Comment by yieldcrv

6 hours ago

Best of luck, the reason it took so long for males to be approved for Gardasil use and they slowly keep pushing it up by age is two fold:

1) if you've ever been exposed to HPV already, then the vaccine is useless

2) there is no test to determine if a male has been exposed, although there is one for females

so they just push the ages up by probability, over time. As the probability of a man being with an older and therefore unvaccinated woman decreases - since with women is the most probable - the age can rise

> 1) if you've ever been exposed to HPV already, then the vaccine is useless

This is patently incorrect. The vaccine protects against 9 variants. Having been exposed to all 9 before vaccination sounds like really bad luck.

> 2) there is no test to determine if a male has been exposed, although there is one for females

The female HPV tests, as I understand, only test for the presence of HPV in the cervix. It can be present in many other areas. No one is testing women for the presence of HPV on their hands or in their throats.

Most places now offer HPV vaccines to young boys as well. People over 40 more or less missed the boat, but they can still get vaccinated. How useful it is depends entirely on their personal circumstances and risk profiles.

> 2) there is no test to determine if a male has been exposed, although there is one for females

It is incorrect. I had it tested multiple times. It is done less routinely, usually under assumption that since it is women who are mostly at risk, why bother testing men. Which is horrible mindset in anything related to epidemiology.

See:

- https://www.droracle.ai/articles/607248/what-methods-are-use...

- https://pmc.ncbi.nlm.nih.gov/articles/PMC12256477/

- https://www.tandfonline.com/doi/full/10.1080/22221751.2024.2...

> 1) if you've ever been exposed to HPV already, then the vaccine is useless

Also no. See other comments.

  • > It is done less routinely, usually under assumption that since it is women who are mostly at risk, why bother testing men. Which is horrible mindset in anything related to epidemiology.

    No. The general reason that people don't do the test for men is that DNA testing is extremely sensitive, and produces a lot of false positives for a virus that is widespread.

    It's also not actionable. You can't treat an asymptomatic infection, and a positive leads to the same outcome they would give anyway: use physical barriers and abstinence.

    (Edit: hilariously, your first link says exactly what I just wrote, at the very top of the page. Did you read it?)

    • The claim I refuted is that there are no test for men (there are). Not sure why you want to get needlessly argumentative here, repeating things I already linked (sic!).

      Sure, test from penis has lower specificity and sensitivity that for cervix, but it is not binary "works or not" (as side note, just measuring from urethra is rarely enough [1]). Life is probability, and it is a huge fallacy to believe that things work 100% or 0%, nothing in between (rarely the case in medicine).

      Results are actionable on many ways. Most important, screening for female partners, informed risk for partners or your on safety for ones partners (condoms BTW reduce infection rates, but do not fully protect, as HPV can be on other parts of skin).

      [1]

      > The overall prevalence of HPV was 65.4%. HPV detection was highest at the penile shaft (49.9% for the full cohort and 47.9% for the subcohort of men with complete sampling), followed by the glans penis/coronal sulcus (35.8% and 32.8%) and scrotum (34.2% and 32.8%). Detection was lowest in urethra (10.1% and 10.2%) and semen (5.3% and 4.8%) samples. Exclusion of urethra, semen, and either perianal, scrotal, or anal samples resulted in a <5% reduction in prevalence.

      https://pmc.ncbi.nlm.nih.gov/articles/PMC3904649/

      2 replies →

    • so far the comments are adding more vectors to understanding the situation, but nothing that fundamentally changes the user experience

      I think the most insightful thing is that there are 9 HPV variants some of which someone wouldn't have exposure to so its worthwhile to get the vaccine anyway

      but other than that, the situation is the same. for men's age the utility of the vaccine is based on probability alone, as its a waste of resources to even attempt checking for prior/current exposure

this is what I don't understand, why is it useless? there're multiple variants, vaccination could create reaction to a different part of the virus, etc.