A Common Virus

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I'm confused/concerned/suspicious (?) that this flood of information about HPV and its relationship to cancer has come out with and is tied to Merck's campaign for their vaccine. It may be coincidence, circumstance or fortuitous, but I have been ignoring most of the "bumpf" on this topic as just another example of the drug companies' creativity and immorality with regard to marketing their products. The only reason I am paying attention this time is because I respect you, Michel, and NPR. Still, I would like to hear some medical testimony, pro and (especially) con, before I buy into what right now seems to be the latest scare tactic aimed at women's sexuality. Here are questions I would like to have answered:

1. Why has this taken so long to come to light -- given the incredible amount of energy that women have expended on behalf of their health issues?

2. What research (besides Merck's own) is being cited?

3. Who did that study which resulted in the shocking statistic (re: sexually active women and HPV)? What kind of a study was it? What were the numbers? What were the demographics of the study and the control group?

4. Is there anyone who is denying the veracity of this study and/or the need for the vaccine? Who are they? What are their claims?

5. Both of your guests are African-American, and you mention the prevalence among Black women. Is this coincidence? Or are Black women more vulnerable?

I could go on ... I've been a radio reporter, so I understand the vagaries of tape and time. But this story right now is too loosey-goosey for my liking.

Sent by Jane Gassner | 5:48 PM | 1-5-2007

Yes, I was aware of HPV before this interview thanks to public radio. Yes, I do find health stories interesting. Yes, as a man, I found it interesting because I could get HPV as well. Yes, I appreciated getting a non-healthcare professional perspective on this issue. It makes the story more human and less clinical; further, these guests were knowledgeable about the topic. Make sure that guests are knowledgeable, but professionals -- medical in this case -- aren't always necessary.

I also found the statement, "Every single sexually active person is going to get it at some point in their life," startling. What I would've enjoyed was some of the segment explicitly spelling out the vetting process behind researching this story/fact/topic. What evidence enables NPR to deem this statement worthy of a tease? What makes the sources of information authoritative and reliable for NPR's analysis?

Personally, I would like to have the news media help educate non-journos on information literacy. I think that NPR is not afraid to go to such lengths to show editorial responsibility and commitment to its listeners.

Sent by Steve Petersen | 6:02 PM | 1-5-2007

Tamika is a hero, plain and simple. Please continue this crusade to inform sexually active adults of the dangers of HPV and cervical cancer to their wives, girlfriends, mothers, daughters and sisters.

Sent by Bissi DiCenso | 9:53 AM | 1-8-2007

I was diagnosed with cervical displacia (cell mutation that leads to cervical cancer) and the HPV that caused it last year at the age of 23.

The reason this subject has been flying under the main street news radar (it has been on blogs like Pandagon.net for some time) is not because of some greedy plot by big pharma, this vaccine had been discovered years ago. The FDA however refused to realize it on the market because of right wing pressure for fear of it increasing promiscuity among young women. (Statistically speaking it is older women that are more likely to contract the virus as well as have it progress into cancer.)

Why aren't pap smears and condoms freely and easily available? Why aren't we having straight forward sex education in schools? Why did the FDA sit on this vaccine without any real concern over its safety, letting scores of daughters, mothers, and grandmothers become sick?

Michel, this is an important story and not just for woman. Men don't want their friends and loved ones getting sick and certainly men don't want to be the ones who get women sick.

Sent by L. Sarid | 11:39 AM | 1-8-2007

I almost fell out of my chair when reading the last sentence of this story. As a gynecologic oncologist, I see the most extreme consequences of women who are infected with the virus, namely cervical cancer. The issues revolving around HPV are not limited to females and I think we need to target male audiences as much as female audiences. How do you think these women with cervical cancer acquired the HPV virus? As with all sexually transmitted diseases, both sexes need to be equally aware of the consequences of being infected, regardless of the fact that the adverse outcomes are seen primarily in women. I guarantee that if men got penile cancer from this virus necessitating radical surgery to remove the penis or radiation therapy to the penis, it would have been a front page story 10 years ago. I don't care if male listeners are interested in this story, it is a story they need to hear.

Sent by Allison Axtell | 11:44 AM | 1-8-2007

In response to a previous post, the HPV virus has been well-known in medical circles for a number of years. You can find some of the best information on Medline, the Federal Governments medical library.

