HPV: The STD of a New Generation
A brief American cultural history of sexually transmitted disease: The "Greatest Generation" faced propaganda posters warning sexually active patriots of syphilis and gonorrhea. In the '80s, Time magazine declared herpes the "new scarlet letter" for people having casual sex. Then the AIDS crisis hit, and in the '90s-defining film Reality Bites, even Janeane Garofalo's straight white girl agonized over the results of an HIV test. But as AIDS is increasingly coded culturally as a poor person's problem, the dominant conversation surrounding sexual health has focused on the human papillomavirus, the sexually transmitted infection that most people don't even know they have.
In recent years, the ways that HPV is transmitted, treated, and talked about has shone a light on America's developing cultural attitudes toward sex. HPV is not AIDS, and it can't even be our generation's red "A"—in many people, HPV has no symptoms. Instead, the spread of HPV among sexually active youth has quietly revolutionized our cultural script surrounding sexual stigma.
Thanks to HPV, just about everyone has a sexually transmitted infection these days. About 20 million Americans are currently infected with one or more strains of the virus. Six million more are infected each year. If you have sex, you're more likely than not to get it before you die. Forty percent of women will contract it within just 16 months of their first vaginal intercourse. And the virus' proliferation has complicated Americans' moral judgments concerning sexual activity. The ubiquity of HPV has democratized sexual stigma—the virus infects people of all races, classes, and sexual orientations. If contracting a virus from sex is the norm, it makes it more difficult to dismiss people with STIs as moral degenerates or irresponsible sluts.
At the same time, the proliferation of HPV among young people has stoked longstanding fears over sexually promiscuous youth. There is no cure for HPV, and even the rules of '90s "safe sex" no longer apply—even with condoms, certain strains of HPV can be transmitted through the skin. The virus clears from most bodies within a couple of years without a trace, but in others, it will develop into genital warts or slowly convert cervical cells into cancer. Every year, 12,000 American women develop cervical cancer, and 4,000 women die from it. But strangely, fears over HPV's spread exploded only after Gardasil, a vaccine that can prevent common wart and cancer-causing strains of the virus, hit the market in 2006.
Arguably, both the pharmaceutical companies that developed the vaccine and the evangelical Christians who oppose it have contributed to the hysteria surrounding the virus. After the CDC recommended Gardasil for all girls and women ages 11 to 26, the prospect of routinely vaccinating girls against STIs before they even become sexually active sparked a political firestorm. Some conservatives claimed that protecting girls from a virus that will almost certainly affect them later in life could in fact encourage them to get busy earlier. And last week, Republican presidential hopeful Rick Perry added fuel to the fire when he reversed his previous support of administering Gardasil to every 6th grade girl in Texas. Today, fewer than half of all girls in the United States receive the vaccine.
But Gardasil developer Merck has also fanned the flames. Guli Fager, a sex educator at the University of Texas at Austin, told me that while Gardasil is effective in preventing some cancer-causing strains of the virus, it doesn't protect against all of them, and it doesn't eliminate the need for condom use or regular Pap tests. The HPV vaccine is "like using seven airbags at once," Fager says—it's nice, if you can afford it.
But well-situated women already have a couple of effective cancer-preventing tools in their arsenal. Condoms do help to prevent HPV from infecting the cervix, and regular Pap screenings are highly effective in curbing HPV's transformation to cancer. That means that the virus is most dangerous to women who have reduced access to preventative care or don't have the power to negotiate condom use with their partners. Every woman is at risk of contracting HPV, but certain women may be more likely to actually die from it. In the years to come, how cultural commentators negotiate that divide will help inform our generation's views on sex, shame, and just as importantly, class.