I am a journalist major at Indiana University and I am doing a report on HPV. I want to know why the focus is all on women when men are 50% of the reason women have HPV?? Why is there no STD test for men, yet a woman can have a pap smear and be tested? If a woman has her boyfriend tested for STD's, an HPV test is not even an option, making her at risk. This makes no sense. Why is there not a shot for men, too? I am just confused on why we are only stopping one end of the spectrum. Thanks, Whitney

_________________
Whitney Riggs

Why is there no HPV test for men?

HPV DNA testing is indeed approved for clinical use as a cervical cancer screen, along with a Pap test, in women in two specific circumstances: 1) as follow up to an unclear Pap test result at any age and 2) as primary screening for women over age 30. It is not used as a general screening test for HPV infection.

One reason HPV testing is not licensed for routine use with men relates to the traditional difficulty in getting a good cell sample from male genital skin, which is somewhat tougher and thicker than the covering of the cervix and not as likely to produce a good specimen for testing. Recent research studies have looked at ways of getting a better sample from men, such as using a fine-grade of sand paper to “exfoliate” the skin; yes, our reaction was the same as yours… No specific sampling method for males has yet to gain wide use.

Another reason why there hasn’t been a bigger push to develop HPV testing for men is that most men with HPV will not develop easily detectable skin lesions related to the virus and associated health complications (such as male anogenital cancers) are fairly rare in the U.S. and Canada. So from a health care provider’s perspective, the need to routinely screen men for HPV may not have the same priority as for women. While controversial and not widely done, men who have sex with men might want to discuss with their provider the need for anal cancer screening (such as anal Pap tests).

Also consider that people often want to have HPV testing done in the context of answering questions such as “Am I contagious, do I still have the virus?” or “Will I develop symptoms?” none of which can be definitively answered with HPV DNA screening.

Why is there no HPV vaccine for men?
This is answered fully in the HPV vaccine thread at http://www.ashastd.org/phpbb/viewtopic.php?t=417. The quick version is that there is simply not enough data yet on the efficacy of HPV vaccines with males (or women over age 26, for that matter) but studies are ongoing and early data indicate males (and women over 26) tolerate the vaccine well and do have an immune response to it. When more data is known re: males and HPV vaccines, they may one day be included in guidelines, too.

Hope this helps,
Fredo

_________________
ASHA Moderator