Is HPV about Sex or Cancer?

by Dr. Nileema Conlon Vaswani in

The sexual health of our teenagers and, in some cases, even our pre-teens is a subject of increasing worrying and attention. There was a time when sexual intercourse at a young age was frowned upon because it was seen as an immoral lifestyle choice. Regardless of what one may think on that issue, couple that with a sexually transmitted disease and we are dealing with a very different problem from an allegedly immoral lifestyle choice. Consider now if this sexually transmitted disease gave your child or teenager a life threatening disease and the severity of the situation increases. This is exactly the type of situation that is being grappled with in the UK today. Many young girls and women contract HPV (Human Papilloma Virus) through sexual activity. This virus can, in many cases, lead to cervical cancer. This week, it has been proposed that girls as young as 12 ought to be given the vaccine that is designed to offer them protection from HPV and ultimately from cervical cancer. Although it is estimated that the cost of each course of vaccinations will be almost £300 per person, the long-term costs of treating HPV will be spared. The idea behind the proposal is simple: prevention is better than cure. Some people have welcomed the decision because of its medical benefits; others have criticised it for fears that it will promote promiscuity. Let us consider the moral issues surrounding the vaccine.

The fact that the vaccine is available is beneficial from a medical point of view. Other vaccines such as the MMR vaccine are intended to prevent serious diseases so there is no reason why one ought not to have the HPV vaccine available. One of the problems with a vaccine that is intended to guard against HPV is the image that it portrays. When one thinks of HPV, one tends to also think of sex, i.e., the activity that precedes the contracting of HPV, rather than cancer, the disease that could develop after the contracting of HPV. This distinction is important because it governs our attitudes towards whether or not the vaccine ought to be offered to young girls. If we think of cancer, we are bound to believe in the vaccine’s worth; if we think of sex, we are more likely to raise moral objections to the vaccine.

Society's changing moral attitude towards HIV provides a useful point of reference. At one time, the majority opinion regarding those infected with HIV was that they were deserving of their condition, that they were sexually promiscuous, etc. Those who disapproved of homosexuality also sometimes thought that AIDS was a punishment for those who engaged in what they considered to be inappropriate behaviour. Over time, we have grown to understand that many of those who are infected with HIV have contracted it through non-sexual means such as via breast milk from their mothers who were HIV positive or through the birth canal of an HIV positive mother. Blood transfusions are another means of transmission of the virus. Of course, the virus is, in many cases, sexually transmitted. What is important, however, is that regardless of how one contracts it, the medical profession as a whole has moved beyond moral judgement of lifestyle choices or unfortunate circumstances to aiming to find cures for those infected with HIV that ultimately develops into AIDS.

In broad terms, the purpose of medicine is treatment and prevention and, for this reason, the vaccine is a positive medical advancement. Some concerns have been raised about the safety of the vaccine per se but if these were to be addressed, it is a positive medical step. Although it might serve as an uncomfortable reminder that children grow up much faster these days than they did in previous generations, the fact remains that the vaccine has the potential to prevent a serious virus and thereby also cancer. The offering of the vaccine to young girls is a means of addressing a problem that exists, i.e., that of HPV via sexual intercourse. It is not the reason for HPV but a solution to it.

Critics of the vaccine fear that the availability of this solution will intensify the problem. They are afraid of an increase in promiscuity because young girls may believe that the vaccine offers them protection from HPV and this gives them the licence to engage in even more sexual activity than they otherwise would. If young girls or indeed boys want to be promiscuous, a vaccine is unlikely to encourage or discourage them. If anything, the vaccine may draw their attention to the fact that there can be health implications to sexual activity and may encourage them to seek more information about what else could happen if they were not to use appropriate contraception. Further, it is possible to explain to girls who are given the vaccine that contraception is important for preventing other sexually transmitted diseases as well as preventing pregnancy. As long as the vaccine is used for the purpose for which it is intended, i.e., to stop young girls from contracting HPV, it is beneficial. It is only if its use is misunderstood and girls stop using contraception or requiring that their sexual partners use contraception, that there is a problem.