Though HIV may receive all the media attention, Sacramento researcher Sharon Liberatore says the No. 1 sexually transmitted virus is human papillomavirus (HPV), the one that causes cervical cancer. Liberatore works at Solano Clinical Research in Davis and was a sub-investigator for the clinical trials that led to the HPV vaccine the Food and Drug Administration approved in early June. (The Advisory Committee on Immunization Practices backed the vaccine later that month.) Liberatore stresses personal responsibility in the prevention of HPV, but she also gives credit to the volunteers who participate in clinical trials. She urged anyone interested in volunteering for a Solano Clinical Research trial to call (530) 757-7797, ext. 227, for more information.
What is HPV?
HPV is the human papillomavirus. There are probably well over 100 types of it. It is the virus that makes warts. It makes warts in lots of places. They’re site-specific, and warts go to the hands, and feet warts go to the feet, and genital warts go to the genitals. … In order to get cervical cancer, you have to have HPV. Not everybody who gets an infection of HPV will get cervical cancer, and quite honestly, very few will. Most of us can live our whole lives with an HPV infection and never go past that. It goes infection, then possibly cervical change, then possibly cervical cancer. It is not an absolute in any way. … Most people with good immune systems will resolve this infection probably never even having known they have it in the first place. In the United States, this is not as big of an issue because we have a good pap-smear screening program.
How did you get started in HPV-vaccine research?
I had been working for a doctor’s group for 19 years before it was sold to an HMO. I didn’t really want to work for an HMO, so I took three months off. One of my co-workers saw an ad in the Davis Enterprise for a research position, so I sent in my résumé. I’m toward the end of my career now, and I really wanted to find something I have passion for—not to say that before I didn’t have passion for [women’s health], but in a day of 15-minute doctor’s visits, it is hard to feel you made a difference. I knew about HPV, and I was fascinated by the prospects of a vaccine. I think my conviction about making a difference here and saving women’s lives throughout the world is infectious to the people who volunteer for the clinical trials.
And who volunteers for them?
At first, I thought people would just do it for the money, but that’s not the case. The people who volunteer want to do their part; they want to help save people’s lives. We’re right across the street from UC Davis, so we have a lot of college students who volunteer, but even after they graduate they stick with the program. Most women dread their pap-smear and pelvic exams; our volunteers receive a series of them throughout the year. I’m really proud of them.
What does the vaccine do?
In this particular vaccine, they are vaccinating for four types of HPV. Two that cause about 70 percent of cervical change in women and then two other types that produce probably 90 percent of all genital warts in men and women. So, it is not all-inclusive. Certainly, there are more strains than this vaccine will cover, but those are the predominant ones, and it gives pretty good coverage.
And the vaccine is only for women at this point?
Right now, the vaccine is only for women. There are ongoing studies that will look at men and will look at older women—women beyond the age of 26. But those are ongoing, so the indication is for 9- to 26-year-olds, and that’s where the bulk of research has been in those age groups; well over 20,000 people.
Some people say that the vaccine—like advocating the use of condoms—will undermine abstinence teaching and promote promiscuity. How do you respond to that?
There will be people who will feel like that. “If I withhold the vaccine, or not talk about condoms …” Well, parents, whether or not you tell your kid, “Don’t be sexually active,” they are. If I had a child, I would give them [the vaccine]. If I could give my child a vaccine for something that they could die from, I would absolutely do it. I’d make sure [parents], if they chose to withhold it, knew about the virus—that it can spread through genital contact, not just intercourse. Do they know that? HIV and herpes are like that, too. For every one partner you are with, there is a 20-percent chance of contracting HPV. Yes, condoms are important. Abstinence is important. Limiting your sexual partners is important. But if you’re going to make a decision to withhold, make sure you’re doing it for all the right reasons—that you have all the information and are making an educated decision. We’re sexual beings. We kind of need to get our head out of the sand about that.