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According to the Centers for Disease Control (CDC), by the age of 50 more than 80 percent of women in the U.S. will get at least one strain of genital HPV.

HPV: An STD with life-threatening strings attached


March may be cold, but it's hot and heavy here at OnMilwaukee.com as we celebrate our first-ever Sex Week. We're taking a mature look at local video and sex toy shops, area strip clubs, sexy Milwaukee events -- and even some connections between Brew City and Playboy magazine. It's serious, responsible, adult-themed content -- but don't worry, parents, we'll keep it PG-13 in case junior stumbles upon these stories as OnMilwaukee.com turns a pale shade of blue for seven days.

When Dina Gruber had abnormal results on her pap test and was diagnosed with human papillomavirus (HPV) in the form of genital warts in November of 2005, she was completely shocked. Gruber, then 35, had been practicing safe sex, using condoms 100 percent of the time, and still contracted HPV.

"As a society, we're so focused on AIDS, and the fear of transmitting infected body fluid, that we still think condoms will protect us from all STDS, and they don't," says Gruber.

HPV is spread through casual skin-to-skin contact, which means it can be contracted during foreplay or even just snuggling. There are more than 100 strains of HPV, a few of which cause genital warts and/or cervical cancer. (Note: Only 1 percent of women who contract HPV will get cancer.)

When Gruber shared her diagnosis with friends, some assured her that it would be easy to treat. Unfortunately, this was not the case. Because Gruber's virus worsened very quickly -- she went from a "level one" to a "level three" within two months ("level five" is full-blown cancer) -- and had two LEEP procedures during which a thumb-sized portion of her cervix was removed with a heated metal loop. Plus, her wart outbreaks continued to worsen, even though she was refraining from sex and applying a doctor-prescribed cream.

"(My vagina) looked like a sea creature. It was horrifying," she says.

It's difficult to glean information from HPV statistics because most of them vary greatly. However, it is believed that most people encounter one of the many strains of HPV during their lifetime and fight it off naturally, or they carry it for their entire lives without a single outbreak.

Both men and women can transmit HPV, but at this point, only women can get tested for the virus.

Dr. Julie Webb, an OBGYN at Columbia-St. Mary's, explains that it's difficult to screen men for the virus because the test involves swabbing the urethra, and many of the HPV cells get flushed out every time a man urinates. Women, on the other hand, are swabbed in the cervix, which provides more accurate results.

"We're able to diagnose HPV in women earlier because of pap tests," says Webb. "We didn't know the correlation between HPV and the pap until relatively recently."

Experts are unsure why some women are more susceptible to the virus than others, but smoking cigarettes is believed to increase a woman's chance of getting HPV.

In general, there is still a lot of gray area surrounding HPV, as well as the vaccination, Gardasil, that protects against four strains of the virus, including types 16 and 18 that cause 70 percent of HPV-related cervical cancer cases.

The FDA approved Gardasil in June of 2006 for women who are between the ages of 9 and 26. The somewhat confusing Gardasil ad campaign "One Less" encouraged women to get the vaccine so they would be one less person with cervical cancer.

Should a woman over the age of 26 consider the vaccination? According to Webb, women of any age should consider the vaccination if they are not in a monogamous, long-term relationship. Unfortunately, however, most insurance companies won't cover the cost -- which is roughly $500 -- for women older than 26.

"It definitely can be beneficial for women outside of the age range," says Webb.

Because HPV spreads so rampantly and isn't preventable through contraception, it's possible that many peoples' sexual behavior will decrease. And because men cannot get tested at this point, many women could become uneasy with the concept of casual sex.

"I felt so much shame, especially since I was 35 years old and had contracted my first STD," says Gruber. "When I was first diagnosed, I thought I could never have sex again. I wanted to have a funeral for my (vagina)."

Gruber still hasn't received a clean bill of health, and because the disease is still relatively "new," proper support networks are not in place. Gruber says she is yet to find an HPV-specific support group for women like herself who have a strain that could lead to cancer. One local support group combines people with herpes and HPV, but Gruber says the two diseases are very different because a person could potentially die from HPV.

"In my case, HPV is not just an STD," she says. "My mortality is attached to it. The bottom line is that I might get cancer ... This isn't the case with herpes."

Currently, Gruber is working towards starting an HPV support group. She is trying to move beyond her depression, shame and anger, and do something to educate the public about HPV -- which is still confusing to a lot of people.

