HPV VACCINE

hpv-kling2ALAN KLING, M.D

Dr. Alan Kling is recognized as one of the foremost specialists in the field of HPV infections. Throughout his years as an HPV specialist, Dr. Kling has contributed to research and lectured at various medical schools, including Columbia, Cornell, Mount Sinai, NYU, and Yale as well as having been a part of a number of national panels on HPV and HPV prevention. His extensive research has allowed him to keep up with the latest HPV treatment protocols and to educate others in the field as well. While HPV is an important field of dermatological study for many physicians, Dr. Kling has clearly separated himself from the pack, making him the top HPV treatment specialist in NYC today.

Dr. Kling's private practice offices are located at his Park Avenue practice on the Upper East Side and in Park Slope, Brooklyn.

Q: What is the HPV vaccine?
A: The HPV vaccine protects against contraction of the HPV virus and is specifically targeted towards the HPV strains most likely to cause genital warts and cancer.

Clinical studies have documented that the vaccine provides close to 100% protection against genital warts and pre-cancers. HPV-related cancers take 20+ years to incubate within the body.

Q: How effective is the vaccine?
A: The vaccine is effective in preventing genital warts and pre-cancers in almost all cases. However, the vaccine offers varying degrees of prevention. The two low-risk strains of HPV in the vaccine which cause genital warts offer protection against 90% of the low risk strains

The seven high risk strains of HPV in the vaccine protect against 80% of the strains that cause cervical cancer and an higher percentage of protection against certain other cancers. The high-risk HPV strains in the vaccine represent the most aggressive high-risk strains that exist so the individual who is vaccinated is protected against the most dangerous strains.

Q: Will the vaccine help me get rid of the HPV infection that I now have?
A: The vaccine is preventive but is not therapeutic. The vaccine will not help decrease the infection from strains that the patient had before being vaccinated.The vaccine will protect only against those strains to which a patient has not been exposed to previously.

Q: When is the best time to get the HPV vaccine?
A: The HPV vaccine is most effective for those people who have not yet been exposed to the HPV strains in the vaccine. People are encouraged to get the vaccine before they are sexually active or before they have had many sexual contacts.

Adolescents ages 9-14 are advised to get two vaccines over a 6-12-month period. Teens and young adults ages 15-26 need to get three vaccines over a 6-month period.

Q: Can I get the vaccine if I am older than 26?
A: The vaccine will only give a person protection against those strains in the vaccine to which they have not been previously exposed. The older that a person is the greater the chances are that they had already been exposed to at least one if not several of the strains of HPV. The vaccine will be more effective against more strains of the virus in a person who has had fewer partners. This explains why the vaccine is most effective in people who are younger and/or have had less sexual experience.

Q: What is the advantage to women if men get vaccinated?
A: Men are frequently carriers of the HPV virus. A carrier refers to a person that has an infection and sheds the virus which can then infect their partner(s). If men are vaccinated before they are exposed to an

HPV infection there is less of a chance of them acquiring it at a later date and infecting their female or male partner(s).

Q: Should men get vaccinated just so that they can decrease the chance of giving their female partners an HPV infection?
A: Men should get vaccinated because it this will protect both their partners as well as themselves from the consequences of getting an HPV infection. Men should get vaccinated in order to minimize their own chances of getting an HPV infection as well as cancers of the anus, rectum, oropharyngeal area and penis. A man who is vaccinated will have a decreased chance of acquiring a new infection if it is one of the strains in the HPV vaccine.

Q: Any other advantages for the man to get vaccinated?
A: The man who is vaccinated will be able to avoid any one of many negative psychological aspects of having a sexually transmitted disease. He will avoid the embarrassment and discomfort of informing his current or future partner(s) that has an infection. The man who is vaccinated and protected from HPV infection will be able to avoid the time, hassle and cost of visiting doctors in order to be treated.

Q: Is the HPV vaccine expensive?
A: The vaccine is not inexpensive, but is covered by insurance for men up to the age of 21-26 years of age. The advantages of getting the HPV vaccine far exceed the disadvantages of the long term expense, time, and the emotional and psychological hassles associated with having an HPV infection

Q: What kind of HPV-conditions can a man get?
A: Men can get genital warts as well as cancers of the anus, rectum oropharynx and penis.

Q: What is the most common HPV-related condition that a man can get?
A: The most frequently seen HPV-related condition that men can get are genital warts. Genital warts are usually caused by low risk HPV strains. HPV strains 6 and 11 are the most common HPV strains, and represent 90% of the causes of genital warts.

Q: What kind of cancers can a man get caused by HPV and which strains cause them?
A: In men, HPV causes cancers of the penis, anus and rectum that are associated with the high risk strains of HPV. HPV 16 and 18 represent about 70% of the HPV strains that cause these cancers. Cancers of the oropharyngeal region are also seen more frequently in men than in women, and those cancers are caused almost exclusively by HPV 16 alone.

Q: What are the guidelines for the vaccine in the gay population?
A: The vaccine is strongly recommended for gay and bisexual men and men through the age of 26. The vaccine is most effective when given at a younger age and before a person has had many sexual contacts.

Q: How effective is the vaccine in the gay population?
A: The protection against HPV infection is the same in the gay and heterosexual men. Both heterosexual and gay men who will benefit most from the vaccine are those people who have not been exposed to those strains in the vaccine to which they have not been previously exposed.

Q: Why are gay men being strongly encouraged to get the vaccine?
A: Gay men on average have a greater number of risk factors that can predispose them to increased chances of HPV infection, which includes both genital warts caused by the low risk strains and HPV-related cancers related to the high-risk strains. The cancers of the anus and rectum which occur in gay men are more aggressive and resistant to treatment than those observed in the heterosexual population.

Q: What are the risk factors for HPV that are observed more frequently in the gay population?
A: Gay men have a greater number of sexual partners and practice high-risk sex more frequently than in the heterosexual community.

Q: What is the incidence of HPV-related infections in the gay compared to the heterosexual community?
A: Genital warts are extremely common in the gay community and occur more frequently in gay men than in heterosexual men.

Q: What are the advantages to be vaccinated for a gay man?
A: Gay men who have been vaccinated have a statistically significantly decreased chance of getting genital warts as well as precursors to anal cancer. The social and psychological advantages of getting the vaccine are similar to those for straight men.

Q: What is the incidence of genital warts in the gay population?
A: Genital warts occur much more frequently in gay men than in heterosexual men.

Q: How does the frequency of anal and rectal cancers in gays compared to heterosexual men?
A: The risk of anal and rectal cancers is 30x greater in gay HIV negative men compared to heterosexual men. The incidence of anal and rectal cancers in the HIV+ population is 80x greater than in heterosexual men.

Q: Is the direct benefit to gays to get vaccinated greater than for the heterosexual male population, given the significantly higher occurrence of genital warts and anal and rectal cancers in gays?
A: Yes. Gays are a high risk group for getting HPV infections.

HPV TOPICS
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