HPV: There’s a Vaccine For That

The Human Papillomavirus (HPV) is the most common sexually transmitted disease (STD) in the U.S. It is linked to cervical cancer and cancers of the vagina, penis, anus (anal), throat, tongue, and tonsils. These cancers can take years develop but begin when someone becomes infected with the virus. There is only a routine screening for cervical cancer.

The Science Behind HPV

HPV has a genome made of double stranded DNA. Like other DNA viruses it has the ability to incorporate itself into the genes of its host, in this case humans. Once it is incorporated into the hosts DNA, its genes get replicated whenever the cell replicates. Depending on where the virus incorporates itself into the hosts DNA, it can turn cell growth genes permanently. This results in abnormal cell growth that leads to cancer. When you go to the gynecologist for Pap smear (Pap for Papilloma), this is what the doctors are looking for: abnormal cervical cells.

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Every year, an estimated 17,600 women and 9,300 men are diagnosed with cancer resulting from HPV infection. When broken down into communities, statistics show Hispanic women have the highest rates of cervical cancer, but African American women have the highest rate of death as a result of HPV infection since 1975 due to decreased likelihood of early disease detection. AA women also have the highest rates of vaginal cancer as a result of HPV infection. AA men have higher rates of anal cancer when compared to white men and Hispanic men have higher rates of penile cancer than non-Hispanic men.

The good news is that the HPV strains that are most likely to cause cancer are preventable and have been since the advent of the HPV vaccine in 2006. The bad news is that women of color, particularly Black women, are less likely to have their children (or themselves) vaccinated. The advisory committee on immunization practices recommends males age 13-21 and females age 13-26 be vaccinated. The vaccines are administered in 3 doses at timed intervals: 0, 1-2, and 6 months.

Vaccination rates from 2015 indicated that coverage for females age 13-17 was at 60% for the first dose of the vaccines and 39.7% for the third dose as of 2014. African Americans have the lowest series completion rate at 61.6%. Studies have shown that 48% of AA have never heard of the vaccination and those who were aware were female, employed, had some years of college education an annual income of $40,000, a regular doctor, had fewer children and were younger than 41 years of age. Awareness of HPV and the vaccine was also associated with cervical cancer diagnosis (i.e. they or someone they knew had a diagnosis).

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Lets Talk About Vaccination

Among AA parents, the most common vaccination barriers were concerns about safety, concerns that the vaccination would encourage promiscuity or pre-marital sex, lack of information, and lack of recommendation by doctor or perceived hesitance of a recommendation by a doctor. Additional barriers included perceived low risk of children acquiring HPV, mistrust in pharmaceutical companies, mistrust of medical providers, religious denomination and frequency of religious service attendance, concern about daughters being too young, and creating a false sense of protection against all HPV strains.

After wading through all of the facts, what it boils down to is that Black women have the highest rate of cervical cancer deaths, yet we are least likely to have our daughters vaccinated. The reasons why people are vaccinating their daughter boils down to either distrust in doctors and pharmaceutical companies or the fear that having our children vaccinated against an STD will somehow encourage them to start having sex or have more sex. Does anyone see the faulty logic in this? This falls into the same line of reasoning that talking to your kids about sex promotes sexual activity.

MERCK - Merck's HPV Vaccine, GARDASIL®9, now available in Canada

As a mother, a Black Christian women, and a scientist, I do not understand this logic. Even if your child does wait to have sex until they are married, chances are that their spouse did not. If protecting your child is the goal, denying them a vaccination in the name of purity culture does not serve them well. Perhaps reframing the discussion as that of your preparing a child to be a successful adult might encourage parents and caretakers to reconsider how helpful a vaccination can be in helping the current child avoid contracting a preventable virus from a future sexual partner. This vaccine can prevents cervical cancer. That is nothing short of a miracle that I embraced with all of my identities and encourage others to do the same.

