Roundups Sexual Health

Sexual Health Roundup: HPV Vaccines Protect “the Herd,” FDA Approves In-Home HIV Test, and More on Sexting and Teens

Martha Kempner

In this week's sexual health roundup: new research suggests that the HPV vaccine lowers the likelihood of HPV in both the young women who have had them and others in their communities; the FDA approves the first completely in-home HIV test but some worry about its potentially high rate of false-negatives; and the latest addition to research on teens and sexting finds those who sext are more likely to have had sex. 

HPV Vaccine Protects Not Just Individuals but the Community as Well

Since the introduction of the HPV vaccine, public health professionals and health care providers have been fighting what seems like an uphill battle to make sure that all young women (and now young men as well) are vaccinated against this virus that causes cervical, penile, and other kinds of cancers. The popularity of the vaccine has suffered both from a generalized distrust of childhood vaccines (that began largely with a now entirely discredited study) and the unfounded arguments that providing the vaccine will encourage sexual behavior and make young women promiscuous.  For these reasons and others, only 20 percent of girls have gotten all three shots needed to prevent HPV and cervical cancer. 

Early this year, I wrote an article about how vaccinating your children against childhood diseases is not just something you do for their health but for the health of the community as well.  When a significant portion of the community is vaccinated, the entire community is protected. I argued that the same is true of the HPV vaccine; we now have a vaccine that can prevent cancer and it is our social responsibility to get vaccine rates up.  New research out of Cincinnati Children’s Hospital Medical Center supports this argument.

Researchers compared HPV infection rates in women who received the HPV vaccine to infection rates in those who had not. They found that women who had received the HPV vaccine cut their likelihood of having an HPV infection by 69 percent. Moreover, they found that the likelihood of HPV infection among women in the same community who had not gotten their HPV shots dropped by 49 percent as well. This shows that the HPV vaccine “bestow[s] what is known as ‘herd immunity’—an indirect protection against the virus for those who have not been vaccinated—in a community at large.”

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While this is good news, researchers caution that it should be taken as a reason to get your child vaccinated (reducing rates in the whole community) rather than an excuse to skip the vaccines. The lead researcher explained: “Although the study shows evidence of early herd immunity, the results cannot be generalized to imply you shouldn’t get vaccinated. [It is] still very important… there is no way of knowing you are one of those protected unless you actually get the vaccine.” As another researcher not involved in the study added: “…herd immunity is routinely achieved when greater than 80 percent of the population has been vaccinated. Thus, it is incumbent upon immune-competent individuals to participate in the vaccine effort in order to protect those who are in one way or another immune-compromised.”

FDA Approves an All-At-Home HIV Test

The Food and Drug Administration (FDA) has approved the first over-the-counter HIV test that allows individuals to find out if they are HIV-positive entirely at home.  The OraQuick test (by the makers of OraSure) lets individuals collect a sample of their saliva through a mouth swab and then returns results within 20 to 40 minutes. The FDA has previously approved tests where individuals can take their own samples at home but these samples had to be sent to a lab for analysis. The CDC estimates that one-fifth of people who are HIV-positive do not know their status.

Some public health professionals are nervous, however, because the at-home test is not 100 percent accurate. The manufacturer has been selling a similar version of this test to health care providers and has found it to be 99 percent accurate but this drops when consumers do the test themselves. 

The home test only correctly detects HIV in those carrying the virus 92 percent of the time. Meaning that it could miss one person for every 12 HIV-positive people who use the kit.  This person would likely then base medical decisions as well as decisions about sexual behavior and prevention on an inaccurate confidence that they were not infected.  The test is more accurate (99 percent) in ruling out individuals who do not have HIV. That means for every 5,000 HIV-negative people tested one would receive a false-positive.    

Still many experts are excited about this new option as testing and having as many individuals know their status as possible, is seen as one of the most important methods of preventing the spread of the virus.  As the director of the FDA’s Center for Biologics Evaluation and Research explained: “The availability of a home-use HIV test kit provides another option for individuals to get tested so that they can seek medical care, if appropriate.”

Sexting Teens More Likely to be Sexually Active

The estimates of how many teen send “sexts” vary widely from as low as 1 percent to as high as 31 percent.  Researchers continue to attempt to quantify and explain this new form of sexual expression. The newest addition to the body of research surveyed 948 teens in public school (most of whom were 15 and 16 years of age) looked at whether they had sent or been sent naked pictures or had been asked to do so.  It also looked at the teens’ sexual and dating behavior to see if there was a correlation between sexting and, well, sex. 

The study, published in the Archives of Pediatric & Adolescent Medicine found that 28 percent of the sample reported having sent a naked picture of themselves through text or e-mail (sext), 31 had asked someone to send them a sext, and 57 percent had been asked to send a sext.  There was no difference in the percentage of boys and girls who had sent texts (27.8 percent boys and 27.5 percent girls).  However, girls were more likely to have been asked for a sext (68 percent versus 42) and boys were significantly more likely to have done the asking (46 percent versus and 21 percent).  

Participants who engaged in sexting behaviors were more likely to have begun dating and to have had sex than those who did not sext. Among girls, more than 77 percent of those who had sent a sext reported having had sex, compared to 42 percent of the non-sexters. Among boys, nearly 82 percent of those who had sent a sext reported having had sex, compared to 45 percent of those who didn’t sext.

Finally, the researchers noted that girls who engaged in sexting, but not the boys, also had a higher chance of risky sexual behavior, such as using drugs and alcohol before sex or having multiple partners.

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