Cervical cancer, mainly caused by Human Papillomavirus (HPV) infection, is the most common cancer found in women in India and the most common cause of death due to cancer in developing countries. As per a study by Indian Council for Scientific Research, cervical cancer killed more than 63,000 women in India in the year 2015, that's over 170 women per day.
Despite the risks, misinformation and lack of awareness have resulted in many people not being vaccinated against HPV. Women in same-sex relationships are a section of society that particularly suffers because of this misinformation.
In 2018, a survey conducted by the LGBT Foundation in the UK found that 40 percent of LGB women were told they didn't need cervical screening because of their sexual orientation. This is due to the common misconception that since women in same-sex relationships are not having penetrative sex, their chances of contracting HPV or any other kind of Sexually Transmitted Disease (STD) is reduced.
However, the health experts we spoke to and research on the subject busts this myth.
The truth is that women in same-sex relationships and transgender men who have retained their cervix are also at risk of contracting HPV and other complications.
What is HPV? How Does it Spread?
According to the World Health Organisation (WHO), HPV is the most common viral infection of the reproductive tract. Most sexually active women and men will be infected at some point in their lives, and some may be repeatedly infected.
According to the Centres for Disease Control and Prevention (CDC), one can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex.
HPV is the most common risk factor for cervical cancer. According to the American Cancer Society (ACS), there are nearly 100 types of HPV, and only two common types of HPV - HPV-16 and HPV-18 - can cause cervical cancer.
However, HPV can also cause other types of cancer, such as cancers of the anus, penis, vagina, vulva and back of the throat.
According to WHO, it takes 15 to 20 years for cervical cancer to develop in women with normal immune systems. It can take only five to ten years in women with weakened immune systems, such as those with untreated HIV infection.
How Are Women in Same-Sex Relationships Infected With HPV?
In 2015, University of Washington researchers found that lesbians were at a higher risk of cervical cancer because they get fewer screenings than heterosexual women, as some healthcare providers assumed their chances of getting an STI were less.
We spoke to Dr Esha Chainani, consultant obstetrician and gynaecologist and laparoscopic surgeon, who told us that HPV, like any other STI, does not depend on the sex or gender of the person and can spread among lesbians.
"Your sexuality has nothing to do with STIs. It can spread from one person to another in same-sex relationships as well. It's untrue that you can't get an STI if you are not having penetrative sex. You can get an STI through oral sex, fingering, and so many other ways, " Dr Chainani said.
Dr Harshit Shah, Surgical oncologist, Associate Consultant, Fortis Hospitals, explained how it affects same-sex couples.
"The occurrence of oropharyngeal cancer explains how it can spread in women in same-sex relationships. Oral sex transmits the HPV through the oropharyngeal tract. The virus is absorbed in the back of the throat, where the tonsils are present. It is absorbed by the tonsils and can lead to oropharyngeal cancer."Dr Harshit Shah
"It is again important to note that HPV does not only cause cervical cancer. It also affects men and can lead to cancer of the anus and penis. Similarly, transgender men who have retained their cervix can also develop cervical cancer because of the virus," he added.
How Can One Protect Themselves From HPV?
Many times, a person might not show any signs or symptoms even if infected by HPV. Therefore, ACS has laid down specific guidelines on when and how frequently people should get tested for HPV. According to the ACS, one should get screened for cervical cancer and an HPV test every five years.
Dr Shah also recommends that people get screened for HPV and cervical cancer every five years from age 30.
"This helps us detect the HPV infection and keep the patient under surveillance to prevent cervical cancer in the future," Dr Shah said.
"HPV testing is done on the tissues or cells in the genital tract, anal region and even oropharyngeal regions by PCR tests or histopathology. We also look for HPV-16 and 18 using by pathology."Dr Harshit Shah
Using protection while having sex is another way to prevent getting an STI. "Apart from dental dams, there are female condoms that are useful for protecting against STIs in women in same-sex relations, " Dr Chainani said.
However, the most effective way to prevent an HPV infection is by getting vaccinated against it. Earlier, people between the age of 9 to 26 years were only eligible for the HPV vaccine, but now 27 years and above can also get vaccinated.
Multiple vaccines protect against both HPV 16 and 18, and both women and men can get the vaccine. The vaccines are more effective if administered before being exposed to the virus.
However, there might be some side effects after the vaccination, like abdominal pain, muscle or joint pain, nausea, redness, swelling, pain, etc. Therefore, ask your doctor before getting yourself, or your child vaccinated.