"For women who have cancer-causing strains of HPV, I want them to know they are not alone, and that help is on the way," she says. "Through education, and giving HPV a voice, hopefully other women won't have to go through what I did."


Talkbacks

MLM30 | March 14, 2009 at 10:36 a.m. (report)

The previous comment is correct. There are several different strains of HPV and the cancer causing one is different than the strain that causes warts. Two totally different strains. I had the cancer causing strain 5 years ago. My pap came back abnormal so I had to come in for a colposcopy to have a biopsy done. When the biopsy came back it gives you results on how severe the cervical dysplasia is. There are levels called CIN 1,2 and 3 from what I remember. I had to have the LEEP procedure done and was referred to different doctor and had another colposcopy done and it went from mid grade CIN to high grade CIN. They ended up having to remove more from my cervix. Luckily after getting results from the pathology dept it was not invasive cancer. This can be a very scary thing for a women to go through. To the person who said this will never happen to you if you're in a monogomous relationship you're wrong. If your partner that you're with carries HPV, you can get it. It doesn't mean that you're sleeping around. Thank you for writing an article about this...women need to be informed, but you should clear up the different between the strains....girls who end up with warts won't have the scare of cervical cancer!

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person11 | March 13, 2009 at 3:18 p.m. (report)

ACK! YIKES! The cancerous HPV strains DO NOT CAUSE WARTS. They are asymptomatic. Your writing was unclear and seemed to imply that you can get both Cancer and warts in the same strain. NOT TRUE. THEY ARE DIFFERENT STRAINS. Gruber supported this in the quotes! She actually lucked out with the "low risk" (warty) kind, unless she had high risk strain too-- and that important fact was just glossed over? Having HPV is a bummer, but it is something that can be dealt with. I had high grade, high risk HPV at 30 years old (no warts just Cancer possibilities). That meant that I was *really* close to possibly getting Cancer (and I never smoked!), but I changed my diet and got lots of folic acid (per my OBGYN) and by the time I got a second opinion for the LEEP, it went down to *low grade*. No LEEP needed! I then had cyrosurgery to kill of the messed up cells (which wasnt totally necessary) and I'm hopefully all better. There are resources available. It wasnt responsible to say that there werent, and to tie up the article in that way with the end quote like a "happy ending". Here are some actual online support groups/forums. There are many more and they are fantastic! There are support groups available online. http://tinyurl.com/mdjunctionhelp http://www.hpvsupport.com/ http://www.inspire.com/groups/national-cervical-cancer-coalition/discussions/

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newguy | March 13, 2009 at 2:15 p.m. (report)

I know most will hate me for this, but the answer is right in the article: "According to Webb, women of any age should consider the vaccination if they are not in a monogamous, long-term relationship." In other words, if you are only having sex with your spouse, and your spouse isn't cheating, and you saved yourselves for marriage, then YOU WILL NEVER HAVE TO WORRY ABOUT THIS. And if everyone did this, the disease would disappear completely from the face of the earth. And they say abstinence education is bad . . . (For the record, I am not passing judgment on ANY PERSON. I am trying to state that the best prevention is not putting yourself in the situation where you can get it. This is the option that most don't want to consider, but it is the cheapest, 100% fool-proof way of eliminating it. But, instead, the message that is delivered is more often one of trying to come up with fixes after the fact, rather than stopping it dead in it's tracks. I am passing judgment on the education system, and our society who promotes and applauds promiscuity. And this week, in particular, this website is just as guilty. Can't wait until next week, when I don't have to cringe at what my kids will see when we log onto the internet, and our homepage of onmilwaukee.com.)

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gmwrobel | March 13, 2009 at 1:19 p.m. (report)

well, you can add me to that statistic....i just turned 22 and was told two years ago that i have HPV. i have been going to the OBGYN every six months since so she can keep an eye on whether there is progress or not. I have no outwardly visible signs though so it is always done with a special microscope and i've had a few biopsies of my cervix. at one point it was gone but then it came back. the virus is only supposed to take two years to run it's course but there's no saying how long the pre-cancerous cells will be around and how bad they could get. i completely agree about it being more than an STD. i ended up getting it because a long term boyfriends ex lied to him. she said he got tested and everything came back negative. using our logic, we figured out it was her. I can't believe a girl would lie about something intentionally but that may stem from not having the education about what could happen if someone else got the same virus. i hope they come up with something soon. i want to have children and i want to be able to not worry so much about whether it will be possible or not.

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