Black communities in the United States have legitimate reasons for not trusting the scientific and medical industries (Tuskegee, Henrietta Lacks, the origins of US gynecology, etc). As a member of both the science and Black communities, I encourage us to consider that we can be both healthily skeptical of practices and intentions within the science industry/community AND recognize the ways that scientific and medical advances can support our health and well-being. How can Black communities build trust with medical and scientific communities? I genuinely want to know because as a Black scientist, I chose this field because I wanted to help my community through my research. I want to break down the walls of communication so that we can be free to live long and healthy/healthier lives.

Moving Forward

The biggest take home message for me with these data is that we need to get the word out to the parts of the community that are older, less likely to be college educated and more likely to be skeptical of the medical and scientific community. I think the best way for us to get vaccination rates up is by reaching out to the people in our communities who fit this description. I know that I do my fair share of communicating these things to my friends and family and I can only hope that they are passing these things along. This may also require leading by example. If you are reading this and you aren’t vaccinated and you are 45* and under, GET VACCINATED! If you have a child (of any sex and/or gender) within the recommended vaccination age, GET THEM VACCINATED!

I am challenging the #CiteASista community to share this post among friends and family and begin/continue a conversation about sexual health. Do your own research and share that too. We have to be able to uplift our community so that we can be more informed and healthier. If you have any ideas on how to improve communication between doctors and scientists to our communities, please leave them in the comments.

*Point of emphasis: The vaccine has been recently been cleared for people up to age 45!!!! This is GREAT NEWS.*

Want Your Birth Control Delivered? There’s an App for That!

Thanks to the ever-evolving intersection between women’s health and mobile app technology, you can now have birth control pills delivered to your home faster than the next book on your Amazon wishlist!

One of the most important health achievements in the modern era has been the ability for women to decide when or if they want to become parents. Contraception has allowed for women who want to become parents to space their pregnancies for optimal maternal and child health outcomes.  It’s also allowed women to help support themselves and their families through educational and career advancements.

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But often women who want to prevent pregnancy, encounter issues that make it difficult or impossible to get the care they need. These issues include:

  • Difficulty taking time off school or work to get to a doctor’s visit
  • Getting enough medication to last until you can get back to a doctor or pharmacist
  • Paying for transportation to/from a doctor’s appointment
  • Paying co-pays
  • Finding a doctor that prescribes the type of birth control you want

These barriers to accessing health care can exist for anyone but they have a much larger impact on women in rural locations, those with limited financial resources, and Black women who simultaneous experience racism within the healthcare system. So, now that the technology industry and women’s health have converged to help women overcome the many challenges we face in accessing health care, it’s essential that we support Black women by getting the word out.

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For some time now, pharmacists in many states have been providing emergency contraception (EC) to women without a prescription. Now, many women’s health experts believe that other forms of birth control are safe enough to be sold without a prescription. In fact, several states, California, Colorado, New Mexico, and Oregon, trained pharmacists can prescribe birth control so you can skip the doctor’s visit and get the medication at the same place you purchase condoms and feminine hygiene products.

Although no smartphone app will ever completely replace the valuable experience of meeting face-to-face with a clinician, these apps do offer an alternative to those who want to avoid many of the pitfalls of the traditional healthcare experience. And although women must visit a clinician to get access to the most effective forms of birth control, research suggests that for Black women,

the ability start/stop birth control that comes with less effective methods like birth control pills, the patch, and the ring, are important to Black women. Here’s the scoop on a few options to have your birth control delivered to your doorstep:

NURX

They are committed to disrupting the traditional healthcare model that too often leaves women of color with poor outcomes. Perhaps the most popular of the mobile health platforms, Nurx also provides the widest range of birth control, with over 50 options that include the patch and the ring.

Nurx also prescribes pre-exposure prophylaxis (PrEP), to women at risk for contracting HIV, making it unique among the online options. It’s available in 17 states and expanding to offer services in other states.

PRJKTRUBY

PrjktRuby aims to break the cycles of generational poverty by empowering women to decide if/when they want to become parents.

PrjktRuby is available in 48 states, giving it the widest reach of any of the platforms. Also, they demonstrate a commitment to their mission of halting generational poverty by donating 25 cents of every $20 pack of birth pills purchased, toward the provision of contraception in developing countries.

