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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
Cervical Cancer: New US Global AIDS Law Will Undermine Condom

October 22, 2003
Women's Health Weekly (10.16.03) - Wednesday, October 22, 2003

A recent paper contends that high cervical cancer death rates among women in developing countries reflect a lack of access to Pap smears and other screening programs, not a high prevalence of human papillomavirus (HPV) infection.

Genital HPV - certain strains of which can lead to cervical cancer - is common globally, but in countries where women receive timely screening and treatment, cervical cancer rates are low. A new US global AIDS law requires an analysis of HPV prevalence and a study of the impact of condom use on the spread of HPV in sub-Saharan Africa, ostensibly to combat high rates of cervical cancer.

According to the paper, "HPV in the United States and Developing Nations: A Problem of Public Health or Politics?" by Cynthia Dailard (Guttmacher Report on Public Policy; August 2003;6(3)), evidence from developed nations suggests the law's focus on HPV prevalence is misplaced and will undermine confidence in condoms without helping poor women get screening services.

Despite high rates of HPV infection among Americans, cervical cancer accounts for only 1 percent of cancer deaths in women. Pap tests allow early detection and treatment of precancerous changes in cervical cells. Globally, cervical cancer kills 225,000 women a year, almost 85 percent of them in developing countries where cervical screening is often unavailable.

Proponents of the US law say that because HPV is spread by skin- to-skin contact, it cannot be entirely prevented by condom use, so only abstinence before marriage and monogamy within it can protect women from HPV and cervical cancer. According to Dailard, using HPV to undermine global confidence in condoms places people at risk of contracting a number of diseases and does not address the issue of providing cervical cancer screening for developing nations.