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HPV Vaccine for Men (HPV) (GARDASIL FOR MEN)
Aug 14, 2007

Are there any recommendations for men (esp poz gay men) to get the HPV vaccine?

Response from Dr. Frascino

Hello,

There are no formal recommendations yet; however, some guys are already getting vaccinated. (See below.) Clinical trials are underway to evaluate efficacy and safety of using Gardasil in men. I'll reprint some information from the archives below. I would recommend, as a first step, you get an anal pap smear to ascertain if you have active HPV and if so what subtypes. Then talk to your HIV specialist to ascertain if the HPV vaccine is something you should consider, even if the formal recommendations are still pending.

Dr. Bob

Gardasil Follow-Up Jun 22, 2007

Hi Dr. Frascino,

I noticed a post recently about Gardasil, and I had a follow-up question. I realize that there is some debate about whether gay men should get this vaccine, but isn't it true that the vaccine would only help those not already infected with HPV? I have read that some 80% of HIV+ gay men are also infected with HPV. (I have no idea whether this statistic is accurate.) So wouldn't I have to first be tested for the presence of HPV before considering whether to get these injections? It sounds like the vaccine would be a waste of time and money if I *already* have HPV. Or does this vaccine have therapeutic properties as well in those already infected? Basically I'm just confused about this whole thing and am looking for someone to clear all this up for me.

Many thanks.

P.S. Your line in another post about Dubya not knowing when to pull out made me laugh out loud.

Response from Dr. Frascino

Hello,

As it turns out, there are many variants of HPV, but only a few are associated with the subsequent development of cancer. The key question is whether vaccinating someone who may have been exposed to HPV, but not to the specific variants the vaccine is intended to prevent, will be effective. Time will tell. Stay tuned. We'll keep you posted as this story evolves.

Dr. Bob

Doctors Urge HPV Vaccine for Men and Women

July 31, 2006

Eventually, men, women, girls and boys should be universally vaccinated against the STD human papillomavirus (HPV), regardless of their individual risk factors, two doctors argue in a new article. In June, the Food and Drug Administration approved Merck & Co., Inc.'s HPV vaccine Gardasil for girls and women ages 9-26. A month ago, a government advisory panel recommended routine vaccination of girls ages 11-12; and girls and women 13-26 who have not been vaccinated, have had an abnormal Pap smear, genital warts or other specified conditions.

About half of sexually active adults contract HPV at some point. HPV is usually harmless, though it can lead to cell abnormalities in the cervical lining that can progress to cancer. It can also cause genital warts and penile cancer. Gardasil protects against four types of HPV that can lead to cervical cancer and genital warts. "We need to move toward a paradigm where this is a universal vaccine," said co-author Dr. Bradley Monk, a University of California-Irvine associate professor in gynecologic oncology. Because males can transmit HPV to their sexual partners, it is sensible to vaccinate boys, he said.

Some groups oppose the idea of vaccination as a requirement for school admission, saying parents should decide whether children receive an STD vaccine.

Monk dismissed the argument that an STD vaccine could encourage promiscuity. "Just because you wear a seat belt, does that mean you drive recklessly? Or just because you give your son a tetanus shot, does that mean he is going to go out and step on a rusty nail? Of course not," he said. "To have a vaccine that prevents cancer and not use it would be one of the greatest tragedies."

The full commentary, "Will Widespread Human Papillomavirus Prophylactic Vaccination Change Sexual Practices of Adolescent and Young Adult Women in America?" will be published in the Aug. 1 issue of Obstetrics & Gynecology (2006;108(2)).

HPV Vaccine: In London, Men Demand -- And Get -- Equal Treatment Since it was approved last year, the buzz has grown louder over the human papillomavirus (HPV) vaccine, which can protect women from the four strains of HPV that together cause 70 percent of all cervical cancers. But as the world debates whether HPV vaccination should be mandatory for young women and girls, another question looms: What about men? After all, HPV can cause anal cancer, and may also be a cause of penile cancer. That's why dozens of gay men in London have requested -- and received -- the vaccine, in spite of the fact that the United Kingdom's government hasn't approved it for men to use. The Freedomhealth clinic in London started offering HPV vaccination to gay men in January and now vaccinates about 10 people a week, even though some experts have called for more research before offering the vaccine to men. (Web highlight from The Advocate)

What about vaccinating boys?

We do not yet know if the vaccine is effective in boys or men. It is possible that vaccinating males will have health benefits for them by preventing genital warts and rare cancers, such as penile and anal cancer. It is also possible that vaccinating boys/men will have indirect health benefits for girls/women. Studies are now being done to find out if the vaccine works to prevent HPV infection and disease in males. When more information is available, this vaccine may be licensed and recommended for boys/men as well.



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