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.*

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.’