Take it from ‘Angela’: hooking up can be dangerous

Although her doctor had just finished up a routine gynecological exam, the young woman inquired about the bump on her bikini area, just above her vagina.

"I went to the gynecologist for a normal update at the beginning of this summer, and right when we were done and I was about to put my clothes back on, I said, 'Hey, I have this bump, not on my vagina, but up above, like it looks like a shaving nick but it hasn't gone away'," said Angela, a 20-year-old girl whose name has been changed due to requested anonymity.

What she did not know, though, was that it was actually a genital wart, caused by a strain of the Human Papillomavirus, the most common sexually transmitted infection in the United States.

"She said she would look at it, and right away she said, 'Yep, you have HPV'," Angela recalled. "And I literally thought I had AIDS or something or that I was dying when she said that. I freaked out. I didn't scream or cry or anything. But I was totally in shock."

Angela's doctor proceeded to explain the facts about HPV including much of what appears on the website of the federal Centers for Disease Control and Prevention. The CDC reports that "at least 50 percent of sexually active people will have genital HPV at some time in their lives." About 20 million Americans are currently infected with HPV, and another 6 million people become newly infected each year, according to the CDC. The malady is so common, according to the federal agency, that "at least 50 percent of sexually active men and women get it at some point in their lives."

This being the case, it was no surprise to Angela when her doctor then informed her that she had had to break the news of HPV to three other female patients prior to Angela's appointment that day.

"She said that it's so common now that's it's like catching a cold," Angela said. "I really don't think people realize what a big deal this is. People need to be more informed on this subject."

HPV is a sexually transmitted infection with the ability to cause cervical, vulvar and vaginal cancers as well as genital warts, said adolescent gynecologist Dr. Jane Broecker. who works at River Rose Obstetrics in Athens.

It comes in many different strains, and wears about 120 different disguises, some of which are fatal. Most people, especially males, do not realize they have it, as it can be asymptomatic for years, Broecker explained.

The good news, according to the CDC, is that in 90 percent of HPV cases, the body's immune system clears it naturally within two years. Often, a person doesn't even know he or she has the virus.

Stealth STI

Angela's doctor explained the widespread ignorance about this infection to her, citing reasons similar to those that Dr. Broecker mentioned.

"She (my doctor) told me also that she has had patients that have been married for 10 years and then all of a sudden they get genital warts," Angela recalled. "She told me that it can literally take up to a decade for the bumps to even surface; that the HPV virus is still there and still can be contagious, but that people don't often know they have it because they aren't seeing any actual bump."

HPV reaches further than genital warts, though, which the immune system can typically clear from a person's body in about a year or two, Broecker confirmed.

Aside from bumps appearing near the genitals, pap smears can determine whether or not women have abnormal cell growth in their cervixes, which can be a sign of HPV.

"Most people do clear the virus, but the important thing to understand (is that) there are some people that are called persistent carriers meaning they continue to carry the virus," Broecker said. "Those people are at risk for cervical cancer, vaginal and vulvar cancer."

One of the most alarming realities of HPV infections is that condoms don't always protect from it, since the virus is contracted through skin-to-skin contact, rather than transmission of bodily fluids. (The CDS advises that condom use losers the risk but isn't foolproof.)

Angela said that she might have learned this the hard way.

"I was sort of promiscuous last summer so I'm sure that is when I caught it. However, you don't have to be promiscuous to get HPV," Angela added. "Literally, all it takes is one person you mess around with to have been involved with someone who maybe had been involved with someone else who had it I used condoms, of course, too. But even that doesn't always stop it."

Although condoms, which are viewed by most sexually active college students as armor against STIs, don't provide full protection against HPV, two vaccines have been developed that prevent four different strains of HPV, including the precancerous strains #16 and #18 as well as strains that carry genital warts, Broecker said.

Gardasil and Cervarix are the two vaccinations that can prevent HPV. Gardasil focuses on precancerous strands as well as those that cause the genital warts of HPV. Cervarix focuses on the strands that can cause abnormal pap smears, Broecker said.

Anyone under the age of 27, male or female, can benefit from the vaccination, Broecker explained.

"All young women should get the vaccine, ideally before initiating sexual intercourse and regardless of sexuality," she said. "Every time you sleep with somebody new, you need to think 'is this person worth getting HPV or herpes over?'"

Hook-ups, Blackouts and HPV

In Athens, hooking-up can be synonymous with a night of navigating the Court Street Shuffle. Many students are looking for a stranger to share their bed with, even though they know the dangers.

"Here's the problem; you can give people information and it doesn't mean they'll use it," noted Gregory Janson, professor with the OU School of Human and Consumer Sciences/Child and Family Studies.

Janson said most students are aware of the dangers of drinking and hooking-up, which can lead to HPV, but educating people requires more than just telling them.

"It's like quitting smoking," he said, referring to how people know that it's not good for them, and do it anyway.

Alcohol probably is the biggest factor in the spread of HPV at OU, Janson said. It is likely that when a student is sitting in a lecture hall, he or she is sitting among peers who have contracted the virus, he said.

A quick fix to help slow the spread of HPV would involve vaccines such as Gardasil being administrated universally, he said.

"No Gardasil, no school," Janson said about such a requirement.

Angela, as well, said that contracting HPV shed a different light on alcohol-induced hook-ups for her.

"People need to stay away from drunken sex," she said. "Like I said, all it takes is for that person you sleep with to have touched someone, who touched someone else, who touched someone else who had an STI. Stay away from drunken sex because it makes sex feel cheap anyways plus you make poor decisions when there's alcohol involved and trust me, it's an even cheaper feeling to know you have genital warts."

Janson said that for women, getting tested for HPV and knowing that there is a chance they might be infected, is hard.

"You see women have a double bind (when it comes to sexuality)," he said. "You're supposed to be both Madonnas. The mother of God and the Madonna on the loose. So these girls have been socialized to be nice girls and 'nice girls don't have multiple sexual partners'. It's very difficult."

For Angela, contracting HPV changed her view on both sexual activity and relationships she said.

"My advice to girls is to just be careful. Thing is, I thought I was being careful, too. I know that the next time I have sex, won't be for a long time," she aid. "I'm sort of grossed out by it all now, and to tell you the truth the STI made me sort of feel unattractive and unsexy because I don't want to give it to anybody."