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Contents

Author's Note		vii
Preface		ix
Disclaimer		xiii
Introduction		1
Chapter 1	Growing Knowledge About STDs and the Use of Contraception in the United States: 1900-1950	13
Chapter 2	Medical Science and the Family: 1950-1960	37
Chapter 3	The Changes in Social Behavior: 1960-1970	53
Chapter 4	The Acceptance of New Social Norms: 1970-1980	67
Chapter 5	The Diffusion of Viral Infections: 1980-1990	79
Chapter 6	The Medical and Personal Problems of HPV: 1990-Present	95
Chapter 7	STD Transmission and Viruses	117
Chapter 8	Warts	151
Chapter 9	Cancers	163
Chapter 10	Nutrition	189
Chapter 11	Pap smears and Conditions of the Cervix	199
Glossary		211
Acknowledgements		221
References		223
Index		225

Excerpt

Author’s Note

I wrote this book to give readers some answers about human papillomavirus HPV (HPV). The book relates the history of HPV research while at the same time providing a wide spectrum of information about the virus. The book includes:

1. A glossary of cancer terms related to HPV, and an explanation of medical procedures such as a conization. The glossary also provides descriptions of some common medical instruments associated with HPV.
2. Information and statistics about various cancer locations in the body associated with HPV and the methods of treatment. The book also includes methods of prevention, including the use of dental dams, and male/female condoms. The book has the most recently published statistics from the Centers for Disease Control and Prevention (CDC), National Cancer Institute and the World Health Organization concerning this disease and its association to cancer.
3. Some information about the association of HPV with other diseases such as herpes, hepatitis C and HIV.
4. Information about the “risks” of transmission of HPV and methods of prevention including the use of microbicides.
5. Results of clinical trials about herpes 1 and 2 and detailed information about defense mechanisms of the herpes virus that make its detection more difficult. This information offers some insight about all viruses, including HPV.
6. Detailed information about HPV and other STDs which answers some frequently asked questions concerning the transference of HPV and HSV (herpes) to other body locations and other people.
7. Internet links to allow access to information about HPV, HSV and other STDs.

The book is presented in an historical format to allow the reader to gain an understanding about beliefs over time regarding HPV transmission and the virus’s role as a cancer-causing agent.

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Preface

My purpose for writing this book is to help fulfill the public’s need for knowledge with respect to HPV (human papillomavirus). A large amount of information about HPV has been discovered in recent years, while the rate of infection has grown. The disease has brought medical problems and heartache to the personal lives of many. I am not a doctor nor a research scientist, but a schoolteacher with a compassion for others. Up-to-date information about the virus is available, but this information is not readily available in one location. This book, then, is my attempt to provide a comprehensive review of the information available about HPV. Will Rogers once said, “All I know is what I read in the newspaper.” I must say to you that virtually all I know about HPV is from personal communication with others, books from the library and what I have read from reports and scientific research being posted on the Internet. You might say that I am like Will Rogers trying to use common sense and reasoning to come to conclusions about the complicated information available on HPV.

It has been said that if it were not for the AIDS (acquired immunodeficiency syndrome) epidemic, the HPV epidemic would be frontpage news. The growing number of people diagnosed with HPV has made it the most commonly acquired STD in the United States.

Recent information has revealed that it should no longer be considered as just a sexually transmitted disease. Transmission can occur not only through sexual acts, but also by touch or skin-to-skin contact. This transmission can take place without any moisture or liquid being present. Since it has been found in areas of the body other than the genital area, and associated with other diseases and health problems, it should not be considered solely a sexually transmitted disease.

This writing is not intended to direct treatment or diagnoses of HPV, but to assist those that are living with the virus every day. Even as I write, new discoveries are being made about HPV. I will try to answer questions that people have about HPV. The information that I supply should enable them to talk to their doctors and to their health care professionals about treatment and health problems associated with the virus. Information supplied here should also enable them to talk with their spouses, children and/or potential spouses about the disease.

