Kønsvorter - Human Papilloma Virus (HPV) er et meget reelt men forbigået problem i prostitutionsmiljøet. Af en eller anden besynderlig årsag er der kunder, der ønsker at spilel hazard med ikke alene sit eget liv og helbred men også - hvad er langt værre - den prostitueredes og kundens egen families (især samleverens) liv og helbred. Fakta er, at der et stort antal kunder, der ønsker at købe sex uden kondom eller de forsøger at tage kondomet af under transaktionen. Visse bordeller sælger ydelser uden kondom, blot kunden betaler ekstra. En fuldkommen tåbelig og utilstedelig handling, da HPV er stærkt smitsomt og giver kræft. Kræft i hals, livmoderhals og endetarm.
HPV er så smitsomt, at kondomer kun giver ca 70% beskyttelse mod dem, men dog en form for beskyttelse.
Nedenunder er samlet en del undersøgelser om HPV.
HPV - HUMAN PAPILLOMA VIRUS
Genital Human Papilloma Virus - fra Brisbane prostitutions service
http://georgiafrench.files.wordpress.com/2011/04/hpv_website.pdf
"Safer sex equipment—Using dental dams, condoms and gloves reduces the risks of transmitting or acquiring HPV through skin-to-skin contact. However, it’s important to remember it only reduces the risks because genital warts can be present in places that a condom or dental dam does not cover, and you may not necessarily be able to see them."
Undersøgelse af prostituerede i Belgien 2004 for HPV og cancer.
Cervical smears and human papillomavirus typing in sex workers. http://www.virushunters.net/showabstract.php?pmid=15054172
"CONCLUSION: Abnormal smears and high risk HPV were significantly more prevalent in sex workers than in controls. Current screening policy would miss many sex workers with an abnormal smear who should be referred for further follow up. It is proposed to screen sex workers when they enter prostitution regardless of their age."
Undersøgelse fra Holland 2004 om Human Papilloma virus. 96 ikke-prostituerede og 63 prostituerede deltog.
http://www.ghapro.be/NEDERLANDS/Ghapro_artikel-08.pdf
The Prevalence of the Human Papillomavirus in Cervix and Vagina in Low-risk and High-risk Populations
Tallet (17) der står nævnt sidst i citatet refererer til undersøgelsen: Do condoms prevent genital HPV infection, external genital warts, or cervical neoplasia? A meta-analysis.
"Condom use is generally associated with more risky sexual activity, as is witnessed by significantly more frequent condom use in the STI clinic population. Sex workers are at higher risk for HPV as well as for other STI (16). On the other hand, this finding is in line with the suggestion that condom use does not protect against HPV infection (17)."
"RESULTS: Among 27 estimates from 20 studies, there was no consistent evidence that condom use reduces the risk of becoming HPV DNA-positive. However, risk for genital warts, CIN of grade II or III (CIN II or III), and ICC was somewhat reduced."
http://jcm.asm.org/cgi/content/full/42/3/1330#R17
Concordance of Prevalence of Human Papillomavirus DNA in Anogenital and Oral Infections in a High-Risk Population
"The overall HPV DNA prevalence at the gynecological sites of 39.4% was quite similar to the prevalence reported for other populations of similar age and sexual behavior. A previous study in Denmark (17) reported a similar HPV prevalence (47%) among prostitutes, representing an almost threefold-increased prevalence compared to that in the general population of that country. In our study, HPV prevalence among sex workers was 10-fold higher than that observed in an age-matched sample of the general population (24). These differences are consistent with the low HPV infection rate in the general population of Spain (9). "
Den danske undersøgelse, der henvises til, er her:
http://journals.lww.com/stdjournal/Fulltext/2000/09000/Human_Papillomavirus_Infection_in_Danish_Female.3.aspx
En interessant dansk undersøgelse - se især de to figurer.
Ovennævnte undersøgelse findes på dansk her:
http://www.ugeskriftet.dk/portal/page/portal/LAEGERDK/UGESKRIFT_FOR_LAEGER/KLINISKE_VAERKTOEJER/KLARINGSRAPPORTER/Human%20papillomavirus%20%28HPV%29.pdf
"I danske undersøgelser er der fundet en HPV prævalens på 15% blandt 1000 tilfældigt udvalgte 20-29 årige kvinder (26) og en HPV prævalens på henholdsvis 35% blandt kvindeligeHvor mange kunder har slæbt en lille - undertiden dødelig - hilsen med hjem til partneren. HPV er kønsvorter og kønsvorter er det virus, der giver livmoderhalskræft. En kræftform, der alt for ofte bliver opdaget for sent. HPV er en stærk smitsom virus.
venereapatienter (27) og 32% blandt kvindelige prostituerede (28) .
HPV er også mistænkt for at give halskræft.
http://www.scitopics.com/Human_papilloma_virus_vaccination.html
Vaccinating against oncogenic Human papilloma virus: are the high expectations justified?
"Since boys are not vaccinated an enormous pool of HPV maintains. The role of man in spreading HPV is well known. Monogamous women were infected by their husbands that visited prostitutes [5]. The prevalence of HPV is orders of magnitude higher in workers in the sex industry than in normal controls [6]. This holds for different countries [3] [7,8] . Since sexually active man visit Asian countries to have sex also Asian serotypes will arise [9]. Those serotypes are oncogenic and not in the vaccine. High prevalence of HPV-51 is also detected in Poland [10]. Moreover, the occurrence of other serotypes than the ones in the vaccine are now already circulating in the “adult” industry."
http://ajph.aphapublications.org/cgi/content/full/99/4/659
Structural and Environmental Barriers to Condom Use Negotiation With Clients Among Female Sex Workers: Implications for HIV-Prevention Strategies and Policy En undersøgelse fra Vancouver om ubeskyttet sex og smitte.
"This pattern was also reflected in the overall HPV DNA detection rate, in which sex workers had a higher HPV prevalence (47%) than women in the STD group (43%) and from the general population sample (15%). In all three groups, HPV‐16 was the most prevalent single type, followed by the HPV‐X group, which was detected in 25% to 29% of the women (data not shown). The prevalence of infections with more than one HPV type was 11.7%, 15.7%, and 12.9% in sex workers, STD clinic attendees, and cytologically normal women from the general population sample, respectively."
