HIV Digest	HIV Digest Archive

Question for from TheBody.com's "Ask the Experts":

I'm recently out of the closet, and have had very few sexual encounters so far. I realize that I might already be infected with some strains of HPV even after one or two encounters, but still it seems to makes sense that I get vaccinated for HPV. I've had several friends of mine who are finishing their residencies in gynecology tell me this. However, when I've gone to my doctor, and even started calling clinics, they all refuse to offer me the vaccine because it's still not officially approved for men. I was even laughed at by one health care provider: "Don't you know that's only for girls? Ha ha!" I'm not going to put my sexual life on hold to wait for approval of the FDA and by that time it may no longer make sense for me to be vaccinated.

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What should I do? Where should I go?

-- A young gay man who wants to maintain a clean bill of health

Response from Dr. Frascino

HPV infection in men causes genital warts and has been linked to penile and anal cancer. HPV-infected men can transmit the virus to their sexual partners. Merck, the company that makes Gardasil, has tested the vaccine's safety and immune response in boys aged 9 to 15 years and found that they have a slightly better immune response than girls and/or women. However, what we don't know yet is whether or not the vaccine will actually protect against infection and disease caused by HPV in young men. The clinical trials designed to answer that question are still ongoing.

The National Institutes of Health is also carrying out a clinical trial to see what benefits Gardasil might have for HIV-infected folks. A number of men, both HIV-positive and negative, have opted to get vaccinated despite the fact Gardasil is not yet FDA-approved for use in men. This is considered an "off-label use" of the vaccine. As you found out, most all physicians or clinics are unwilling to use it for off-label (non-FDA-approved) indications. Also health insurance often will not cover unapproved uses of expensive therapies. If you are both willing to pay for the vaccine yourself and accept the risks of off-label use, you should be able to find a physician willing to administer the vaccine. [Info online at TheBody.com.]

from TheBody.com