If you've ever read Tom Sawyer, you'll remember the graveyard scene where Tom and Huck witness a murder committed by the nefarious Injun Joe. Tom and Huck were in the graveyard initially to work a spell they were convinced would cure Huck of his warts. The putative cure involved swinging a dead cat at midnight over a wicked guy's grave. The central idea was to wait for the devils (you can hear 'em in the wind) to take the spirit of the bad man away. You are then to hurl said cat in the direction of the wind while chanting "Devil follow corpse, cat follow devil, warts follow cat, I'm done with ye!" Quoth Huck, "That'll fetch any wart." Whether the cure did "fetch" his warts was never mentioned, but it's unlikely to have had much effect as we now know that warts are caused by human papillomavirus (HPV) infection.
HPV hit the news several years ago when it was established as the causative agent in just about every case of cervical cancer. If a woman has cervical cancer, in almost 100 percent of cases, it's because some dude gave it to her. Think that's bad? It gets worse. There is also some evidence that prostaglandin, a hormone found in ejaculate, fuels the growth of cervical cancer once it takes hold. Men are the Typhoid Marys of cervical cancer.
Now, if you have warts on your hands like Huck Finn, that doesn't mean you're a walkin', talkin' cancer spreading machine. There are over 100 types of the human papillomavirus (hand warts are caused by HPV 2). The vast majority of these are harmless (ugly, but harmless). Only 30 or so are transmitted through sexual contact and of these only two, HPV 16 and 18, have been directly implicated as causative agents in cervical cancer (although HPV 31 and HPV 45 are also thought to be suspects). Unfortunately, HPV 16 and 18 are among the most common and easily transmitted strains of the virus. What makes these strains so dangerous are two viral oncogenes that when incorporated into the host cell genome, produce proteins that interfere with the tumor suppressor genes, R1 and P53. Slowly but surely, HPV kicks out the blocks that prevent runaway cell division.
In developing countries, cervical cancer is the third leading cancer killer (behind lung and breast cancer). In affluent nations it is relatively rare (Only 10,000 cases are diagnosed annually in the United States leading to approx. 3,000 deaths) because it's usually caught in the pre-cancerous lesion stage by an annual Pap test. But Pap tests are no picnic. Your girlfriend has to lay on her back with her feet in stirrups while the doctor inserts an instrument called a speculum into her vagina and cranks it open to give him/her a view of the cervix. The good doc then inserts a special stick to scrape cells from the surface of the cervix that are then sent to the lab for testing. The procedure is, unsurprisingly, deeply uncomfortable; and Bub, you'd best believe it's all your fault.
You're probably thinking; "Well that's not me, my dick is wart free!" But even if you have nary a wart on your dick or anywhere else, even if you've had a modest sex life; odds are you've been exposed to the virus and will always be a risk for transmission. Once inside your cells, viruses are never eradicated, they're only controlled. Viruses exist because they love to replicate themselves. What prevents them from keeping you in a constant state of infection are the cells in your immune system that recognize and destroy the virus when it's found outside the cell.
Even if you're currently infectious, the virus may not be symptomatic. Most men infected with HPV never know it. Paradoxically, visible genital warts are usually associated with HPV 6 and 11 which are not thought to be cancerous agents. At any given time, it is thought that between 5 and 10 percent of the population are infected with genital HPV. Only 1 percent are visibly symptomatic.
Unfortunately there is no general test to detect the presence of HPV infection in men as there is in woman. The only effective and reliable method is to collect a sample of skin cells. But most men, me included, are simply not up to having bits of our dicks snipped off for testing on a regular basis. One way to detect the presence of genital warts is to douse a little vinegar on your dick. Apparently ascetic acid reacts with the virus, turning the infected cells white. But like I said, even if you appear clear you may not be.
So, what are we guys supposed to do about all this? Luckily, there are things we can do to reduce the risk of transmission. Condoms are an obvious example. They don't completely eliminate the risk but do reduce it. Circumcision may be another. The virus appears to be significantly more persistent on uncircumcised men. But before you run out and have your foreskin hacked off, be advised that the threat of transmission is not reduced if you're not currently infectious. Which brings us to the most effective means of reducing the risk of transmission - being faithful. I know, I know... Bummer! But it's true. The more partners you have, the more likely you're going to encounter someone who is currently infectious and once infected, the more likely you are to pass it on. Promiscuity is the single biggest risk factor for HPV. And hey, it takes two to tango. If your partner was promiscuous herself, or if she was attracted to the type of man who is attractive to other women, chances are she will have contracted the virus from someone other than you. It's been estimated that 50 percent of men and 75 percent of women have been infected with HPV at some point in their lives.
The link between HPV infection and promiscuity is the main reason the American religious right was opposed to the introduction of a vaccine to immunize against HPV 16 and 18 (the thinking presumably being that people who have sex deserve to die of cancer). In spite of their wrong-headed protests, the vaccine (called Gardasil�) was approved by the FDA in June 2006 and is currently available for about US$130. In clinical trials the vaccine appeared to be 100 percent effective in blocking infection and transmission. That beats the heck out of heaving a dead cat into the wind.
