AUSTIN, Texas — How could a woman who has had relations only with her monogamous husband get cervical cancer, a disease that develops from a sexually transmitted virus?

Her husband was a widow whose first wife died of the disease.

That case underscores the need for education about sexually transmitted diseases (STDs), according to Dr. Gary Rose of the Texas-based Medical Institute for Sexual Health.

He and other abstinence advocates welcome the first cervical cancer vaccine as both a medical breakthrough and a teachable moment.

“Many women don’t realize the Pap test screens for cervical cancer caused by human papilloma viruses (HPVs),” Rose said, or that genital HPVs can be spread by skin-to-skin contact without sexual intercourse.

On June 8, the Food and Drug Administration gave pharmaceutical giant Merck & Co. approval for Gardasil, a vaccine intended to prevent 70% of the HPV infections that lead to cancer. Gardasil also targets strains that produce genital warts.

Nearly 4,000 deaths from cervical cancer occurred in the United States in 2003, and AIDS claimed 14,000, according to the Centers for Disease Control and Prevention.

“This shows the need for more abstinence education,” said John Margand, executive director of Healthy Respect, a New York City pro-life group. “The vaccine addresses a certain percentage of one disease, but there are 25 STDs now. You won’t find hostility to this among abstinence providers, but it’s not a panacea either.”

Pro-family groups such as the Family Research Council have been misrepresented by hostile media reports suggesting they opposed the vaccine, policy analyst Moira Gaul said.

In fact, several such groups have spoken in favor of the vaccine’s development and availability. But they did raise concerns about whether it would abet promiscuity if its limitations were overlooked, and about parents having a say in children’s immunization.

Gardasil was approved for girls and women from ages 9 (before the onset of sexual activity) to 26.

“It’s not an either-or situation. STDs are serious business,” Margand said. “Unfortunately, children as early as fifth grade are exposed. Parents are the primary educators. They need to be brought into the conversation quickly, early and often. To do nothing is irresponsible.”

Needed for School?

Rose, of the Medical Institute for Sexual Health, added, “The vaccine is a very positive step, as many people don’t have access to Pap tests.”

Cervical cancer causes 280,000 deaths worldwide annually.

“We’d encourage drug companies to develop vaccines for all STDs, but abstinence is still best,” Rose said. “The vaccine doesn’t affect the message. Abstinence is what you do because of who you are, because you think it’s the right thing to do, and not out of fear.”

That message is evidently getting across to some, according to data just released by the National Center for Health Statistics, which showed a 23% drop for older teenage boys in sexual intercourse from 1988 to 2002.

With the U.S. market now open, Merck is seeking Gardasil’s approval in 50 other countries. On June 29, the CDC’s Advisory Committee on Immunization Practices will consider whether to recommend this immunization be added to the universal vaccine list.

If so, states can decide whether to make it a prerequisite for school enrollment.

Focus on the Family issued a statement supporting the availability of HPV vaccines but opposing their requirement. The statement advised parents: “Seize this moment to talk with your child about your family’s values and God’s plan for sexuality.”

The proliferation of STDs highlights the problem of promiscuity, noted Dr. Kathleen Raviele, vice-president of the Catholic Medical Association, which is formulating a vaccine policy statement.

“Parents should have a choice,” she said. “And to reduce the incidence of HPV in the general population, you’d also have to vaccinate boys. My concern would be that women might not think they have to continue Pap tests. And would it be effective 20 years from now?”

If states make vaccination mandatory, officials and insurers must then decide who pays the $360 per person cost.

“The reason [pharmaceutical companies] want this on the ‘mandatory’ list of vaccines is because that’s the only way that they can make a significant amount of money off the vaccine,” charged Catholic moral theologian Pia de Solenni. “Once it’s ‘mandatory,’ then it’s also eligible for government funding.”

De Solenni is founder of Diotima, a new women’s project aimed at authentic femininity. She formerly worked with the Family Research Council, where she met with officials from both Merck and GlaxoSmithKline Biologicals, which is developing a similar vaccine.

Merck Response

Financial analysts estimate Gardasil could produce $2.6 billion a year for Merck, hit with big losses from having to withdraw its arthritis drug Vioxx.

Other concerns with the vaccine were that people might think it offers more protection than it does, and the unanswered question of booster shots, according to de Solenni.

Merck spokeswoman Kelley Dougherty said data now show Gardasil’s “effectiveness does not wane after five years,” but the company will track one test group for a lifetime.

“We stress the need for women to continue with regular Pap tests,” she said, and to clearly explain the vaccine’s limitations. In April the company launched “Tell Someone,” an advertising campaign to increase awareness of cervical cancer.

What’s really needed in the long run is respect for human sexuality, de Solenni concluded.

“Having sex isn’t about ‘protecting’ one’s self. It’s fundamentally about forming an indissoluble union where our vulnerabilities are accepted — it’s about giving one’s self.”

Gail Besse is based in

Hull, Massachusetts.