Sent by Chris | 11:48 AM | 1-8-2007

The HPV article was very interesting and made me think a lot- enough to research it on my own. Being a male I was more intrigued by the male aspect of the virus and how to prevent it. I was also taken aback at the suggestion that everyone in the world will eventually get HPV. This sort of fact needs some sort of verbal reference and discredits the show with such bold statements being made. I did appreciate that HPV is a topic not normally talked about, and that NPR took up this cause. I would caution NPR to be careful about how far certain taboo topics are verbalized. Keep up the good work.

Sent by Matthew Gulseth | 11:53 AM | 1-8-2007

I am a cytotechnologist. Simply put I screen pap smears for a living. I have been aware of HPV since cytology school 10 years ago. I wrote a paper about HPV and was shocked to learn how common it is and how long the medical community had been aware of it. To address some of the questions posted above, all the information given today was correct. Virtually all sexually active people will be exposed to HPV at some point in their lives. ALL sexually active women are at risk. There is no increased incidence related to race or ethnicity. Under-insured women and younger women are at higher risk to develop cervical cancer because they are less likely to be receiving medical check ups (i.e. pap smear screening). The statistics about HPV are shocking but people should not be alarmed.

The pap test alone reduced the incidence of cervical cancer by 70% since its inception in the 1960s. The new vaccine against HPV is very exciting. It is a very helpful tool in determining the type of follow up care a women will receive after an abnormal pap test. Test results can vary from mildly atypical, which could just be a reactive or benign process to cancer. No women should die from cervical cancer with all the medical advances of recent time. The vaccine combined with regular pap smears should virtually eliminate cervical cancer. I beg all women to take care of themselves and visit the doctor for annual check ups. There are so many cancers that we cannot prevent. Lets do something about the ones we can.

The next goal should be to bring these innovations to places like Africa and Vietnam where cervical cancer is still the #1 cancer killer of women.

Sent by Andrea Christophersen | 11:55 AM | 1-8-2007

As an activist for young womens health, I think its important to make a story as real as possible. I had known both the official research documenting HPV prevalence and the day to day reality of many young women being diagnosed with HPV or the resultant effects like Pap smears that turned up problems. So many might hear the official statistics but not realize that all the women they know who had to return to the doctor for extra tests or "procedures" as the doctors like to call them- were the result of an incredibly common virus.

We don't necessarily need both approaches - peer (inside expert) and outside expert in each report but hearing from each perspective adds to all.

I find it significant that we still don't have a widely available test for HPV in men and we don't know some of the resultant effects on their health.

Sent by Claudine O'Leary | 11:58 AM | 1-8-2007

It can't primarily affect women if men are often the carriers! Why aren't men involved since they are part of the problem?

Sent by Kathleen Shull | 12:13 PM | 1-8-2007

I was told by a gynecologist, Dr. Travis French, in the 1960s, that cervical cancer was caused by a sexually transmitted disease.

Sent by Joanne | 12:16 PM | 1-8-2007

I agree with Jane and Steve. As a nurse, I feel it is very important for journalists who are reporting on scientific findings to know how to examine the validity of the research they are reporting on. This is particularly true when reporting on health issues. People sometimes do make personal health decisions based on what they hear in the news.

Also, I have to say that when "studies" create "market opportunities" for large companies, I consider it a red flag. In addition to the questions asked by Jane, it is important to know who funded the studies and how the research question came to be considered worthy of being researched.

This is a higher level of scientific sophistication than is generally possessed by journalists, but as Steve pointed out, NPR is up to the task.

Sent by Alicia Bright | 12:27 PM | 1-8-2007

I agree with the points made by Susan Glassner, I became aware of HPV not as a consumer but as a health care professional. My question, which has never been answered is: Why are the advertising campaigns/education directed solely to women? If, as stated, all people who are sexually active will contract HPV, then where is the push to include men in the dialogue and education. It would appear that once again women are being given the mantel of responsibility. HPV is a shared responsibility Where do men go to be tested? What is the treatment plan, can men be given a vaccine if not why not? This dialogue is far reaching and long in coming. On another note, if 100% of all sexually active people will get this, than it CANT be more prevalent in one ethic group or another, 100% is all you can have. NPR is just the medium to bring this dialogue forward.

