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Men also suffer some HPV-caused cancers, but their health concerns are typically
downplayed relative to the more prominent cervical cancer risks. This
is likely because gay men are at greater risk for anal and throat cancers, and
ongoing stigmas about homosexuality shroud attention to the epidemiology.
Thus, even in the “anti-stI” justification, men appear less as potential patients
than as disease vectors and risks to women. There is precedent in treating
one sex more as a vector than victim: until the mid-1990s, women were more
likely to be perceived as vectors of HIV/aIDs through prostitution and gestation,
than as at-risk themselves. 5, 6 Does the marketing of the vaccine thus
represent an attempt to restore justice for women, but at the expense of men?
Adolescent sexuality: Parents may be placed in an awkward position regarding
the HPV vaccine, as they are responsible both for protecting their
children’s health and for influencing their children’s social and sexual behaviours.
The vaccine is most effective if given prior to first sexual/HPV
exposure. Does routine vaccination of pre-teens, or a parent’s consent for inoculation
for an individual child, send the message that early sexual contact
is to be expected and accepted? It is important to distinguish the two senses
of ‘norm’ here: the typical or frequent age of first sexual contact in a demographic
group is not the same thing as the moral norm or acceptability of
the behaviour. Rather than establishing social norms of teen sexuality via
discussion, reflection, informed choice or even parental dictates, vaccination
may prematurely settle any debate in favor of presumed early sexuality, inadvertently
making it harder for teens who want to wait to do so.
On the other hand, one might hope that routine use of anti-stI vaccines would
encourage greater social dialogue and parent-child communication around teen
sex, as it becomes harder to ignore the issue when a specific decision about
vaccination must be made. If the provision of a vaccine is part of a comprehensive
framework of information, support and dialogue about healthy sexuality,
rather than a stand-alone intervention, there is potential to help parents and
teens navigate important but typically uncomfortable topics together.
Options and verdict
The HPV vaccine could be offered to girls only, or to both girls and boys, or
to adults instead of children; it could become one of the required series of
childhood needles, or an optional addition; it could be targeted to certain age
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