HPV Transmission

Here is the Power Point slide indicated by tanglethis.

Nonsexual transmission of HPV does occur. I do not know what the portion of HPV is transmitted nonsexually. I think the great majority of HPV is transmitted sexually. But clearly the situation involving children with genital warts, which is always a very difficult situation, lends evidence to the concept that HPV can be nonsexually transmitted. We have one very small study to look at which is depicted on the slide. But what it shows is that in a small group of children in Seattle, 26 children with external genital warts after a full investigation, only 5 of those children were found to be sexually abused. And so again, this tells us that in the case of children with genital warts at least, nonsexual transmission appears to be rather common. In adults I think it is less common than sexual transmission, but again I think it still occurs. I do not think that HPV is like chlamydia or trichomoniasis, which are exclusively sexually transmitted.

Besides the fact that it’s full of “I think’s” and “I do not think’s,” I’ll grant the point that HPV could be transmitted non-sexually. I doubt tanglethis would appreciate a concession that the HPV vaccine should be available to those who do not get it sexually.

The larger point is this, as I wrote in my comments on the previous post–and I will try to be as clear as possible about my position: we love to do ethics in the margins. But if there are no ethical standards about the vast majority of our everyday experience, it’s pretty much garbage what anyone thinks about the “exceptions.” Exceptions to what? Oh, that’s right, I don’t have an ethical standard outside my own head, so I make up my “ethics” as I go. Fine. But don’t argue with me about exceptions unless you have a rule from which exceptions really are exceptions. What is the rule here? “We must protect all women from all diseases all the time”? Or is it, “We must protect sexually active children and adults from the consequences of their actions”?

Once again, I do not think this or any other vaccine or inoculation should be outlawed. The point is not that we should ignore the hypothetical (or even the not-so-hypothetical) women in the margins, but that you can’t do ethics for the exceptions unless you’ve got ethics for the rule. Thus, tanglethis and I will not ever agree on this issue, because we have different starting points and we’re working from different narrative structures.

Thanks for the conversation.