Sent by Kathleen Dubuque | 12:29 PM | 1-8-2007

As someone who was diagnosed with HPV a year ago and who recently developed the other manifestation of HPV: genital warts-- I appreciate you delving into this story however I feel like you need to spend more time spelling out the facts. Its been incredibly difficult to find out simple information like who gets it and how, what the treatments are, can I pass it to someone else, will it ever go away, etc. There is a dearth of information available and this story misses an important opportunity to educate!

Sent by M. O'Hara | 2:11 PM | 1-8-2007

I was diagnosed with HPV at age 55 and have been in a monogamous relationship for 28 years. I was shocked to be diagnosed since I had no overt symptoms the only treatment recommended from the gynecologist was to get a episiotomy every year along with a PAP. I decided to contact my naturopathic doctor who put me on an immune boosting regimen. After 6 months, my pap was normal, a sign that the HPV was receding. I researched the virus on-line and stress can be a significant factor. I recommend various treatments to decide on the right one.

Sent by Carolyn Kavanagh | 2:15 PM | 1-8-2007

As a man, almost all the information easily accessible on HPV is useless. Ive tried to research this subject and found many frustrating dead ends.

Here are a few things Ive read, all of which should be confirmed before being trusted as fact, as I cant seem to get straight answers from books, the web, or doctors:

There is no test for men to know if they have HPV, unless the develop warts.

The type of HPV that causes warts, isn't the type that can be harmful to women. In fact, a man cant know if he has the type of HPV harmful to women.

There are 12 different strains of the virus.

There are 30 different strains of the virus.

HPV "goes away" on its own.

HPV has no known cure.

HPV can be treated, but might come back, within three months.

Men don't need to worry about HPV, only women.

The vaccine is only good for the harmful strains of HPV, not all of them.

When I saw the podcast, I thought to myself, "Finally, some straight answers on how to deal with this." Oddly, I feel like I didn't really get any.

What is a man who suspects he might have HPV - but doesn't know, because there is know test and he hasn't manifested any symptoms to do. Abstain on general principle?

Indeed, hat can men do, if anything to stop the spread of this disease. The vaccine seems completely targeted towards women. I can imagine, just by the general nature of any vaccine that it would work for men too...maybe.

The podcast was helpful, and raising awareness is a Very laudable goal. However, in short, I would want to hear from an expert as well as the interview as presented.

At the very least, point the listeners and readers in the right direction for more information. As in, in the posting above, cite a book, website, organization, anything, where I can go to inform myself on actual facts as they pertain to HPV and men.

Raising awareness without providing a better path for more information besides go get vaccinated isnt nearly as powerful as giving people resources to inform themselves.

Good new show. Keep up the good work!

Sent by Sam T. | 2:26 PM | 1-8-2007

I am a 20-year-old male and while I certainly appreciated the perspective of the two women and their trials with HPV, I do think something was missing by sticking with the first-person point of view. (I do not think a male voice was necessary, by the way.) Without a professional doctors advice and knowledge, I am still a bit confused about HPV.

How, even with condoms, is it spread? Is abstinence truly the only thing a sexually active youth should look forward to in order to stay healthy "down there?"

My best friend contracted HPV but luckily caught it early and sought the professional help to clear it up. What should people be looking for to catch it? Just paps? HPV is discussed a lot, but no one discusses what symptoms it takes.

I do feel this episode will be invaluable for the young and minorities in America. Hopefully a few will hear it and have the courage to go to their college health clinics, etc., to ensure a safe lifestyle.

Sent by Neal Morton | 2:33 PM | 1-8-2007

Your ?bottom up? approach is very effective in bringing the message to those who need to know. But to do this you must have solid science behind the message. In this case, the science is ironclad. Researchers have developed the data linking cervix cancer and HPV over the last 20+ years. This is not new knowledge, as anyone who has had an abnormal Pap smear in the last decade should be able to attest. As a gynecologist I have followed the progression of this issue through my entire practice.

HPV is ubiquitous. Virtually every human has been infected with one of the more than 100 types of this virus. Anyone who has ever had a wart has suffered such an infection. The list of HPV types that cause genital disease gets longer with ongoing investigation, but 4 types stand out: 6 and 11, which cause benign warts, and 16 and 18 which cause about 70% of cervix cancers.

