The Gillard government recently announced that boys will be included in the nation’s free vaccination program to eliminate cervical cancer. It’s the first time any nation has done so and the media made an effort to promote our ‘world-first’ status.
What’s less well-known is that we’ll be the first country to start protecting future generations of gay men.
The reason this good news story fell by the wayside is that we’ve fallen victim to the oversimplification of the issues around cervical cancer, the Gardasil vaccine, and one hell of a nasty sexually transmitted infection.
So let me start by taking a few questions:
Q: They gave that stuff to girls to stop them getting the cancer all up their lady bits. Why would they give it to guys too?
That’s right anonymous figure of my own creation, the Gardasil vaccine has been given free to girls and young women for a few years now. Back when it was starting there was a whole bunch of publicity about it being the cervical cancer vaccine. Hell, we even made the guy who invented it Australian of the Year and made him honourary hero of cervixes.
That’s… kind of wrong. The vaccine doesn’t immunise you against cancer, it immunises you against a virus that causes the cancer. But cervical cancer is only the main billing of what this virus does. It also causes genital warts, followed by cancers on your throat, tonsils, genitals of whatever flavour, and finally, cancer of the ass.
One virus can cause all these shitty-ass cancers. The vaccine stops that virus.
Q: Ohhh, that’s nasty. What the hell is this thing?
Probably heard of it: the Humanpapilloma virus, HPV in brief. It is particularly nasty for a few reasons.
1) It’s freakin’ everywhere.
Estimates are that three-quarters of the population will be infected with HPV at some stage in their lifetime. Within the LGBTI community that’s even higher.
Chatting with Simon Donohoe, who’s the Acting-Executive Director of the Australian Federation of AIDS Organisations, he suggests that about 80% of gay men will be infected and that among HIV-pos men it’s ‘almost universal’.
2) It gets freakin’ everywhere.
Wherever your private parts end up while playing the copulation concerto, you can get HPV there. For the most part the infection is harmless but on the rare occasion it can lead to cancers, some more common than others.
If you avoid precancerous lesions then that’s all splendid for you, but while you’re infected you are capable of passing it on to your lovers, therefore putting them at risk.
3) You can’t stop it!
Thing’s notoriously hard to protect yourself against. Condoms and other prophylactics are known to help, but they don’t give complete protection. Even the most diligent of wrappers only reduce their risk of infection by 70%.
As far as STI’s go, it’s not the nastiest but it is the most common for both men and women.
Q: If it’s everywhere for everyone then why were girls only getting protected?
Because it’s the most cost-effective way to do it, you great, big ‘ol manifestation of my multiple personality disorder.
Since it was invented, the vaccine has mostly been given to girls because it not only protects them, but also protects their partners. If women are protected against HPV then not only are they not getting all the associated nasties, they’re also not passing it on to their lovers. It’s the classic idea of herd immunity, or, saving the most lives with the least money.
And this works. Cancers take a while to develop so we can’t yet see huge reductions in these cases, but we can tell very rapidly whether the vaccine is working by looking at the cases of genital warts. So far the figures are looking good.
Prof. Christopher Fairley, who is the director of the Melbourne Sexual Health Centre at the Alfred Hospital recently told ABC Radio National that: “We have seen the number of women [younger] than 21 presenting with genital warts… fall from 20% to 2% over about four years time, since 2007 to 2011.
“Exactly the same thing has happened in heterosexual men, it’s gone from 23% down to 3%.”
But you might ask: what about homosexual men then?
Q: OK, sure, why not…
By vaccinating girls we protect them and their partners, right? And to some very small degree that protects bisexual partners too. But unless you’re screwing women somewhere in the equation, you get no protection at all.
And that is happening. Talking with Marian Pitts from the Australian Research Centre in Sex, Health and Society at La Trobe University, she told me that when it comes to genital warts in gay men ‘we see no change at all.’
That’s not the worst of it though. Want me to tell you about anal cancer?
Q: Oh please do! Great dinner table conversation.
Right. Well, this whole issue of vaccination has been framed around cervical cancer, which most definitely takes the lives of the most people in the broader population. What’s interesting though is that, amongst gay men, anal cancer is just as common as cervical cancer is in women.
In fact, Prof. Andrew Grulich, who heads the appropriately titled SPANC study into preventing anal cancers, told me that it’s actually more common now than cervical cancer was before we started screening for it decades ago. And it’s getting more common too.
So, HPV is as deadly to gay men as it is to women.
Q: Right… Your point?
Doesn’t that seem a little bit shit?
That this whole time we’ve been giving the vaccine solely to girls, and gay men have been completely left off the cards? To get cancer? Of the ass? Which we know we can protect them against?
Q: Ease up crusader!
This is important to me dammit! You, and your anus, and everybody’s anus is important.
And if Australia is going to be giving free HPV vaccines to school boys then future ladies and gents of whatever gender will be protected from bad things.
We will be the first country to do that.
And that is awesome.
Q: ... Unless you’re no longer a school boy.
There’s that, yes.
But Australian GPs can give you that Gardasil hit whenever, If it’s appropriate though. Like if you haven’t been super sexually active and are likely not to have HPV already.
You’ll have to pay though. About 450 dollars.
Q: HA! Who would be stupid enough to do that?
I would. And I have. See below…
And listen, given that getting cancer sometime in your life is about a coin-flip’s odds then I’d rather not be getting it anywhere near my junk if I had the choice.
Q: With all this talk of anal cancer and dying and stuff I take it you don’t have many friends.
I’ll always have you.
Q: Oh, person! Let’s never fight again.
Daniel Keogh is a freelance science journalist and Ex- Hungry Beast member. He shares strange and inspiring science stories on Twitter – @ProfessorFunk.