PLANNED PARENTHOOD DIRECT

If you live in California, Hawaii, Idaho, Minnesota, or Washington, you can order birth control online through Planned Parenthood Direct. They offer delivery of 5 different birth control pills through the app. You can also get information on more effective birth control like IUDs and implants. Consistent with their provision of comprehensive care in person, they also provide treatment for UTIs. Unique to this app is that you always have to option to turn your online visit to an in-person one if necessary.

LEMONAID HEALTH

Lemonaid Health’s mission is to provide ultra-low cost healthcare to everyone in America. Birth control is just one of many medications the deliver. They offer a wide array of birth control pills and although you can skip the doctor’s visit, you will need to go to the pharmacy to pick it up the patch or the ring.

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Photo Cred: thoughtcatalog.com

In general, the mobile health platforms require an online medical assessment, which most women are capable of completing quite accurately. Licensed clinicians then review your responses and meet with you, usually via telephone or video. No physical exam needed so the mobile app options may be most appropriate for women who have no pre-existing health conditions. And there is no substitute for the experience of meeting face-to-face with a licensed health care provider so it may be a good idea to visit the doctor’s office if you’re just getting started on birth control and use the online option for refills. Without insurance, prices start as low as $9 per cycle, depending on the birth control method and the platform you use. In most cases, that’s less money that it takes to take the train to the doctor’s office!

So what do you think! Have you tried either of these platforms? Do you think ordering your birth control online s something you’d be willing to try? Let me know in the comments below!

 

Here’s the Truth About Her Weight

Recently, a friend brought to my attention a blog post on the AfroPunk website because it discusses health and because it used a photo taken by the incomparable Saadi Khali as part of a discussion on the way we view bodies that are considered fat (I’m careful with my language here because I have a hard time using the word ‘fat’ to describe a person who does not describe themselves that way. Similarly, I don’t like being called ‘skinny’, though I am often described as such), especially when the body belongs to a woman. Khaali’s work aims to use photography as a means to restore Black love and Black beauty. For me, his work captures both the vulnerabilty and the power that is inherent in every human body in way that feels authentic. I have followed his work for years.
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So, I was a bit annoyed at many of the comments about the featured image used in the article. Specifically, I was annoyed because some the comments echoed similar conversations I’ve come across on the interwebs that 1) the tend to focus on a persons weight as something the each individual alone, has control over and 2) they tend to focus on a person’s weight as the sum total of their overall health (as well as the sum total of their humanity – but I hope I don’t need to talk about why that makes no sense and is simly not acceptable over here). So, for all the people out there who are living under these misguided (albeit understandable given our cultures fascination with policing other people’s bodies, especially the Black bodies and the ones we believe house uteri) beliefs, I ask that you consider the following:
Her weight isn’t just a matter of her lifestyle behaviors (eating well, working out, etc).
A person’s weight is socially determined. In short, this means that a woman’s health is determined by how factors like the city she was born in, where she works, her income, her level of education, her race/ethnicity, etc. all interact to determine the status of her health, including her weight. A woman’s health status, including the size of her waistline, is determined by much more than what she eats and how often she works out. If that were only a matter of those two things, you would not see entire segments of the population, even those who eat well and are physically active, being at what is considered to to an unhealthty weight. We only need to look to the inimitable Oprah Winfrey to know that weight, indeed almost every health status, is not that simple.
Of course self-care is important. I personally hold the belief that self-care is essential because it helps maintain harmony between the things a woman has control over and the things she does not. But, it’s important that if we are going to have a conversation about bodies, especiall the bodies of Black women, we have to be honest about the fact there are many, many factors acting upon her body, that affect her health and her weight that she does not have control over. Can we say race and racism?!  The literature on the effects of race and racism on the body is so expansive that it will suffice to say that if we are really concerned about size and weight as it relates to health, particularly for Black women, we really should have some honest and frequent conversations about race and racism. To that end, I suggest that the next time any of us decides to comment on the size of a woman’s body, particularly a Black woman’s size, for health reasons or any other reasons, ask yourself when was the last time we allied with her to mitigate or resist any form of oppression she undoubetedly experiences on a daily basis. If we can’t remember, then let’s do ourselves a favor and just keep quiet about folks’ body’s. I promise it will work out better that way.
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Her weight impacts her overall health. It is not the sum total of her health.   
We know that losing or gaining even 10% our body weight can have an impact on our health. Think about it. Have you ever tried to lose or gain 5-10 pounds? It’s not easy. You body will resist the change and even after you achieve your goal, maintaining it is a different story entirely. Every woman who has ever tried her change her weight knows this is true. That’s partly because the body is designed to maintain homeostasis. Every woman who has ever tried to change her weight will also tell you that a change in weight does not necessarily mean that she is better off any other area of her life tht impact her health. Issues like imposter syndrome at work or school, body acceptance, social stress, financial stability, family issues and other chronic illnesses may all still be present, and therbye affecting her health, regardless of her weight. You can probably name any number of women who lost weight but still struggled with mental health, emotional health, or spiritual health. So, in regards to the feature image in the Afropunk piece, I prefer to highlight the ways the woman centered in the photo showed an admirable level of courage, vulnerabilty, and power that truthfully, when I get my photos take by Saadi Khali, I doubt I’d be beave enough to show the whole entire world.
Finally, to quote @thedopeplesoul, one of the more purposeful comments on an instagram post intended to highlight the work Saadi Khali does to capture the beauty of all black bodies, especially Black folk in love, ‘Black love is so beautiful.’

