HPV – news.lgbti.org

HPV Vaccine & Benefits for The LGBTI Community

HPV, Human Papilloma Virus, has been known as a silent killer.

Fortunately, there is now a vaccination for some of the most common strains of HPV. Still, many remain unaware that they have the virus until symptoms become severe. Most strains of the virus do not cause any visible symptoms in those who are infected, and the strains that do develop symptoms don’t necessarily do so in everyone. Symptoms include genital warts and cancer. For some time now research has linked cervical cancer to HPV. A more recent discovery is that anal cancer is also linked to HPV, as are many head and neck malignancies.

HPV is spread and contracted regardless of the use of condoms or other forms of protection. Thus the virus is easily spread through oral sex as well – causing cancers of the mouth, head, and neck. While there is no cure for HPV, the body usually fights off the virus within a few years. People with weakened immune systems, such as HIV positive individuals, aren’t usually able to fight off the virus. Many people who otherwise have strong immune systems may have the virus dormant only to have it flare up and change cells, causing dysplasia, during times of stress.

So why does HPV seem to disproportionately affect the LGBTI community?

It’s not that our bodies are any different. It’s that our habits are. Many people in the LGBTI community are less likely to go in for check-ups or follow-ups, increasing their chance of developing cancer. Cell changes can actually be treated if caught early enough. Men who have sex with men are also more frequently infected with HPV because it is more easily contracted through irritated skin, which is often the case with penetrative sex.

Speak to a professional today and go in for a check-up, even if you only have one sexual partner – it’s always better to be aware of what’s going on in your body.

What is commonly known is that HPV is the leading cause of cervical cancer in women. However HPV can also cause an genital (anal) cancer, for which gay, bisexual… men are at the greatest risk. Genital HPV is transmitted through skin to skin contact, the likelihood of transition is greater in the presence of irritated skin often present as a result of penetrative sex. Studies have consistently found that only 25% of men who have sex with men are familiar with HPV or the benefits of the HPV vaccination.

There are more than 60 forms of HPV, many of which are transferred by sex, and primarily infect the genitals frequently causing genital warts, and less frequently causing cervical, or anal cancers.

HPV is viewed as the most common sexually transmitted disease, at any time between 20 to 40 million persons are infected with the virus, and infections have been on a rise over the past decade. In adition, those infected with HIV are at a greater chance of complications from forms of HPV.

There exist two forms of vaccination against the forms of HPV which can lead to cancer—Cervarix and Gardasil. The United States approved Gardasil for use in men in 2010, and is particularly advised for gay, bisexual… men.

Gay Men’s Health & Healthcare Providers

Have you ever had a healthcare provider who didn’t understand you?

Maybe you just didn’t feel comfortable with him, or maybe she was outright rude. Either way, having an open relationship with your physician is extremely important. Aside from the fact that you don’t want to work with someone looking down their nose at you, being able to raise concerns and discuss health issues openly and honestly is a major contributor to your long-term health.

As a gay man, there are a couple of issues that are particularly important to discuss with your healthcare provider.

#1 HIV/AIDS

Men who have sex with men are at disproportionately high risk for contracting HIV, in addition to other sexually transmitted infections. Many infections may not initially show symptoms so following up regularly for check-ups and discussing your sexual practices with your physician may end up making all the difference in the long run. Many healthcare providers are also able to provide you with other resources and referrals – when it comes to your doctor, it’s always good to talk!

#2 HPV

The serious effects of HPV have only recently hit the forefront of health news. HPV has many strains, but it is mostly known for being the virus that causes genital warts. Genital warts are generally easy to treat, your healthcare provider can prescribe a removal cream, or, if needed, laser treatment. The concern with HPV isn’t the genital warts as much as it is cancer. Unfortunately, there aren’t many other symptoms of HPV to warn you, but the virus is now being linked to increased levels of anal and oral cancer. Oral sex can transmit HPV to the mouth and throat, causing problems in the long run. The virus is also transmitted through anal sex, possibly causing anal cancer. While this is difficult to test in men, keep up to date with your check ups.

If you are a sexually active man, find a healthcare provider that you are comfortable with and check in regularly. Reach out to a professional today!

Cervical Cancer Risk for Lesbians

The risk factors for developing cervical cancer are the same for all women regardless of gender identity and sexual orientation (LGBT Health Education .org). That said, bisexual women and lesbians are ten times less likely to get tested for cervical cancer.