So why the current explosion of information? Two reasons: First, because there is something new that can be done about it. Until the development of the vaccine, which protects against infection with types 6,11,16 and 18, the only protection against this illness was education. Sadly, Americans have long been ambivalent (to put it mildly) or openly hostile to sexuality education. Teaching safe-sex practices as part of responsible sexual behavior isn?t very sexy and convincing adolescents of the importance of these practices requires far more than the lip service that most young people encounter.

Second, there is a huge marketing organization with tons of money at Merck with a fine product to sell and they want to recoup their investment. The safety and efficacy of the vaccine are both excellent.

Every major medical society supports the recommendation to vaccinate young women before the onset of sexual intercourse. The only opposition to the vaccine comes from those who oppose vaccination in general and from those who believe that removing the threat of cervix cancer will make young girls promiscuous.

So, tell the stories that help everyone to understand what the science supports. But don?t leave out the expert support that vets the science.

Sent by DB Preskill | 2:37 PM | 1-8-2007

I think it is well founded to have suspicions about claims that pharmaceutical companies make, but I am here to tell you that HPV is not being blown out of proportion. On the contrary, I think the media is being conservative. As a practicing Obstetrician/Gynecologist, if it weren't for HPV I might not have a job!

Sent by Carmela Pettigrew M.D. | 2:41 PM | 1-8-2007

I would've thought NPR would look at both sides of the very controversial vaccine issue rather than just link to a very AMA approach to disease. I am hardly an expert, but I got HPV 14 years ago. I was treated, it never returned, I never transmitted it and nowadays I test negative for it. One clinician mentioned "transmediated cellular immunity," something the drug companies would hardly want the public to know about. The theory is that my body, and many other womens bodies, actually encapsulate the virus within the cell. This same clinician also mentioned that they had discovered many more types of the virus than previously thought, and some had even been detected in virgins. It may be that this virus, in its myriad forms, has migrated into our genetics.

While I believe in testing and early detection, I would hardly trust Merck has my best interest in mind when promoting a vaccine with no long term studies ever having been done. Why not talk to Planned Parenthood? If anyone has been aware of this disease for a long time, it is them.

Sent by G. Biegner | 2:43 PM | 1-8-2007

I think it irresponsible to report a health scare like this without quoting a medical expert, and I certainly put more credence in the CDC's stats that your guests "understanding."

Sent by A. F. Williams | 2:45 PM | 1-8-2007

I have been hearing about your show on the NPR Podcast blurbs. I also heard Michel on the Wikinomics segment. I think that the idea for the show is great and after listening to the segment on HPV I think it is developing very well.

As to the segment itself, I think a doctor would have been a good addition to the panel. However, I do not know the time constraints. If the segment must only be 15 minutes long then the two panelists you had were wonderful and their stories were very moving and informative. However, if there was more time a doctors opinion would have been nice especially as it related to public health policy and the problems of dealing with the virus from a heath care standpoint. Additionally, as a man, I think this segment was very informative. I know that the tie to cervical cancer has led to HPV being seen as a womens issue. However, as a sexually active and health conscious man I think that educating men is just as important as they are carriers of the virus.

I did have some questions that I wish the segment had covered:

Why is the vaccine being limited to individuals between 9-26? Are most adults already carriers who would not benefit from the vaccine?

What are the health risks to men? Or tests for men who might want to know if they could spread the virus to their partners?

That's all,

Sent by Robert Schwaller | 2:50 PM | 1-8-2007

I just found the Rough Cuts Podcast and am very excited about the topics that you are covering. I was glad to hear about HPV on a recent episode and I think the personal commentary was good. I would have liked to have a medical perspective though because I found myself asking many questions like How exactly does HPV get transmitted? It is possible however that one could simply ask their own doctor but what about those who don't have a doctor or insurance.

On another note I know someone, my cousin inlaw, who has just been told that she has cancerous cells. So hearing this hit very close to home for me.

Thank you.

Sent by Laura Rodriguez | 2:53 PM | 1-8-2007

The knowledge that HPV is linked to cervical cancer has been widely known for many years. However, it is only recently that pap tests have advanced far enough to actually test for the presence of the HPV virus. The new advancement in testing has confirmed that certain strains of HPV are indeed linked to cervical cancer changes on the cervix. Of course, the pharmaceutical companies have noticed this link and have made a product that definitely protects women from the more common high-risk strains of HPV. Since an estimated 80% of sexually active Americans have some strain of this virus, the timing and effectiveness of this vaccine could not be better. Yes, women of color are more at risk for the virus, because of socioeconomic factors that limit the amount and quality of preventative health care screenings. Please encourage all parents to vaccinate their daughters. This vaccine has so far shown to be near 100% effective in preventing infection of some high risk strains of HPV.