Surprising Signs That You’re Stressed Out

diana-simumpande-463372-unsplashListen. Stress is unavoidable. It’s part of daily living and it happens to all of us. In fact, stress is essential for helping us live our best lives. It protects us and alerts us to what needs our attention. The problems come in when we don’t properly use stress to our advantage…or when we don’t recognize the symptoms of stress in the first place. We’re all familiar with the stress responses of an increased heart rate and sweaty palms and armpits. Here are some of the less obvious signs that our bodies give us to let us know we’re experiencing stress.

Stomach Problems

Research suggests that high levels of daily stress is associated with gastrointestinal problems for many women. In fact, several months ago, I received a call from a friend who had a high stakes admissions interview to her dream graduate school. I was super excited to hear the good news and surprised to hear her say, “I think I’m going to vomit.” Because stomach problems can be caused by so many things, it’s often overlooked as a symptom of stress. So, after talking with my friend about the opportunity that lay before her, I reassured her that what she was experiencing was likely a normal reaction to the stress that she was enduring.

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Frequent Restroom Breaks

Remember that stress is the body’s way of defending itself against threats.  It’s an evolutionary defense mechanism that can’t distinguish between the very real threat of a lion in the wild and a perceived threat of a tight deadline or high-stakes interview. When the body is threatened, the last thing you have time for is controlling the bladder. So, when the body is experiencing stress, the bladder can become more sensitive, leading to frequent bathroom breaks, even if the bladder isn’t particularly full. Some people even experience the inability to go to the bathroom when they are stressed. Again, stress diverts energy from the less essential control of the bladder to the more important thing that is causing you stress.

Neck Pain and Headaches.

High levels of stress can literally be a pain in the neck! Many people clench their jaws or tighten the muscles in the upper body in response to stress, causing soreness and pain. Stress can also have the unsettling effect of worsening any neck and shoulder pain that you already have. Because neck pain, headaches, and tight shoulders can be caused by anything from sleeping in an odd position the night before to sitting at a desk for too long, they are often overlooked as symptoms of stress.

The next time you experience any of these signs of stress, stop and listen to what your body is trying to tell you. If you realize that school and obligations with work, family, and friends have you experiencing more stress than usual, try these stress relieving techniques.

What are some other ways that your body lets you know that you are experiencing stress? Let’s talk about it in the comments below.

