Kiwi men are being urged to take note of a new study into the rates of the cancer-linked human papilloma virus (HPV) in men.
The study is reigniting debate over the Government's vaccine policy. Right now girls can be vaccinated against HPV for free, but not boys.
Andrew Miller's bone graft has yet to heal – the pain unavoidable after part of his leg was used for facial reconstruction.
"I noticed that I had a lump right next to my nose, and I thought 'oh, that's kind of weird'," says Dr Miller.
He had nasal cancer, associated with HPV.
"I had the cancer removed from my nose, which involved taking out my five front teeth, my hard palate and the inside of my nose," says Dr Miller.
His case is rare, but it is one campaigners for across-the-board HPV vaccinations hope will be heard.
HPV is sexually transmitted, and nearly everyone will at some point have it. Right now, girls can get the vaccine free of charge, but for boys it costs around $500, even though boys can get HPV-related cancers too.
Kiwi researchers say because of that, it's important policymakers know just how many men are infected. A world-first study to find out is almost done.
"Gay and bisexual men are particularly at risk because of sexual activity and, because it's a small group, rates of HPV have been shown to be about 30 times higher in this group," says University of Auckland researcher Adrian Ludlam.
Researchers at the University of Auckland are keen to stress that most HPV infections will clear up on their own, and very few will go on to become cancer. In saying that, they say it's still important we know just how prevalent the virus is among men.
A Ministry of Health advisory committee wants the vaccine to include boys aged 11 to 25 who identify as gay or bisexual, but the decision lies with drug-buying agency Pharmac.
"It's not just gender discrimination; it's also sexual orientation discrimination," says Dr Miller.
Until the drug is cheaper, it's likely to stay in the box.
“HPV is a common STI that in some people persists and causes cancer of the mouth and throat, penis or anus, or cervix. A safe and effective vaccine is available (Gardasil) but in New Zealand this is only funded for young women, not young men. A particular concern are the rising rates of anal HPV-related disease seen internationally in gay and bisexual men, that are 20 times higher than in heterosexual men - for HIV positive gay men these are higher still. This raises serious health equity issues. ” says Adrian Ludlam, a PhD candidate at the University of Auckland and Gay Men’s Sexual Health research group.
“Currently little is known about HPV in New Zealand men. Our study is an initial investigation into the prevalence of HPV in the mouth and anus, awareness of HPV and related cancers among men, and acceptability of the vaccine.” Says Ludlam.
The study is funded by the Health Research Council and undertaken by researchers at the University of Auckland’s Immunisation Advisory Centre (IMAC) and Gay Men’s Sexual Health (GMSH) research group, in partnership with Auckland Sexual Health Service, Auckland City Hospital and an Auckland City general practice.
HPV factsheet for men: http://www.hpv.org.nz/hpv-men