Sent by Dulce Mia Warren MS, RNC, WHNP | 3:01 PM | 1-8-2007

It was a great story that needs to be re-told again and again because so few are aware. Almost the single cause of cervical cancer and the only cause of anal cancer. If it works it can prevent cancer. It was recommended by my doctor the second week after it was available and I took it. Very expensive $180 per shot X 3. While it is covered by insurance companies for women, it is not covered for men.

Sent by Arillius Santos | 3:12 PM | 1-8-2007

It is my understanding that this STD can be fatal to women. What is being done to prevent its transmission from male sex partners?

I have known about this STD for a number of years in conjunction with researching the performance of annual pap smears. I found that the main reason was for the detection of HPV though this reason is rarely disclosed to women.

I would appreciate more balanced reporting from NPR that would discuss and disclose this information.

Sent by Janice Poehner | 4:18 PM | 1-8-2007

As a young woman I had heard of HPV and how incredibly common it was. I looked at it as a common cold - unavoidable and harmless. Then I contracted HPV and was told I had one of the 13 dangerous strains linked to cervical cancer. I'm mad at myself for not paying attention to current information about HPV, and for not protecting myself. I'm also upset that Merck is using a scare tactic to sell a "cancer" vaccine. At the same time I am very sad that the "Oneless" campaign was about 3 years too late for me.

I'd like to know if I could vaccinate my son someday, or encourage him to get vaccinated to help him protect someone he loves from this virus. Why is the responsibility and consciousness being expected only of young girls?

The statistic interpreted as everyone getting HPV is a sad stretch of science that probably isn't very scientific.

Sent by Amanda | 4:29 PM | 1-8-2007

I found out I had HPV about two years ago and of course was devastated... if there is anyone out there who could give me some advice on how to go about telling someone I have HPV without scaring them away. I know it is ultimately "their" choice to stay with me or leave me after finding out that I have it, but I believe in WORD choice and how it is said. I also believe in being honest...

Sent by Becca Dardd | 4:33 PM | 1-8-2007

I would like to have an expert back up statements in the story. While personal stories are interesting you still need to verify the facts. There is so much hype in reporting health studies that people do not realize that the very nature of research will raise questions about other research. I would like to know what kind of studies produce the headlines. How reliable are these studies? Who are the people who conducted these studies?

Sent by Betty Ann Wonderly | 4:35 PM | 1-8-2007

Yes, I thought the program was effective in raising awareness about HPV and cervical cancer. I was aware of HPV before listening to the show because I was diagnosed with a false positive (I had what the doctor thought were precancerous cells) at the age of 20. Since then, I have been using the ThinPrep during my annual exams. I did not know about the vaccine until listening to the show.

I thought the personal voice approach was very effective - HPV is indeed a very personal problem for many young, sexually active women.

Sent by Joanna Schenke | 4:37 PM | 1-8-2007

Thanks for this segment. What wasn't addressed is - what about the 80% of women that already have HPV? Does the vaccine do anything for them? Does it have to clear up before taking the vaccine? Or can the vaccine arrest its development?

Sent by Penny | 4:39 PM | 1-8-2007

You have requested feedback on what you believe is a unique and innovative npr format. I have subscribed to your podcast and listened to the HPV show. Unfortunately I find the format particularly pedestrian and the level of insight and perspective provided during the discussion not up to standard NPR fare. There are innumerable talk shows with interesting and underexposed guests on NPR and community radio shows all over the dial in my small market. Why would I have interest in another show (albeit national) that provides interesting, but undifferentiated and underexposed content? I actually would have preferred additional perspective on HPV beyond the perspectives provided by your guests (although I appreciated their personal and professional response to this health crisis). So I am underwhelmed by this experiment in radio that I feel is not particularly new and different. Nevertheless, I will continue to listen, selectively, to this new show.

