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AT LARGE : How much to tell?

How much to tell?

By Rina Jimenez-David
Last updated 00:53am (Mla time) 08/29/2006

Published on page A11 of the August 29, 2006 issue of the Philippine Daily Inquirer

WHILE Filipino parents have yet to confront the dilemma of whether and how much to tell their daughters about the new vaccine against HPV, they would do well to heed the lessons learned by parents of teenage and preteen girls in the US and elsewhere where the vaccine has been approved for marketing.

HPV stands for "human papillomavirus," a very common virus that causes genital warts and which has been linked to as much as 97 percent of all cervical cancer cases. The vaccine has been developed against two types of HPV most commonly linked to cervical cancer, and is administered through three shots over a six-month period. Because the vaccine works most effectively before sexual initiation, since HPV is transmitted primarily through sexual contact, it's been recommended that girls as young as nine years old be inoculated against the virus, before they become sexually active.

And here lies the crux of parental uneasiness about the anti-HPV vaccine. How much information should they give their daughters when telling them about the vaccine and convincing them to get the shots? "Do they simply say it's a vaccine against cancer and leave it at that? Or should they also explain that HPV is a sexually transmitted disease that, among other symptoms, causes genital warts?" asks Martha Irvine, in an article written for the Associated Press.

If the vaccine had not been developed for a disease that has been linked to a sexually transmitted virus, odds are that parents would not hesitate at all about urging their daughters to go for the shots, or giving them all the information they need to make the right decision. But as with all matters related to sex, the anti-HPV vaccine is raising uneasy questions among parents, if not a measure of hesitancy.

* * *

"HPV is a weighty topic that more parents are addressing with their daughters, since the Food and Drug Administration recently approved the vaccine . Some parents, particularly those with preteen girls, are wondering just how much information to share," writes Irvine.

Irvine quotes Linda Zabrowski, the mother of 14-year-old Amanda who agreed to take the vaccine: "When I was young, my mom said, 'Here's a book.' That's how we learned about sex. But it's not like that now."

"She started to realize that when she sat in on Amanda's fourth-grade lesson on reproductive anatomy a few years ago and discovered that some girls were already menstruating," relates Irvine.

The article states that US government surveys have found that about 7 percent of children have had sexual intercourse before age 13, while about 25 percent had sex by age 15. "And while teen pregnancy rates have steadily dropped since the early 1990s," writes Irvine, "millions of teens and young adults are contracting sexually transmitted diseases-HPV among the most common."

The Centers for Disease Control estimate that more than six million Americans-many of them teens and young adults, says Irvine-get a new infection of HPV each year.

"Theresa Rohr-Kirchgraber, an adolescent and internal medicine specialist at the Emory University School of Medicine in Atlanta, says parents need to take those statistics seriously when deciding how to address the HPV vaccine," writes Irvine.

"Cervical cancer is real. Sex is real -- and even though we believe our kid is different and will never have sex until (he or she is) married, it is not reality," Rohr-Kirchgraber says.

* * *

PARENTAL discomfort with addressing -- or even admitting -- our children's sexuality has been a serious issue in the Philippines, where the anti-HPV vaccine has yet to be approved.

The issue has emerged time and time again in various guises: Sex education in public schools, marketing condoms to teens, making reproductive health services accessible to young people, even talking about sex on TV. The common thread is the adults' fear that recognizing young people's curiosity about sex, and providing the answers to their urgent questions, will somehow send the message that it's "okay" for them to indulge in sexual relations.

Well, for parents still laboring under the myth of their children's naivete, the news is that young people aren't exactly waiting for our permission before satisfying their curiosity. The bad news is that when they do begin acting on their sexual impulses without adequate information and counseling, ignorance and misinformation will put them at greater risk.

We raise alarms about teenage pregnancies, out-of-wedlock unions, rising rates of sexually transmitted infections and general "immorality," and yet we also refuse to take the necessary measures that will ensure that our children avoid these unwanted consequences of sex.

I won't be surprised if, in the course of seeking recognition, drug companies marketing the anti-HPV vaccine will face opposition from so-called guardians of public morality who would much rather keep young women ignorant about sex than keep them from dying from cervical cancer. Just once, please prove me wrong!

* * *

CORRECTION. Professional Regulation Commission Chair Leonor Tripon-Rosero wrote to clarify a point in a recent column on the controversial nursing board exam. I had written that secured diskettes with the exam questions were brought to accredited printers for printing into booklets. The PRC chair made clear that this procedure is followed only in the exam for teachers, given the large number of examinees. For the nursing and other board exams, the booklets are printed "inside our own in-house printing facilities, at the Confidential Printing Room."

Tripon-Rosero added, though, that they are thinking of using a printer contractor for the nursing boards because of the limitations of their in-house facilities.


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