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.



3 thoughts on “HPV Transmission

  1. I’m glad we’ve agreed to disagree on ethics. “All women must have access to the means to protect themselves all the time” sounds like a good rule to me, so that’s where I’ll be.
    You’ve been mostly courteous, I do appreciate that.

  2. There are a miriad of ways that diseases can be transmitted. Problem with identifying transmission of diseases is that the population studied is usually of people who already know how they got it. The small number of people who get it in other ways is generally small and difficult to isolate as a measurable sample group.

    HIV is one such disease that is commonly known to only be transmissable through sex/contact. However, there is significant evidence to suggest that it is possilbe to contract the virus through liquids expelled from coughing, sneezing, spitting, etc. It would be rare for this to occur, but it may explain the cases of HIV where transmission is can not be specifically identified.

    The other aspect of disease transmission is personal hygiene. Wash your hands. In any given public facility including rest-rooms the dirtiest and most contaminated locations are usually the door knobs.

  3. I hate to beat a dead horse, but I’m still trying to understand your ethics disagreement.

    From previous thread:
    tanglethis August 11th, 2007 at 1.41 pm

    “I think people are right to be suspicious of Merck’s very slick ad campaign because it is, after all, an ad campaign – …… From my research, it looks like the Merck info checks out.”

    Okay. I don’t see Timotheos arguing otherwise.

    It looks to me like you are both agreeing on the issue, just arguing from different ethical perspectives of which I’m still a bit unclear what is so different.

    But what has been glossed over, and important to me is what Jenna said in the previous post:

    Jenna August 15th, 2007 at 9.48 am

    “As a parent, I get tired of the “If you care, you’ll have your daughter vaccinated” comments that I’ve heard so often since this vaccine came out. … …but I *hate* the strong-arm tactics that have come along closely at it’s heels…. …While I have no problem with the vaccine itself, it’s a terrible day one’s government steps in to act as “parent”.”

    Think hard about the ethical implications of what Jenna is saying, in context of the government dictating the administration of STD drugs to children.

    If this doesn’t make the hair stand straight up on the back of your neck…

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