One of the most common sexually transmitted diseases, almost every sexually active person will get human papillomavirus (HPV) at some point in their life if they do not get vaccinated. HPV is in fact the most acquired STD in the United States. Typically, in most cases, HPV can clear up on its own within 2 years without causing health problems. However, when the virus fails to go away, it will manifest in mild or even serious complications. There are low-risk and high-risk HPV strains. Low-risk HPV strains can take the form of genital warts while high-risk HPV strains are behind more than 70% of cervical cancers. Besides cervical cancers, HPV is one of the most hazardous carcinogens responsible for other malignant cancers such as penile, oropharyngeal, vaginal, anal and vulvar.
Owing to the fact that most cervical cancers are caused by HPV, HPV is often associated as a women’s disease. However, HPV is also a threat to men since it can cause anal, penile and oropharyngeal cancers although rare. In some countries including Singapore, HPV vaccination programs are only targeted towards females since they are more likely to be badly impacted by HPV and the consideration for high costs is also at play. A more recent study, however, indicates that the trend that HPV vaccination is only centered around young females has slowly begun to change. In the United States, not only did the HPV vaccination coverage increase from 56.1% in 2015 to 75.4% in 2020, larger coverage among males also increased by 4.7 percentage points annually while females only went up by 2.7 percentage points.
Why it is important for males to get HPV vaccination
According to Dr Tan Kok Kuan, Singapore’s general practitioner specialising in men’s health, cervical cancers is at least 20 times more common compared to anal cancer, which is probably why only young females in Secondary 1 can take the vaccination for free and women and girls between age 9 to 26 can use their MediSave to cover the cost of the vaccine. Nevertheless, there are a number of reasons why HPV vaccination should not be gender-specific:
- Preventing cancers. HPV is a disease that usually manifests years later in someone’s life. Despite the fact that almost every cervical cancer is caused by HPV, men are also equally in danger because HPV can result in anal, penile and throat cancers.
- HPV does not cause symptoms. Known as the ‘silent killer’, HPV is one of several STDs which often displays no symptoms. Thus, people can actually have HPV without knowing it. And because of this, they can unknowingly pass the virus to partners during sexual activities. What is more, the use of condoms does not automatically guarantee that HPV is not transmissible since it can spread through close skin-to-skin contact.
- There are no definitive and reliable HPV tests for men. With women, HPV can be diagnosed more easily through pap smear, but to date, there are no conclusive tests that can determine whether or not men have HPV. The only procedure to get a gauge on what is happening is visual examination and this is only reliable for observing genital warts. The lack of validated screening methods can be hazardous for men as it puts them at more risk for contracting HPV. Besides, according to Dr Chris Chong of Gleneagles Hospital, men’s risks for contracting HPV do not decrease with age.
- Getting vaccinated can help better protect sexual partners. Due to the reasons mentioned above (HPV being asymptomatic and no validated tests for men), even if men want to be responsible towards their partners, it would still be difficult because of the limitations in ways of getting screened. The only reliable way to make sure men are taking responsibility is by getting vaccinated. This situation can lead to awkward circumstances if a partner ends up getting infected as no one can know who is passing the virus and assigning blame becomes inevitable.
Effectiveness of the vaccine and who should take it
Currently, three types of vaccines are available in Singapore: Cervarix, Gardasil and Gardasil-9. Until 2020, these three vaccines can be used by those aged 9 to 26, but the Health Sciences Authority has allowed Gardasil 9 to be used for both women and men aged 27 to 45.
As for the effectiveness of the vaccine, it is most effective when administered before a person has any exposure to HPV. This is why the Centers for Disease Control and Prevention (CDC) advises that vaccination is done for young men and women aged 11 to 12 years because most sexually active people have likely been exposed to HPV.
If you have doubts about the benefits of taking the vaccination after being sexually active, you are not entirely wrong. While there is some truth to your concern, people who are already sexually active can still reap the benefit of the vaccine. This is because there are more than 200 HPV subtypes (based on the National University Cancer Institute Singapore’s website), but only a few are considered ‘high-risk’. Therefore, people might not be exposed to them yet.
Women should really consider to get vaccinated because cervical cancers are silent killers and often asymptomatic until the cancer develops and they start spotting after sex and after menopause. As for older people who are in their 40s to 50s, their chances of HPV infection may be higher if they are sexually active since their resistance is weaker than those in 20s.
Get vaccinated now
Dr Ivan Shim from our clinic definitely recommends that males should get vaccinated as well, and as early as 9 years old. Both men and women should be aware that HPV is a disease that may be dormant now but manifests as serious problems only years later. Besides, getting vaccinated not only shields both genders from unwanted cancers, but also serves as the form of utmost protection towards our beloved partners. Gardasil-9 guards us against 9 HPV subtypes: type 6, type 11, type 16, type 18, type 31, type 33, type 45, type 52 and type 58.