HPV vaccine may not be the only form of prevention for women

Photo by Flickr user Tulane Publications

McGill PhD student Joseph Tota, has recently launched a new research project on HPV prevention under the supervision of Dr. Eduardo Franco. This project, called CATCH, stands for Carrageenan gel Against Transmission of Cervical HPV and seeks to evaluate a possible alternative to the vaccination by the use of a lubricant that contains the algae carrageenan.

Photo by Flickr user Tulane Publications

“CATCH is a randomized controlled trial that was designed in response to a discovery made by scientists working at the National Cancer Institute where they identified carrageenan, an inexpensive gelling agent that is non-toxic, safe on animals and humans, to be a potent HPV infection inhibitor,” explains Tota.

According to the Canadian Cancer Society, the human papilloma virus (HPV) is the second-leading cause of cancer among women in the world, following breast cancer. With more than 120 types of HPV that fall into low-risk and high-risk categories, 75 per cent of sexually active women will acquire the HPV infection over a lifetime. HPV-6 and HPV-11 are two of the more common low-risk infections that infect the skin and genital area and can produce warts.  HPV-16 and HPV-18 are categorized as high-risk infections that can lead to cervical cancer.

In 2006, the Federal Drug Association approved the HPV vaccine, commonly known as Gardasil or Cervarix. The Santé et services sociaux website explains how Quebec offers the vaccine to girls and women as early as the age of nine as part of a free vaccination program administered in schools. Other girls under the age of 18 can be vaccinated for free at the CLSC or with their doctor. However women over 18 who don’t have medical insurance must pay approximately $130 per dose, a price set by the Patented Medicine Prices Review Board of Canada. For both teenagers and adults, three doses of the vaccine over a six-month period are recommended for proper protection, therefore the total cost is rather expensive and Tota explains perhaps not the most preventive after all.

“The current available HPV vaccines only target up to four different HPV types: 6, 11, 16, and 18,” and are  “effective only if administered to girls prior to the onset of sexual debut,” says Tota.

The carrageenan gel being studied by CATCH may be effective in preventing all types of HPV, if administered immediately before sex and among women of all ages. Accessibility and cost of HPV prevention is something Tota and his team are keeping in mind while they run this study.

“If our trial demonstrates carrageenan to be effective in protecting against all genital HPV types, then we expect that many more personal sexual lubricants will become available by different manufacturers containing carrageenan,” says Tota. “Despite being required to apply the gel on an ongoing basis, its costs are substantially less [than the vaccine].”

The gel must be self-applied prior to each act of sexual intercourse, “in the same way as other personal sexual lubricants that are purchased over the counter,” says Tota. A small amount (five to 10 millilitres) may be applied directly to the vagina, penis or condom prior to sex. Afterwards, the gel may be removed with warm water.

This discreet method of prevention would make it empowering for women, explains Tota, especially “women who are unable to refuse sex due to cultural, social, or financial arrangement.” For women in developing countries, where HPV infection is rampant, this gel may prove to be a useful adjunct to the vaccination which would have “enormous and immediate public health implications,” according to Tota.

Currently the HPV vaccine is the only form of prevention and has faced criticism over the years. In 2012, The Globe and Mail published an article expressing parents’ concerns and how their biggest fears revolved around not having enough information about the vaccine, feeling rushed to make a decision about whether their children should get it, and how they questioned its safety. The vaccine looms in the shadows of Big Pharma and some are sceptical about whether it is just a push to promote their vaccines.

In the United States, the vaccine has been argued to promote sexual promiscuity among young teens, an issue The New York Times addressed last October after a study proved that the vaccine is not going to give girls a license to sexual activity.

“Despite our best attempts to convince parents of its safety, some will continue to deny permission to vaccinate their daughters,” says Tota. “For children and adults who have been denied access to vaccination for whatever reason (cost, safety, or other reasons), a carrageenan gel may be the only other effective means to protect against HPV.”

For individuals who are against vaccines, Health Canada’s Natural Health Products Directorate has labelled the CATCH project as a natural intervention. Carrageenan is a gel naturally derived from three species of red algae. It has a long history of human use and has been employed extensively in the food, pharmaceutical, and cosmetics industries as a stabilizer and emulsifier. CATCH has received the support and ethical approval from Concordia’s Student Health Services and the microbiology department at Université de Montréal, something Tota explains is necessary when trying to recruit students to be part of the trial. However, “[Carrageenan gel] should not be considered as an alternative to HPV vaccination in countries that can afford both methods of protection,” reiterates Tota.

HPV is a serious health issue for women and young girls and while there is a lot of talk about HPV in the media. Gabriella Szabo, health promotions specialist at Concordia, explains how it is important to get a pap test, get tested for STIs and discuss the vaccination.

“Unfortunately, the majority of women coming now to get the vaccine have already had changes in their cervical cells,” says Szabo.

“Cervical cancer screening with the pap test and/or the HPV test is a proven way to prevent cervical cancer,” says researcher and clinical specialist in women’s health, Dr. Marie-Hélène Mayrand from the CHUM research centre. “I will always argue that we should and could be doing more to improve women’s health, although, I would like to point out that Canada leads some of the most cutting-edge, academic research in HPV, as the new study by Dr. Franco’s team underlines.”

If you are a heterosexually active woman between 18-29 years of age and you are interested in participating in this study, check out www.mcgill.ca/catch/join-us.

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