ditch the back story:
- I had chicken pox.
- I get cold sores.
- I have HPV.
Well, everyone gets chicken pox, right? Parents used to have chicken pox parties, even. And cold sores, we all know people who get those. I buy lip salve in the beauty aisle, even. People are loathe to stigmatize what they themselves possess or may one day possess, enabling stigma for peculiarities. Did you know that, before the vaccine was launched in 1995, 3.5 million Americans per year contracted the Herpes virus that causes chicken pox, compared to the now over 6 million new HPV cases per year? And 80% of Americans have been exposed to the Herpes simplex virus that causes cold sores, the same percentage as HPV. HPV is just as common, or more. Remember that, because who wants to talk when they feel alone?
Of course, the easiest way to cure the silence is to speak up. The stats attest, in a room of 10 people, 8 of them will probably get or already have HPV. Your partner boldly raised a hand and said “I am one of them.” If you’ve ever seen a timid crowd, you’ll know that kind of unabashed courage can be contagious. My dream is for this to be a candid discussion, full of compassion for the choices we make. Assigning blame chills any hope for this, as does remaining a silent majority. Someone needs to break the ice, even the CDC said so. So, whenever you feel safe to do so, raise your hand. Leave out the back story and embrace your fellow 7. Be the vanguard in eschewing, nay, defying this blanket of shame and secrecy – also known as the context in which stigma attaches. It’s not your fault, and you’re not alone.
And if you’re one of the 20%, or one of the 80% that would rather not (which is cool), breaking the ice is not the only way to break the silence – you can help others feel safe enough to speak, too. There are resources for creating a zone of stigma-free dialogue, whether it extends to just you and your partner, you and your friends, or you and the world. LSRJ has a campus event toolkit focused on reproductive health outreach, including tips for talking to students about HPV and helping them meet their needs on campus (e.g., vaccines, treatment, screening). Raise your hand by emailing us at firstname.lastname@example.org.
June 17, 2010 11:06 PDT