Thursday, June 22, 2006

New Finding: Condoms Prevent the Spread of HPV

The Citizens for a Responsible Curriculum attacked the Montgomery County sex education changes on two grounds. First, the new curriculum was neutral about homosexuality, when we all know it's a morally depraved perversion, and second, there was a video showing how to use a condom.

Their argument against condom use was, you could say, complicated. It depended on a lot of assumptions, and you had to believe their interpretation of the research, which concludes, in their telling of it, that condoms don't prevent the spread of sexually transmitted infections. Of course, the rubber blocks the movement of bacteria and viruses as well as semen, but there are circumstances where an infection can still be passed from one person to another. Most of these circumstances arise from improper use of the condom, and of course that is a primary argument in favor of teaching the correct way to choose one and use it. Not that that kind of logic actually sinks in with that group.

The real ace up their sleeve was HPV. Human papillomavirus is a leading cause of cervical cancer, and most people are infected with it at some time in their lives. Here's the kicker: you can catch it even if the man is wearing a condom. That's because it spreads by any skin-to-skin contact with an infected body part. You can catch it shaking hands, even if the person you're shaking hands with is wearing a condom. (That's a creepy thought, isn't it?)

So the grand finale of any CRC talk on condoms, often drowned out by the roar of the crowd, was "Condoms do not prevent HPV!"

But looky here in this morning's paper:
CHICAGO – In a groundbreaking study that could influence the debate over sex education, researchers have found that consistent and proper use of condoms significantly reduces the risk of contracting a sexually transmitted virus that can cause cervical cancer.

University of Washington researchers will report today that female college students were 70 percent less likely to become infected with human papillomavirus, or HPV, if their partners always wore a condom during sex than those whose partners used condoms less than 5 percent of the time.

Condoms have long been touted as a barrier against pregnancy and sexually transmitted diseases. But advocates of sexual abstinence programs have argued that condoms are ineffective against HPV, which can be transmitted through skin-to-skin contact even if a condom is worn. Condom use lowers HPV risk, study finds

I hate a news story like that. No researchers' names, nothing about the research. Well, it gets us started.

With the help of Google, we find the entire study, from the New England Journal of Medicine, right HERE. Here's the abstract:
Background To evaluate whether the use of male condoms reduces the risk of male-to-female transmission of human papillomavirus (HPV) infection, longitudinal studies explicitly designed to evaluate the temporal relationship between condom use and HPV infection are needed.

Methods We followed 82 female university students who reported their first intercourse with a male partner either during the study period or within two weeks before enrollment. Cervical and vulvovaginal samples for HPV DNA testing and Papanicolaou testing were collected at gynecologic examinations every four months. Every two weeks, women used electronic diaries to record information about their daily sexual behavior. Cox proportional-hazards models were used to evaluate risk factors for HPV infection.

Results The incidence of genital HPV infection was 37.8 per 100 patient-years at risk among women whose partners used condoms for all instances of intercourse during the eight months before testing, as compared with 89.3 per 100 patient-years at risk in women whose partners used condoms less than 5 percent of the time (adjusted hazard ratio, 0.3; 95 percent confidence interval, 0.1 to 0.6, adjusted for the number of new partners and the number of previous partners of the male partner). Similar associations were observed when the analysis was restricted to high-risk and low-risk types of HPV and HPV types 6, 11, 16, and 18. In women reporting 100 percent condom use by their partners, no cervical squamous intraepithelial lesions were detected in 32 patient-years at risk, whereas 14 incident lesions were detected during 97 patient-years at risk among women whose partners did not use condoms or used them less consistently.

Conclusions Among newly sexually active women, consistent condom use by their partners appears to reduce the risk of cervical and vulvovaginal HPV infection.

The Montgomery County school district is currently producing a new condom video. Hopefully they will be able to include this important new finding.

11 Comments:

Anonymous Anonymous said...

Well remember we still have those that want everyone and their children to be ignorant about sex education and condom use. Wonder how they will spin this?

Gracie

June 22, 2006 4:54 PM  
Blogger digger said...

Everyone talks about how HPV causes cervical cancer and suggest that women and girls should be vaccinated (or not), but I wonder whether it causes rectal cancer in people who have anal intercourse. I think I read somewhere that it does. I understand that it can cause both penile and anal warts, but that may be a different strain than the one which causes cervical (and rectal?) cancer. If it does cause rectal cancer, shouldn't we vaccinate men and boys also? Even if we only care about the straight people, aren't men vectors for the disease anyway.

Can someone who knows more about this elucidate this?

Robert

June 22, 2006 8:05 PM  
Blogger digger said...

I did some research:

http://www.lgbthealthchannel.com/msmcancer/

"Most anal cancers are associated with human papillomavirus (HPV), which causes warts on the anus and genitals, similar to cervical and other cancers of the reproductive system. Providers recommend annual anal Pap smears to HIV-positive MSM and biannual Pap smears to HIV-negative MSM."

