Positive Life NSW Blog

There’s something we need to talk about…

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Young woman leans out of a car window with a big smile on her face

Let's talk about a silent STI with no symptoms that 80% of us who are sexually active contract sometime in our lifetime.

Did you know most of us currently have or have previously had HPV? Yep, I found this out myself after my most recent cervical screen came back saying that I have a strain of HPV.

HPV stands for Human Papillomavirus. There's plenty of evidence this common sexually transmitted infection (STI) affects just about anyone who is sexually active - men, women and trans and gender diverse people.

80% of us will get this silent STI at some stage, which has no symptoms. The majority of us won’t know we’ve got it and usually it clears itself without treatment.

So why am I talking about HPV?

When HPV doesn’t clear itself and hangs on in our bodies, this virus has the risk of causing small cell changes, called precancers, which can go on to develop other types of cancer in the cells of the vulva, vagina, cervix, penis, anus and even the throat. For women and people with a cervix living with HIV, the risk of cervical cancer is roughly five times higher than people who are not living with HIV. Worldwide it’s more of a grim picture.

As someone with a cervix, I’m super keen to know what I can do to reduce my risk for cervical cancer, especially since like many people my age I currently have HPV. Thankfully in Australia we have access to a number of different strategies and solutions to prevent and treat this type of cancer.

Since 2007, girls were vaccinated at school when we were thirteen or fourteen as part of the free National Immunisation Program (NIP). This was extended to include boys in 2013. I was lucky enough to be included in this program, however, if you didn’t get the vaccine at school, you can still get it at your GP, community health clinic or local public hospital. Even if you do have the vaccination its important you still get the recommended cervical screens, as not all strains of HPV can be vaccinated against.

Recently Australia started using a more effective Cervical Screening Test which detects HPV and also replaces pap smears. My test detected HPV so now my doctors know what to look for in case it doesn’t clear on its own.  There are also specific cervical screening guidelines for women and people with a cervix living with HIV or immunocompromised which recommends a screen every three years instead of the otherwise recommended five years. The good news is, we can prevent and treat cervical cancer with early diagnosis and treatment. 

A recent national survey of 1,000 women found almost one third of us put off cervical screening because we felt “embarrassed” or “awkward”. In Australia, 80% of cervical cancers are detected in women who are overdue or have never had a cervical screen or pap smear. This shows more conversations with our GPs about testing and vaccination options could save our lives.

While Australia is on track to effectively eliminate cervical cancer by 2035, women and people with a cervix are still being diagnosed late and dying from cervical cancer that could have been prevented. Some have even used the phrase ‘dying of embarrassment’ to describe someone who finds out they have a cancer diagnosis because they avoided talking about HPV and testing for cervical cancer.

I am lucky to have a good relationship with my female doctor who reminds me, and I also get text reminders. Another option to make cervical screens more comfortable is to see if you’re eligible for the self-testing process that started in 2017.

Last year Positive Life NSW and Femfatales, the Australian national network of women living with HIV, asked women and trans and gender diverse people living with and without HIV about their awareness of HPV-related cancers including cervical cancer.  Like other surveys, these results showed that many of us are uncomfortable talking about HPV-related cancers.

We said we would prefer clinician initiated, non-judgmental conversations about HPV and cancer with female doctors or nurses who were non-dismissive, clear, and made them feel comfortable. We also said we’d like to see more public awareness and discussion about screening guidelines, symptoms, risks and general information about HPV-related cancers.  A steering group of clinicians, researchers and HIV sector representatives have formed to start progressing the recommendations from this survey report into the future.

While it’s not my favourite thing to do in the world, in a year I’ll have another cervical screen to check up on my HPV.

I really urge all women and people with a cervix, especially people living with HIV, to check in with your doctor to find out your cervical screening options.

Making our health a priority means we stay in control. When we are informed, we are empowered!

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Guest Wednesday, 11 December 2019

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