Sent by David Nimkin | 4:41 PM | 1-8-2007

I am a 24 year old woman. 3 years ago I found out I had a form of HPV that could lead to cervical cancer. I was treated and am A-okay now. My doctor explained HPV to me and I did research on my own. I was the first of my girlfriends to be diagnosed but since then every one of my girlfriends has had an abnormal Pap smear and been told they have had some form of HPV. One had the form with warts, the rest just viruses that cleared on their own. The reason it has been largely ignored in the past is because it ususally clears up on its own, only a few forms cause cancer. (If I am not mistaken there are over 100 forms of HPV) I am glad it is in the spotlight now (even if it is due to the push by Merck for the new vaccine). I hope women become more educated, get the vaccine, and we have fewer deaths due to cervical cancer. Thank you NPR for doing the story - and making it personal.

Sent by Erin | 4:51 PM | 1-8-2007

My issue with the so-called "bottom-up" method is that when you get a personal account, you may miss part of the bigger picture.

HPV's effects on women were well-discussed in the segment, but facts about the virus's effects on men were poorly dealt with.

I knew about HPV because I'm taking part in the clinical study for the vaccine in men. One of the guests implied that it had already been approved for men in the U.S. -- it hasn't.

And while genital warts are the primary concern for most men when it comes to HPV, gay men should know that HPV can cause anal cancer, much as it can cervical cancer.

Sent by Andrew Jones | 4:56 PM | 1-8-2007

I am a 59 year old (Caucasian) woman, and I have been diagnosed with high risk HPV. Since I had a hysterectomy in my 30s, I am being treated for potential vaginal cancer. I feel very distraught that I was not more aware of this virus. The sheer commonality and potential for people to acquire this more than justifies the need for the vaccine. If one of the comments sent by a man, is questioning the Merck moneymaking as a result of this drug, I say, Walk around in my cancerous shoes for just one day. BTW, I was infected by my husband who had genital warts when he was in college.

Sent by Milli Haug | 4:59 PM | 1-8-2007

As a man, I want to commend you on this story. I really enjoyed. I have just recently heard about HPV and its links to cancer in women. However, the way that you presented the information was really helpful to me. It really brought the issue to heart. Tamika in her telling of her personal story was a really great way of personalizing the disease. It strikes me, however, that the topic of abstinence was stressed more especially for young girls. If the disease is so prevalent, women should not be engaging in sexual intercourse, period. Thank you for this show.

Sent by Justin Boynton | 5:01 PM | 1-8-2007

Yes, I was aware of HPV beforehand. I find health-related stories that are good and bad. This one wasn't all that interesting to me. I do not believe that being a man had anything to do with my opinion on the story.

I also would like to second Steve Petersen's last paragraph. There is so much information available now, it is very hard to know who/what to trust.

I think that, in general, the media - including NPR - tries too hard to find balance, thus giving way more attention to fringe ideas/issues. For example - a story that interviews one Intelligent Design scientist and one pro-Darwin scientist makes it seem as though there *IS* a controversy, when the vast majority of scientists dismiss ID out of hand.

Sent by Ralph Leyland | 5:04 PM | 1-8-2007

The lack of public awareness about HPV is a discredit to my profession, obstetrics & gynecology. HPV is a very real health concern and it is finally getting the press it deserves, no matter what the impetus. The pharmaceutical industry's splash in the commercial realm makes me cringe at times but perhaps, in this particular instance, their desire to sell their product (the HPV vaccines) may have a positive impact on public health.

Our knowledge about HPV has certainly become more sophisticated over the past decade. Not only have we delineated which strains in the many-membered family are more virulent, we've developed very sensitive and relatively cost effective methods for determining who carries the more aggressive forms of the virus. The Pap test is a simple screening exam that tests a woman for HPV. Unfortunately, we have no readily available screening tests for men even though they are as often the vectors passing the disease around. Perhaps lack of screening for men is due to the inability to treat them or eradicate the virus in them.

Whatever the case might be, put aside your skepticism about the import of this disease just because it's being peddled on TV. Ask your doctor. Although the statement "...every single sexually active person is going to get it some time in their life" is a bit sensationalistic, it carries enough ring of truth that everyone should listen to its toll.

Sent by Julie Mahoney, M.D. | 5:07 PM | 1-8-2007

I agree with Jane Gassners comment. Even though it is easier for people to relate to real life stories, I like to hear two sides of an argument. I had only heard of the HPV virus once or twice before this. As a man, I suppose that would be normal. I understand the time constraints for the show and how much work it takes, but I?ve been trained as a scientist and I never believe a story that doesn?t have appropriately cited references to studies done by reputable groups. Even if you did not have time to present both sides on air, I think you could have cited more references. Otherwise the show is lively and it did give me some information about a subject I know little about.

