The hidden epidemic and me… and you too!
Years ago, a friend of mine came back from a regular visit to the ol’ gyno saying she had been told she had cervical cancer. She was freaking the fuck out. Who wouldn’t? After a follow-up however, she came back much less flustered, “They told me I have cancer and then I find out it’s just some virus that 50 percent of people have that doesn’t do anything.” This virus, that according to some studies, more like 75 percent of sexually active people will carry at some point in their lives, was HPV: the Human Papilloma Virus. At the time, we knew little about it and it seemed that even the gynecologists didn’t know all that much more. Because, while my pal was a long way from cervical cancer, HPV was not something to write off.
Awareness about HPV has increased tremendously recently because of its link to cervical cancer and the sadly overwhelming incidence of women suddenly and unexpectedly being informed of “abnormal pap smears” and having words like ‘moderate to severe dysplasia’, ‘pre-cancerous cells’, ‘colposcopy’, ‘loop electrosurgical excision procedure (LEEP)’, ‘cervical cancer’, ‘biopsy’, etc. become a part of their standard vocabulary.
The Human Papilloma Virus is a group of more than 100 viruses, most of which are linked to the common wart. “Papilloma” refers to the small raised lesions many of the strains produce. Out of these 100, thirty of these strains affect the genital area and can be spread through sexual contact. Within this group of thirty, there is a differentiation between “low-risk” forms of HPV and “high-risk.” Low-risk refers to the group of HPV responsible for genital warts. Low-risk HPV, while replete with its own set of novelties, has a minimal (but still there) chance of turning into- da..da..dummmm- cervical cancer. High-risk HPV on the other hand, has, unfortunately, been found to be the leading cause of cervical cancer (if not the only?).
The fact that some strains of HPV cause cancer, while others “only” cause genital warts, combined with the rampant increase in transmission over the last few years, makes it a subject worth knowing about. And hey, cunts being the lovely permeable sex organs they are, are hella times more likely to contract HPV, not to mention every other STD known to our genitalia at large. So those among us sportin’ cunts should read up. I wish I had back when my grrrl friend mentioned the virus we knew nothing about. That said…
Onto my second run in with HPV. A new lover and I had sex with a condom, tralala. Things got more serious, I found out he could not hold an erection while wearing a condom (makes the idea of safe sex a misnomer at best) and we moved into the realm of unprotected sex. I noticed a small bump on the shaft of his penis close to the body, but as it looked like a blip in the melatonin spectrum of his special skin, and assuming he was as in touch with his body and STDs as I was with mine, I wasn’t immediately concerned. I did nevertheless, inquire pretty quickly about it. He said it had been there for about a year and had not changed over that time. My instincts told me it might be a wart but, having never actually seen one (of the genital persuasion), I largely ignored it. Until a year later, after being monogamous with this person, I suddenly was blessed with the revelation that yes, indeed, that was a wart. And now I was the proud owner of HPV as well.
I was initially angry- at myself for being so careless, not following my instincts; at my lover for not paying more attention to his body, at the world for deeming me the lucky one. HPV haunted me, taunted me, made me feel worthless and undesirable, made me resentful, as STDs tend to do. This was before I realized that, while unsightly, genital warts are relatively harmless, and that their appearance, while not fun in any sense of the word, was an indication that I had contracted one of the low-risk strains of HPV, which rarely develop into cervical cancer.
So I went about losing them and that’s when the fun really began. Oh, just trichloracetic ACID applied to the most sensitive, vulnerable part of my body. Burning stinging searing acid to burn off bits of what is essentially a direct canal to the inside of my body. Or the uncomfortable sensation of “cryotherapy”, or freezing them off with liquid nitrogen. Oh, and then there was the do-it-at-home treatment ALDARA (.05 percent imiquimod topical cream) that actually says, “make sure to wash off with soap and water 6 hours after application to avoid a severe skin reaction.” SEVERE skin reaction!? What the hell does that mean? Well, it means yer cooch starts to burn like hell and the skin starts to slough off in painful bleeding cycles. Hey ya’ll, sorry about the mental images I’m conjuring but it is important to get the full story. So then, after the burning settles in, about 2 weeks after the commencing of the cream applications, the yeast infections begin. Your cono is like, “I don’t know what the hell this burning shit is you’re rubbing all over me, but its fucking up my Ph and you will pay!” Needless to say, it was all very traumatic.
