Giovanna Chesler, a film professor, couldn’t have scripted a screenplay more provocative than the drama that recently unfolded in her own life.
Sitting at a 45-degree angle, clad in a paper gown, legs in stirrups, Chesler received the diagnosis from her gynecologist — she had HPV, a sexually transmitted infection (STI).
“I was shocked,” says Chesler, who later found out that the cells were pre-cancerous and needed to be removed.
Chesler, a 33-year-old filmmaker who’d immersed herself in women’s studies during her undergraduate years at the University of Virginia and illustrated the complexities of the female body through film, found herself at the forefront of a women’s sexual health issue that affects millions, the human papillomavirus, better known as HPV.
Her private drama became a public education campaign of sorts in which she produced short videos chronicling her experience and later engaged her American University students to generate more awareness for the little-talked-about, but widely impactful STI.
According to the Centers for Disease Control and Prevention, HPV is the most common sexually transmitted infection. Approximately 20 million Americans are currently infected with an HPV, and another 6.2 million people become newly infected each year. At least 50 percent of sexually active men and women acquire a genital HPV infection at some point in their lives.
There are more than 100 different strains of HPV, more than 30 can cause cancer. About 10 percent of women with high-risk strains of HPV will develop long-lasting HPV infections that put them at risk for cervical cancer. Most with HPV do not develop symptoms or health problems. Certain types of HPV can cause genital warts in men and women.
According to the CDC, in most cases, the body fights off HPV naturally and the infected cells then go back to normal.
But Chesler wasn’t so lucky. Shortly after her diagnosis, Chesler had the pre-cancerous dysplasia surgically removed.
Bedridden for six weeks following her surgery, Chesler began producing short video clips about her experience. She shot and edited three clips titled “HPV boredom, 1, 2, 3” from bed and then posted them to “You Tube” in an effort to “preserve her sanity” during her stint of inactivity. With these clips, Chesler sought to educate the uninformed.
Chesler, who was 31 at the time of diagnosis, knew little about HPV before contracting it. Among the assortment of ubiquitous STIs, she hadn’t considered HPV to be a threat, she admits.
Data show that HPV is more common in younger age groups, with nearly half of all women in their early 20’s infected. Among women 14 to 24 years of age, 34 percent were infected with HPV. A CDC study found one in four teenage girls was affected by at least one sexually transmitted disease, such as HPV, chlamydia, herpes and trichomoniasis. As many as 48 percent of Black teenage girls reported an STD compared with 20 percent of White teenage girls, according to the study.
While discussions on HIV and other sexually transmitted infections saturate public health forums, HPV has yet to garner equitable attention.
“HPV is very common. HIV programs get more funding [and attention] because people think that people will die of HIV, whereas HPV could cause cancer over many years,” says Dr. Niharika Khanna, associate professor in the department of family and community medicine at the University of Maryland School of Medicine.
“Generally, college students are extremely high risk for HPV. Women between the ages of 20 to 24 and men between the ages of 24 to 29 are at the highest risk for HPV,” Khanna says.
QuickStats: Prevalence of HPV* Infection† Among Sexually Active Females Aged 14–59 Years, by Age Group — National Health and Nutrition Examination Survey, United States, 2003-2004
Last year, Chesler served as a visiting assistant film professor at American University in Washington. She taught a class on communication and social change at the university.
Merging activism, education and multimedia, Chesler along with 18 American University students launched a Web site that provides HPV education and resources and allows people to share their HPV stories and experiences called TuneInHPV.
“I wanted to provide a forum that connects people to resources. On the site there are links to the Centers for Disease Control [and Prevention] and Washington, D.C.’s Department of Health, but I also wanted to connect personal experiences,” says Chesler. “There is a lot of sex shame. One of the goals of this project is to eliminate the shame and engage in more conversation about treatment, prevention and awareness.”
Simon Holowatz, a community health educator at Pennsylvania State University Health Services, spends his days working to empower young people to protect themselves against STDs through education but there are those students that behave irresponsibly, he admits.
“This generation of young people has a different definition of what
sex is,” he says. “To them, oral sex, anal sex or heavy petting is just hooking up.”
HPV is passed on through genital contact. Holowatz contends that this sort of behavior leads to the proliferation of STDs on college campuses.
“I have serious concern for college students, in particular. Drinking rates are going up. Getting drunk and ‘hooking up’ is becoming more normalized. This leads to impaired judgment,” Holowatz says.
College health officials agree that vigilance is key in the fight against STDs. They recommend habitual condom use and regular STD testing.
While condoms may lower the risk of HPV, they do not offer 100 percent protection because HPV can infect areas that are not covered by a condom.
To prevent contracting HPV, Khanna recommends that college-age students delay sexual intercourse, maintain a low number of sexual partners, get regular pap smears and HPV tests and get vaccinated with HPV vaccine, Gardasil. This vaccine can now protect women from the four types of HPV that cause most cervical cancers and genital warts, the CDC reports.
“Vaccines do not treat HPV,” Chesler reminds. “They are designed to block several strains of the virus, but they cannot cure someone of HPV.”
In general, HPV is cleared as defined by a negative HPM test, clinicians say.
“The thinking in some research circles is that individuals may actually not be clear. In a sense, the HPV remains latent for a long time,” says Khanna. “Latency is still debated.”
As for Chesler’s former students, she says, “My students did not ask a lot of questions of me. They may have been a bit surprised to meet someone who gave voice to her STI experiences.”
Guest speakers from the Washington, D.C., Department of Health lectured Chesler’s students on HPV and answered their questions.
“During the semester they found themselves creating a Web site, but also educating their friends during conversations. They continuously noted that few people know much about HPV,” says Chesler, who will join the faculty at Marymount Manhattan College in communication arts in the fall of 2008.”
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