Regular screenings, however, have been shown to be the best way to catch it early when treatment options and outcomes are the best. Lesbians are less likely to get preventative healthcare out of all women and lesbians and bisexuals are less likely to have health insurance that heterosexual women. Originally, cervical cancer was the most deadly form of cancer for women. Today, with early screening, it is one of the most preventable.

Since we know now that bisexual and lesbian women are the least likely to be screened, an outreach program is underway to get cervical cancer under control, and these two groups have been designated as priority populations. In addition, black women suffer the highest mortality rates from cervical cancer, while the highest age-adjusted rates are suffered by Hispanic women. Survival rate from cervical cancer within the first five years of being diagnosed is 67.9%, but if it is found early on, the survival rate is 90.7%. That’s why it’s so important to reach out to these populations and motivate them to get regular screenings.

Smoking, immunosuppression often related to HIV, and human papilloma virus (HPV) infection are major risk factors for cervical cancer. Many in the LGBT community such as lesbian women, bisexual women and transgender men who still have a cervix have higher chances of having or developing these other conditions, and so have an increased risk of developing cervical cancer. What makes matters worse, since they are much less likely to be insured, they are less likely to seek out preventative care.

Obesity is another risk factor which is also higher among lesbians. Not as much data is available on bisexual women, though some studies show that they may have lower insurance rates and higher smoking rates, making them also more susceptible. One study found that 2.2% of bisexual women develop cervical cancer as opposed to 1.3% of heterosexual women. Hispanic and black bisexual and lesbian women should be particularly targeted for an outreach program.

Although we are seeing more and more types of studies being done concerning LGBT health, more still has to be done. We see that race and age data is often collected while sexual orientation data often slips through the cracks of the healthcare system. There has been a pivot recently. LGBT health is becoming more of a priority in communities across the country and certainly on the national front. We should see this data being collected more and issues such as this coming to the forefront, as well as policies and procedures to better address the health disparities suffered by the LGBT community.

Cervical Cancer Risk for Lesbians and WSW
Dr. M. Mirza, LGBT Health Wellness – 2015

Understanding Anal Cancer Screenings

It is a rare disease, but anal cancer does exist and deserves our attention.

The cases of anal cancer are a lot more prevalent in gay and bisexual men or, “men who have sex with men” (MSM). Unfortunately, most MSM’s have not been tested or know that any screenings are out there, and do not know much, if anything about anal cancer. Medical professionals are actually divided on whether they should even screen for it and how they would do so. Currently, there isn’t any standardized protocol for anal cancer screening.

Facts about anal cancer:

Anal cancer is diagnosed in approximately two out of every 100,000 people in the general population every year.
MSMs who are HIV negative are 20 times more likely to receive an anal cancer diagnosis (about 40 per 100,000 people)
MSMs who are HIV positive are up to 40 times more likely to receive this diagnosis (about 80 per 100,000 people)
The same strains of Human Papillomavirus (HPV) that cause cervical cancer in women also cause anal cancer
In MSMs, HPV is transmitted through both protected and unprotected anal intercourse and skin-to-skin contact. HPV is very common– approximately 75 percent of all sexually active adults acquire HPV; not all HPV infections lead to cancer.

A number of men don’t have any apparent symptoms of HPV, but possible symptoms include:

Genital warts affecting the anus, penis and/or peritoneum
Abnormal discharge from the anus
Bleeding from the anus and rectum
Itching of the anus; pain or pressure around the anus
A sore or sores that do not heal, around the anus

Since the cervix and anus are similar, biologically, and both are target areas for HPV infection, a pap smear can be used test the anus for pre-cancerous cell changes and cancer. More and more health activists and gay physicians believe this procedure could reduce the incidence of anal cancer as significantly as it has with cervical cancer in women.

It is recommended by them that all MSMs, especially those who are HIV positive, receive testing every 1 to 3 years, depending on their CD4 count and immunology wellbeing. Their recommendation for HIV negative MSMs is for testing every 3 years. Other physicians don’t believe all MSMs need to be tested due to the small number of cases, facility shortages for follow-up procedures, and the cost, pain and fear of looking at small changes in cells (dysplasia). In addition, the number of insurance policies that would cover pap smears for the anus is low.

Even though the AIDS Institute of New York recommends that HIV positive gay men “and others with history of HPV disease” be tested annually, there appears to be little agreement about the importance and practicality of offering all MSM clients this testing.

Dr. M. Mirza, lgbt health wellness .com – 2015