I would like to give credit to all of the people who have contributed to HPV research and to the scientists who posted their findings and reports on the Internet about cancer and sexually transmitted diseases. Most of these reports are very specific in nature, and space does not allow me to personally thank each and every one of you. I would especially like to give credit to the National Cancer Institute and the Centers for Disease Control and Prevention for all of the information that they offer about HPV. My thanks, also, goes to Dr. Stephen Goldstone of New York City, who encouraged me, and Cindy Levering-Berk RN, who worked alongside me to make this book possible.

Dr. Goldstone’s dedication to his work in health care plus his efforts in the search for a cure to HPV inspired me to write this book. Early in the year of 2000, Dr. Goldstone flew to Paris, France, to speak to the Fourth International Congress on Papillomavirus in Human Pathology. He described a study that he had conducted involving 200 homosexual men. He found that 53 percent had precancerous lesions of the anus and five of the men had cancer, including four who had HIV. Overall, 131 of the 200 men in the study were infected with HIV. Dr. Goldstone suggested anal Pap testing for anyone participating in anal sex. His findings helped me to understand the importance of even one individual in the fight against HPV.

I begin this book by giving an historical overview of the spread of diseases that became pandemic. HPV, like many diseases of the past, is spread by a human carrier. HPV is transmitted from one infected individual to another due to a lack of immunity. HPV, which is often invisible without the appearance of warts, makes it difficult for an infected individual to know that they have contracted the disease. The cause of the increased presence of HPV, which has led from its being an epidemic (defined as sudden outbreaks of disease in excess of what is expected) prior to the 1960s to a pandemic (defined as sudden geographically widespread outbreaks of disease) now is not completely clear.

Sexual habits have changed, a fact which may offer some explanation as to the wide spread of the disease. In addition, the lack of knowledge of its implications to the general public has helped it to spread. In the United States, the Centers for Disease Control and Prevention (CDC) does not require the reporting of HPV as it does for four other sexually-transmitted diseases (chlamydia, gonorrhea, syphilis and HIV).

With HIV, for example, when you are in a doctor’s office, it is standard practice to have the patient sign a release allowing the doctor to provide information to the CDC, if HIV is found. This is not so with HPV. Consequently, the epidemic of HPV has spread unnoticed by the public because the government does not require reporting of the disease. The CDC, which helps to inform the public about and collects data to track outbreaks of diseases, has shown no interest at this point in the reporting of HPV infections.

Presently, men and women with HPV too often go undiagnosed because the disease often lacks visible symptoms. When a visible symptom such as a cyst or wart does occur, it often is not seen as a major problem. However, at times visible problems do occur, such as the blockage of the urethra, that would require a visit to the doctor. The fact is that HPV is often present in a sub-clinical invisible state and is called asymptomatic. Women may learn of the HPV infection with an abnormal Pap test result. Men may never know of their infection until the appearance of a cancer.

The fact that only a few particular strains of the disease lend themselves to the creation of a wart or cyst has caused many to believe that HPV must not be a major problem. Often warts go away within a two-year period, giving the impression that the virus is gone as well. A wart is the skin’s response to the infection, and is a visible manifestation of the virus. However, it is not the virus itself. The low-risk types of HPV (those that normally do not progress to cancer) are common and are often associated with wart development. Unfortunately, they are but a few strains (6, 11, 42, 43, and 44). For example, strain 6 can develop into cancer, but has not been found to be able to metastasize to another body location. The opposite is true with other strains of HPV, such as the sub-clinical (invisible) strain 16, which is invisible most of the time but can sometimes cause a visible infection. It is most often associated with the development of cancer. One case of a visible infection with strain 16 is Bowenoid Papulosis. Some recent findings place the ratio of visible to invisible infectious strains of HPV at about 13 to 1 (Merck Medical, 17th ed.). Thus, HPV is invisible more often than visible.