It concerns me greatly that all the talk about the HPV vaccine is about vaccinating females, since apparently HPV does cause anal cancer in men who have sex with men (MSMs). Are MSMs that unvalued, or did people just not think?

rrjr

June 22, 2006 8:12 PM  
Blogger Dana Beyer, M.D. said...

Robert,

Cervical cancer is the number 2 cancer killer of women world-wide, so those vaccinations are first priority. But plans are underway to vaccinate men as well, especially since even straight men have anal sex.

June 22, 2006 8:27 PM  
Blogger digger said...

Thanks Dana.

I did some more reading, and anal cancer is relatively rare though rectal cnacer is more common. I have a friend who had anal cancer, which is why I guess it matters to me so much.

rrjr

June 22, 2006 10:26 PM  
Blogger Orin Ryssman said...

Gracie writes,

Well remember we still have those that want everyone and their children to be ignorant about sex education and condom use. Wonder how they will spin this?

Well, for starters, isn't the research sample a tad small?

"Methods We followed 82 female university students who reported their first intercourse with a male partner either during the study period or within two weeks before enrollment.

Perhaps I am mistaken, but isn't this sampling too small to be statistically reliable? (I am asking because I do not know...).

How about this?...I will readily concede that condoms are 99.9% reliable when they are correctly and consistently used in the protection against STD's and pregnancy. Ok?

Now the question I have for those that would seem to push condoms as the end-all and be-all for teenagers...do you really think that teens have the ability to think that far ahead, practice impulse control...not to mention have a sense of their own mortality, to abide by the strict regimen that condom use requires? Remember and keep in mind that study of a couple of years ago that read (at least in the wire copy), "Study Shows: Teens Not Reasonable"...

June 23, 2006 9:12 AM  
Blogger JimK said...

First of all, Orin, this would be called a quasi-experiment, not a survey. It's "quasi" because subjects were not randomly assigned to conditions, but were assigned on the basis of their behaviors. The classic book on this is Cook and Campbell, every grad student in the social sciences studies it. Among other things, Campbell was a pioneer in statistical analysis of quasi-experimental and experimental data. As far as I see, this sample is satisfactorily large for the kinds of analyses that are done here.

An experiment tests a hypothesis regarding differences in a dependent variable caused by differences in an independent variable -- it is a test of causality. A survey is intended to measure, usually, the mean value of some variable in a population, by estimating from a well-chosen representative sample. That isn't what this is.

Second, as far as "end-all and be-all for teenagers" -- show me where you saw that.

JimK

June 23, 2006 9:25 AM  
Anonymous Aunt Bea said...

Orin asks, "do you really think that teens have the ability to think that far ahead, practice impulse control...not to mention have a sense of their own mortality, to abide by the strict regimen that condom use requires?"

If you do not think teens have the ability to think ahead or control their impulses, it begs the question do you really think that teens have the ability to abide by the strict regimen that ABSTINENCE requires?

Aunt Bea

June 23, 2006 10:33 AM  
Anonymous Anonymous said...

Orin says, "Study Shows: Teens Not Reasonable"...

Remember.....

http://www.washingtonpost.com/wp-dyn/articles/A48509-2005Mar18.html

http://www.medicalnewstoday.com/medicalnews.php?newsid=43126

http://www.medicalnewstoday.com/medicalnews.php?newsid=21606

and more.

Gracie

June 23, 2006 12:04 PM  
Anonymous Tish said...

Digger,

I have one daughter and two sons. I want them all to be healthy and happy, whether they are gay or not. I want them to date, love, and eventually build lives with wonderful intelligent people whose parents accept the fact that they spend Thanksgiving with me every year, whether they are gay or not. I want them all to know to use a condom correctly every time they have sex, whether they are gay or not.

My children range in ages from 24 to 10, so I've gotten over the heebie-jeebies about my babies growing up; it's going to happen and it is not in my best interest to pretend otherwise. All of our students deserve to be taught about sex's consequences. Some of those consequneces are desirable and some aren't, and if we pretend otherwise, we lose our teens' trust.

MCPS needs to stop treating gay kids like they don't exist, and it is not helpful to tell them that anal sex kills, period. Right now, whatever the curriculum says about HPV, it won't have information about a brand-new vaccine, or about the very recent study affirming the HPV risk reduction that comes with consistent condom use. These are goals to work toward.

In the meantime, Dana's point about plans to administer the vaccine to boys and girls is important- it means that insurance companies won't be gender-marking the vaccine and refusing to cover it for boys. Got any ideas about how to get word out to parents who aren't reading Vigilance?

June 25, 2006 8:15 PM  
Blogger Nancy Kathlene said...

Don't rule out the possibility that these girls were slipped a bad batch birth control pills without the parents knowledge. Something like this would be covered up to prevent lawsuits. From what I heard so far sounded like a smoke screen to keep the truth from coming out. genital warts

June 04, 2013 6:18 AM  

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