PhD Student
College of Nursing
University of Utah
Human Papillomavirus
Vaccinations have been a huge success in prolonging
humanity. Low and middle-income countries have been able to eradicate polio and other
vaccine-preventable illnesses. When Edward Jenner developed the small pox
vaccine in 1796, we have seen an influx of other communicable diseases that
have been able to stay at bay. With all of the lives saved and accolades for
vaccines, there has been a backward shift the past couple of decades in vaccine
uptake. Vaccines, like Gardasil, are being blamed for deaths and illnesses with
children and in turn, negative messages are being widely spread across social
media. Human Papillomavirus leads to an array of illness and even scary,
cancer.
Retrieved
from
http://altoday.com/archives/22320-alabama-goes-teal-to-raise-awareness-of-sexual-violence
Sexual Violence
Switching gears, a bit, rape in the U.S. has a culture of
its own. This act of violence is one that is accepted within society, one that
has been perpetuated by the lack of punishment and victim blaming. Rape in the
U.S. is more common than most think, with one in six women experiencing completed
or attempted rape in their lifetime (RAINN, 2018). Women who are college-aged
experience the most sexual violence with one in four being a victim of sexual
assault. There are a multitude of reasons many do not report their assaults,
leaving us to question the potential inaccuracies with our current statistics.
The link between Rape
and HPV
Unfortunately, there is a not a vaccine for rape, rape is
the fault of someone committing an act of violence, although some would say it
can be prevented but we can’t control other humans. Cancer from HPV however,
can be prevented by a set of simple injections, preferably at the ages of 11
and 12 for both boys and girls.
In 2012 the Department of Justice updated its definition of
rape to include men. Rape is now defined as “the penetration, no matter how
slight, of the vagina or anus with any body part or object, or oral penetration
by a sex organ of another person, without the consent of the victim.” HPV is mostly
commonly spread via sex, including oral. The CDC (2017) states that anyone who
is sexual active, even with just one person, can result in the spread of HPV. Sexual
intercourse also includes rape, yet many people don’t consider that as part of
their sexual history and survivors may be reluctant to share their experience
with a provider resulting in limited STI prevention/treatment from the
provider.
http://dhss.alaska.gov/dph/Epi/iz/Pages/hpv/default.aspx
Where do we go from
here?
There is a starting point for all of this. The CDC (2017)
has published guidelines for providers for sexual violence survivors. The CDC
states that the HPV vaccine should be given to female survivors aged 9-26 and
males aged 9-21. Furthermore, the vaccine should be given at time of
examination and then twice more, one to two months and six months after first
dose. If providers are aware and following these guidelines then there is a
possibility that we are mitigating HPV among sexual violence survivors.
With a low reporting rates of sexual violence, how, as
providers, can we make a difference in recommending the vaccine and including and
discussing sexual violence with patient’s sexual
history?
With Utah having low HPV vaccine uptake, are there ways to
change parent’s perception of the vaccine? Many parents believe that if their
children get the vaccine then that is the “go ahead” for their kids to engage
in sexual intercourse. However, I don’t think many 11 and 12-year-olds are
thinking that when they get the vaccine. A possible, but sensitive, topic that
providers can discuss with parents is that of sexual violence and how that can
impact their child’s chance of contracting HPV. No parent wants to think their
child will be a victim of sexual violence, but it does occur, and it occurs
much more often than people assume. As researchers and providers, we need to
change parent’s perceptions of this vaccine as well as have providers discuss
the potential of sexual violence and the possibility of an assault leading to
cancer.
https://blogs.biomedcentral.com/on-biology/2015/10/08/team-science-approach-fight-cancer/
HPV and sexual violence are a team science intervention.
Sexual violence and cancer affects many disciplines, including criminal
justice, public health, nursing, medicine, psychology, etc. We as researchers can
band together to aid in cancer prevention by educating and bring awareness to
sexual violence and the HPV vaccine.
References
Center for
Disease Control and Prevention. (2018). HPV Vaccines: Vaccinating your Preteen
or Teen. Retrieved from https://www.cdc.gov/hpv/parents/vaccine.html
Center for
Disease Control and Prevention. (2017). Sexual Assault and Abuse and STDs.
Retrieved from https://www.cdc.gov/std/tg2015/sexual-assault.htm
Center for
Disease Control and Prevention. (2018). What is HPV. Retrieved from
https://www.cdc.gov/hpv/parents/whatishpv.html
The United
States Department of Justice. (2012). An Updated Definition of Rape. Retrieved
from https://www.justice.gov/archives/opa/blog/updated-definition-rape
Rape,
Abuse, & Incest National Network. (2017). Victims of Sexual Violence:
Statistics. Retrieved from
https://www.rainn.org/statistics/victims-sexual-violence
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