So then, after all the burning, freezing, open wounds, and yeast infections, not to mention the abstinence and mental trauma of the “contraction of an STD”, the warts disappear and I have a moment of peace. Only to find out, no, they’ve just migrated— “To your cervix. We’re going to have to take a sample.” Biopsy and Colposcopy. Which means they crank you open with the speculum, use a special magnifying glass called a COLPOSCOPE to peer inside your vagina, take a little pair of scissors and some local anesthetic and basically lop off enough chunks of your cervix to give them a definitive idea of what is going on. And I could actually hear the snip snip of my cervix being biopsied and colposcopized or what have you. But then I find out that I have only mild dysplasia and run a low risk of developing cervical cancer. Whew! But wait, what is “dysplasia”? Basically, dysplasia is an area of abnormal cell growth on the epithelium (the layers of cells covering the external surface of the cervix), also known as intraepithelial neoplasia. After collecting a sample of cervical cells through a pap, there is a system for categorizing different levels of dysplasia. Mild dysplasia is categorized under LSIL, which stands for “low-grade squamous intraepithelial lesions” (squamous being the cells on the topmost layer of your cervix). Moderate, Severe and carcinoma in situ (pre-cancerous cells, the last step before cancer) are combined under HSIL, “high-grade squamous intraepithelial lesions.” So, my dysplasia was categorized as low-grade which rarely turns into cancer. But, fact of the matter is, however low, there is still some risk of pre-cancerous cells developing . . . .
I do, nonetheless, count myself as a lucky one . . . because now, after a series of paps every four months to make sure the abnormal cells on my cervix (most of which are gone now due to the biopsy’s snazzy snipping) have not mutated into a pre-cancerous scare, I can return to a somewhat normal relationship with my cunt. And, LUCKILY, with warts, after some time, especially if you treat them, your body recognizes them as a foreign entity and will eventually build up antibodies to kick them out of your system. This often results in halting a recurrence of the warts. Some studies even show that people with well-functioning immune systems can completely rid their bodies of the virus.
It has been a year and a half and my body seems to have mostly rid itself of HPV. The trauma of my reproductive organs as open wound lingers, however. Something so closely tied to my desire and sexuality(as well as a slew of other things), mental and physical, turning into a medical dilemma that not only threatens my body’s ecosystem but left me self-conscious, undesirable, and angry over the fact that every time I have been in a medical situation in the last 5 years has been for something related to my reproductive organs, leaves a bit of a scar. And I do consider myself one of the luckier ones- I have not had to deal with the possibility of cancer, surgery on my cervix, hysterectomy, or any other invasive reproductive horror.
Meanwhile, I find out in the last month that one of my housemates has high-risk HPV that has developed into pre-cancerous cells on her cervix. Shortly after, I find out one of my dear friends from home is due, in a few weeks, for a LEEP (Loop Electrocautery Excision Procedure) which involves a wire loop emitting electric current inserted into your cervix to scrape off the infected layers while simultaneously cauterizing the wound…LOVELY. And within two days of finding that out, I get a phone call from my sister in New Mexico telling me her best friend just got diagnosed with HPV and is freaking out. WHAT is going on?!? All of these women I know simultaneously grappling with this scary, if treatable, disease?
