In an effort to discourage sexual contact outside marriage, a fundamentalist Congressman has written legislation setting up a reporting system for women infected with the virus that causes genital warts. The proposed law would also require condom packages to carry warnings about the dangers of spreading the virus.
Rep. Tom Coburn (R-Okla.) succeeded in making his tracking and condom labeling proposal an amendment to a popular women’s health bill requiring Medicaid coverage for treatment of breast cancer and cervical cancer in uninsured women.
The bill with Coburn’s amendment already passed 421-1 in the House. Coburn is seeking a Senate sponsor.
A women’s health insurance bill, without Coburn’s language, is now pending in the Senate. If it passes, the two versions will be sent to a conference committee to hammer out differences.
Fran Visco, president of the National Breast Cancer Coalition, is urging passage of a bill without the Coburn amendment before Congress recesses in August. However, it is possible that Coburn’s insistence on his HPV amendment could sabotage the effort to ensure women can be treated for breast and cervical cancer.
The Coburn amendment would require the Centers For Disease Control, a federal agency, to develop a plan to make the human papillomavirus a reportable disease. In turn that could require reporting names and sexual partners.
In effect, the Coburn plan calls for the government to collect information on about 2 million sexually active women each year infected with the human papillomavirus, known as HPV, said Dr. Penelope Hitchcock, chief of the National Institutes of Health’s branch on sexually transmitted diseases.
The warning label on condom packages also would say that the human papillomavirus, “can cause cervical cancer.”
And even though only a small fraction of HPV infections lead to cervical cancer, Coburn’s language also requires similar warnings on literature released by the Department of Health and Human Services or any organizations that receives funds from it.
“Your risk of cervical cancer from being HPV-infected is about the same as smoking one cigarette in life and worrying about lung cancer,” the National Institutes’ Hitchcock told a health seminar in New York recently.
The very common human papillomavirus, HPV, is distinct from HIV, the virus that causes AIDS.
HPV can be transmitted through bodily contact with another person carrying the virus. The virus has about 100 strains and causes 5.5 million infections each year, most of them harmless. Some strains lead to genital warts, which are treatable. A miniscule percentage of those infected develop cervical cancer, treatable with early detection. An estimated 4,800 U.S. women die of cervical cancer each year.
An estimated 80 percent of sexually active men and women contract the virus at some point but most cases go away on their own, said Dr. Nancy Church of the American Medical Women’s Association.
Pap smears, which examine cervical cells, can detect cervical cancer and pre-cancerous abnormalities, although false readings occur. Pap tests are the primary way of detecting the virus and data from Pap smears could become part of a database under the Coburn amendment.
Women’s health advocates call the proposal an invasion of privacy that might eventually require women to report their sexual partners. They call it an effort to cloak anti-choice, abstinence-only, political agenda with pro-women’s health rhetoric.
The 40,000-member American College of Obstetricians and Gynecologists also opposes the Coburn amendment.
Coburn, a religious fundamentalist and a family physician, has argued that the labels should make couples think of the consequences before having sex.
“His recommendation is that the only form of safe sex is a married, monogamous relationship,” said Coburn’s spokesman John Hart. His position is supported by the anti-abortion, pro-abstinence Family Research Council.
One opponent of the Coburn amendment, Marilyn Keefe, vice president for public policy and communications for the National Family Planning and Reproductive Health Association said that Coburn held the women’s health insurance bill “hostage” to get his plan approved.
It is unprecedented for Congress to write a warning label, Keefe added. To date, that role has been left to the Food and Drug Administration.
“We don’t see a public health benefit,” said another opponent, Helen Fox Fields, senior director of infectious disease policy for the Association of State and Territorial Health Officials, which represents the heads of all state health departments. “What Coburn is trying to do is alarmist.”
Deborah Arrindell, director of public policy for the American Social Health Association, which is dedicated to the elimination of sexually transmitted diseases, believes that Coburn sees HPV as “the Achilles heel of the safe sex movement” because it can be transferred by bodily contact. But his messages will be damaging, said Arrindell, adding that many people confuse HPV with HIV, which can lead to AIDS.
Public ignorance about HPV was confirmed by a survey in February by the Kaiser Family Foundation and the Harvard School of Public Health, in which only 28 percent of adults were familiar with HPV.
Deaths from cervical cancer in the United States dropped radically–as much as 70 percent–after the introduction of the Pap test in the 1930s.
