December 30, 2012

My agenda

Forthcoming posts:

  • Hooey: "Once you have HPV, you have it forever, and it goes dormant and can pop back up at any time, especially after menopause when your immune system becomes defective." In the research, this is a real unknown, but in popular sources and "patient education," the pre-1990s theory of perpetual infection still gets stated as fact. What we do know is that within 2 years of infection, over 90% of women clear HPV from the body to the point that it is not detectable by DNA testing in the genital tract. While some researchers think it goes dormant somewhere, they've never shown where or how, and the population-based research tends to show that most new infections are associated with new sexual partners, not some unspecified immune compromise.   
  • Hooey: "You can't test men for HPV." It is possible to test men for HPV. Research studies do it alla fucking time, and it's less physically invasive and no more expensive or difficult than testing women. We just don't bother because as a matter of public policy, we don't think men should give a crap about women's sexual health.
  • Research Roundup: What is known about HPV prevalence and clearance in men?
  • Hooey: "Either remain a virgin until marriage or just assume everyone already has HPV." Both of these are stupid and irresponsible ways to think about HPV risk and transmission. Practical, ethical, evidence-based ways to reduce HPV transmission while still having sex like a 21st-century person. 
  • Hooey: "Women over 26 can't get vaccinated for HPV." You can, and sometimes your insurance company might even pay for it. 
  • Hooey or Not? Naturopathic treatment of HPV.
  • Hooey: "A little discomfort." We need to stop minimizing HPV-related biopsies and treatment. My gynecologist accidentally stabbed me in the uterus during my colposcopy and I ended up in the ER with a pelvic infection. A friend had a surprise LEEP. And there is a long history of overtreatment and lack of informed consent in this area. This crap sucks. 
  • Off-Topic Rant: Publicly-funded research should be published publicly so it's available to the public whose public funds paid for the damn publicly funded research. Damn it. 
  • On-Topic Discussion: "Why are all these studies done in Costa Rica, and what are these HeLa cells everyone keeps talking about?" Racism in cervical cancer research--is it over? Mostly over? Kinda slightly better? Just the same crap as ever?
  • Hooey: Misrepresentation of other risk factors for cervical cancer. A lot of "patient education" materials list other "risk factors" for cervical cancer and imply that they are causative. Very few of them are. Aside from persistent high-risk HPV infection, one of the few "risk factors" shown to actually help cause cervical cancer is cigarette smoking or exposure to industrial or firewood smoke. So stop smoking. The other "risk factors" (like herpes, early sexual activity, etc.) are statistically associated with cervical cancer, but most researchers now think that these are just proxies for exposure to HPV. There is some research on whether active herpes or chlamydia infections affect the body's response to HPV.
  • Hooey Abhors a Vacuum: Why is there so much hooey on this topic? Feminist medical sociology and women's health 101.
  • Research Roundup: Pap testing is subjective and inaccurate, but still necessary. With pictures!