The problem here is that many women do not even know what HPV is. More are becoming familiar with it, either through the unfortunate event of contracting it, or because of its role as the ‘leading’ (umm . . . only?) cause of cervical cancer. Meanwhile, education about it does not seem to be happening fast enough to counteract its proliferation. For a long time, it has not been considered an STD, which stunts the spread of information as far as I am concerned. Doctors have told me it is atypical of other STDs so it has not been categorized as such. But it IS spread primarily through sexual contact and one has to wonder if the fact that men are not as affected by it has anything to do with its under-the-radar location. If HPV were categorized as a STD and addressed in sex education (as long as the extremely dangerous Abstinence-oriented sex education does not completely prevail) to both males and females, sexually active people could take steps to lower their risk of contracting it.
So many people are still completely in the dark about HPV even though there’s a damn good chance you’re carrying one strain or another as I write this. It is estimated that up to 15 percent of women aged 20-30 have HPV and that up to 75 percent of sexually active women and men will acquire HPV at some point in their lives. The Center for Disease Control estimates that by age 50, at least 80 percent of women will have acquired HPV. 5.5 million new cases of sexually transmitted HPV are reported every year. AAH!
A big problem is that, even though men are as much carriers of the virus as women, unless a man has low-risk HPV and develops warts, it is largely undetectable. And even with low-risk, depending on one’s immune system, it make take a while (3 months to a year, to many years) to show up, or may never even show up at all. And with high-risk HPV, there are no real detectable symptoms in men and so it is often passed to women by partners who have no idea they are carrying the virus. Men and women both need to be educated about HPV, WHAT it is, the different types, WHAT it does, and how to protect yourself . . . .
>REGULAR PAPS!! This is true for all ages of women. While HPV is especially prevalent in those aged 20-30, women over 60 count for 1 in 4 cases of HPV. Catching even the high-risk types of HPV early can mean little to no trauma over what could, if left unchecked, lead to cancer and/or the inability to have children.
> STOP SMOKING! We all know it kills ya anyway but cigarettes are especially detrimental to women’s bodies. Carcinogens in tobacco smoke accelerate the growth of abnormal HPV infected cells.
> GOOD NUTRITION. Lots of anti-oxidents and foods full of beta carotene: fruits, fruit juices, green leafy vegetables, and orange and red veggies.
> HEALTHY IMMUNE SYSTEM. Keep your immune system up by maintaining a generally healthy lifestyle. I know this sounds like old hat and no fun but simple things like sleeping enough, making sure to move your body (exercise, walking, biking, dancing, yoga), saunas/sweats to purge toxins, staying away from craploads of the white death (you know I mean sugar-and take it from me, baker extraordinaire, I know how evil and yes, addictive, the stuff is) and immune system suppressants (drugs . . . alcohol . . . All the good stuff). . HPV will often wait until your immune system is compromised to show itself. Mine didn’t appear for a year after consistently sleeping with someone carrying the virus.
THE GOOD NEWS?? A vaccine seems to be on the way. Research is being done on a vaccine that targets HPV types 16 and 18, the two most associated with cervical cancer. There is also a new test for women that uses DNA samples within the cervix to test for HPV infection. An all-around vaccine would be tricky as there are so many strains and so many people already infected, but curbing the spread of HPV and the contraction of some of the strains even if you are already infected seems damn SuWeeeet to me.
ONE LAST THING…PAPS!
The state of California actually has a snazzy thing called “Family Pact” for low-income ovary bearers to get free reproductive healthcare through the state. Many clinics can give you information on it and help you gain access to this fabulous resource.
On top of that, here’s some clinics that do sliding scale or FREE gyno exams…
Women’s Choice Clinic does sliding scale paps and will also help you apply for Family Pact if you qulaify. Ph: (510) 836-5676, 510 14th St. Suite 3, Oakland.
Planned Parenthood does sliding scale as well (but still not cheap enough for a lot of us) and accepts Family Pact. Ph:1-800-967-7526, 482 W. MacArthur and 210 Eastmont Town Center, Foothill and 73rd- both in Oakland.
Women’s Community Clinic in San Francisco does FREE paps, prego tests, STD testing y todo. They accept drop-ins but appts. are reccommended. Ph: (415) 339-8709, 2166 Hayes St., Suite 104.