Rates of Colon Cancer Increasing Among Young Adults

It’s no secret that millennials and the younger half of generation X have been impacted by shifts in the work place thanks to recent recessions, trickle down economics, and shifts in company culture to value the profit over the employee. I’m not even going to start on the hot mess that is the American Health Care Act (AHCA) also coined as #trumpcare. To add insult to injurty, a recent study published in the Journal of the National Cancer Institute published by Siegel et al. has shown some alarming data on the rates of Colorectal Cancer among young Americans.

 

Though incidence of colorectal cancer (CRC) have been quickly decreasing overall since the 70’s, young(er) adults (<55 years old) are experiencing increased rates as high as 3.2%.This is an alarming trend because CRC is most commonly found in older adults and the recommended age for screening in asymptomatic adults starts at 50. It is likely that because screening for CRC does not occur until later in life, CRC cases in young adults are being missed and not diagnosed in the early stages. Though not expressed explicitly in the paper, this might be an even bigger issue for the young African American population.

CRC starts as polyps, which are typically benign but can become malignant over time. So if polyps are caught in time they can be removed before they become an issue. However, there is currently no screening protocol in place for young adults.

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There are a number of risk factors for CRC. These include obesity, physical inactivity, long-term smoking, overconsumption of red or process meats, low calcium intake, moderate to heavy alcohol consumption and low intake of fruits and vegetables. Many of these risk factors are modifiable, especially for young adults. Increased exercise, healthy diets including increased amounts of fruits and vegetables, as well as intake of whole grain fiber and decreased consumption of red meat can reduce the risk of CRC.

Overall, African Americans have a slightly higher rate of CRC in the U.S. (4.7% AA females, 4.9% AA males vs 4.3% Non-Hispanic White females, 4.6% Non-Hispanic White males). In fact, doctors recommend African Americans begin screening earlier at age 45. The 5-year relative survival rate for CRC among African Americans sits around 59% (2005-2011) and is smaller than that of white counterparts (67%, 2005-2011). The decrease in survival rates among AA reflects differences in treatment, socioeconomic status, and co-morbidities. This might be something that black millenials and gen X folks might want to keep an eye out for more than their non-black counterparts.

 

So what is the cause of increased CRC in young adults? The study didn’t look into potential causes. However experts say the increased rate is not because human papilloma virus (HPV) but could be a combination of an increase of risk facts (obesity, sedentary lifestyle, etc.) and a decrease in fiber consumption.

The increase in CRC rates in this population puts a heavier burden on this generation to have access to quality healthcare in addition to maintain a healthy lifestyle. It is more important now than ever to monitor your health and see a doctor when you are not feeling well. Maybe, write, call, email your local congressman about the AHCA while you’re at it too. In the meantime, try to get a few extra steps, eat more fruits and vegetables, and make small healthy changes. If we start to make changes now, maybe the numbers will start to go down for us young adults too.

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All Things Science and Health

Hey Cite A Sista Fam!

My name is Kishana and I am excited to serve as a writer for Cite A Sista during its beginning stages of greatness! No, really! I think what Brittany and Joan are doing here is wonderful and I cannot wait to see how Cite A Sista continues to grow. My time here will be spent covering a wide swath of science and health related topics. Why? Because I wkishana-image-2ant to demystify and uncomplicate science for those who aren’t in the field. I also want everyone to have to be aware of and have a better understanding of latest disease and health news.

About me:

I am known as the resident virologist and scientist  (and sometimes unlicensed medical personnel. Mostly, only, by Joan) among my friends. I am currently an Interdisciplinary Biomedical Science PhD candidate in the 4th year of my program. I am interested in understanding the biological processes behind disease; specifically viral pathogens spread by insects (vector-borne) and animals (zoonotic).  I also have a masters of public health microbiology and emerging infectious disease where I acquired some environmental health and epidemiological skills.

Basically what this all boils down to is I have spent the majority of life learning about disease, how it works, how to follow disease trends and assess its possible impacts on both the environment and animals (humans included) that exist within the environment. I love science and I want others to as well.

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I hope that you’ll follow along as I write about science and health including issues facing African American women and Black woman more broadly throughout the duration of my column! If there are any topics you would like me to write about please leave it in the comments.