With Gardasil, that is. I know Merck's lobbying campaign to get school systems and states to require childhood HPV vaccination is controversial. Conservative parents don't want to admit their daughters are highly likely to have pre-marital sex. And some on the left are skeptical of any drug company's attempt to shill its product. In a TAP Online column last year, our own Ann Friedman explained the debate well. Now Merck is asking the FDA to approve the use of Gardasil for boys and men aged 9 to 26. And to be frank, I'm all for it. Seventy-five percent of the reproductive-aged population is estimated to be infected with HPV, and most are healthy and symptomless. In men, HPV can cause genital warts. But in women, the virus can be both painful and life-threatening. Indeed, I've heard several horror stories recently about young women infected with HPV by male partners who did not realize they were carrying the disease. In the long run, HPV can cause cervical cancer, and that risk has been the focus of Merck's marketing campaign for Gardasil. That's not surprising, since "cancer" is scary, deadly, and elides the issues of sex and sexuality. But HPV also has shorter term effects that can severely impact a woman's quality of life and reproductive health. Not to get too graphic, but if a pap smear shows irregular cells in a woman's cervix due to HPV, she will often undergo a scraping procedure meant to ensure the HPV does not progress into a cancerous phase. She may have to go through this painful process multiple times. Low-income women, who are less likely to be insured and less likely to regularly visit an ob-gyn, are also less likely to catch their HPV early on and prevent cancer. Men should be sharing in the responsibility of preventing HPV, since they are 50 percent responsible for transmitting it. Unfortunately, they are basically unable to take responsibility right now, because there is not a reliable way to test for this symptomless disease in men. That's why inoculating both boys and girls against HPV is an excellent idea. Most people are infected with HPV within their first decade of sexual activity. --Dana Goldstein