Sent by Jay Tuckett | 5:23 PM | 1-8-2007

Just listened to a portion of your show on the HPV virus. I thought having only lay-persons on was a great approach. I'm well aware of the fact that many professionals can come across as pretentious, unfeeling, and matter-of-fact, but cant help but have a slight to strong bias, and will use that bias to re-direct a discussion or interview as they please. While all the while appearing to be confident and upstanding.

As long as you bring intelligent and articulate folks onto the show, youll have an opportunity to make a sweet connection with your listeners as they listen and identify with your guests. As long as were well-informed and well-experienced, were well-set for good things to come!

And, yes, I had heard of this virus, but was unaware of it causing cancer. Im shocked enough to have my physician check me for it.

Good luck! I wish you the best with your new show. Ill try to listen to some more and offer up any insights.

Sent by Jennifer Topping | 5:25 PM | 1-8-2007

This is a comment more about the style of the articles than the actual topics being presented. The topic of HPV has a relevance to all ages and is an excellent example of reporting to share with students.

As a teacher-librarian I was intrigued with the comment by Steve, above, who was hoping for education "on information literacy". Thank you for recognizing the need for literacy within the realm of massive amounts of information. Librarians- school, academic, public, and special, are confronted with patrons whose needs for information may be answered in ever increasing ways. The variety of answers can be overwhelming. The veracity of sources is often muddling. School librarians teach students to evaluate their resources, but at times the teaching seems to be overpowered by the "ease" of locating an answer. Often that answer is the first one encountered.

I hope to use the example of your articles - good research in action - to show students the value of thinking carefully about a question. I urge you to continue with this timely and educational new show. You are giving us all an example of the thoughtful behavior that needs to be used when approaching a controversial subject.

Sent by Peg Becksvoort | 5:29 PM | 1-8-2007

I found this interview fascinating! I go to the doctor twice a year because I'm over 50 - in fact I have the luxury see two doctors twice a year because of my veterans status. Both doctors know I am very sexually active and neither have ever uttered, "HPV"!

Sent by Herb Harris | 5:44 PM | 1-8-2007

Men love women, so want the best for them. Yes, men are very interested in the HPV subject even if the sole medical studies come from money-grubbing pharmaceutical companies.

Sent by Ronald D Hamann | 5:51 PM | 1-8-2007

I like the idea of presenting stories from the perspective of one who is personally affected, and I think its a great stimulant for conversation and further individual research. Having said that, I think that many people don't have the time, energy or inclination to question what they hear, read or see in the media, and would take the information presented at face value. For example, the guest stated that condoms were no protection against HPV. According to the National Institutes of Health, thats not exactly true. Although no definitive link has been proven thus far, research does seem to indicate that condoms can offer some degree of protection. Would the average listener bother to look this up? Maybe. Maybe not. But for those who don't check it out, they may then spread the misinformation...and for something this important, it would seem to me that getting the correct information out there would be paramount.

Still, I like the personal touch that this format offers. Perhaps a word or two about how the guests are not formally trained in the subject matter would be enough. Or, it may be useful to have an expert make a short appearance. Certainly, I think anyone who has gone through anything like this has something to teach others. There are enormous benefits to hearing what it?s like to walk in someone else?s shoes. Not only can we become more knowledgeable, but we can also become more compassionate and tolerant. It should be understood, however, that the guests are not necessarily all-knowing. Just because Ive had my hair cut dozens of times in my life, for example, doesn't mean that I am qualified to give advice on hair care or styling. The experiences are valuable in their own right...either focus on those and leave the statistics to the experts, or include a little expert commentary.

One final note: any show that can motivate listeners to want to know more about a topic is a valuable gift. I look forward to watching this show develop.

Sent by Kathy McBurney | 5:56 PM | 1-8-2007

I concur with Jane Gassner's keen analysis of the issue. I also believe that the fact that HPV is now national news" is not a coincidence, but a principal part of the multi million dollar campaign by Merck & Co. aimed at marketing their vaccine recently approved by the FDA.

Id like to add that there are at least 100 different stereotypes of human HPV. Only two or three of these subtypes have been ?associated? to cervical cancer and are actually the target of the vaccine. A causal relation to cervical cancer has not been clearly established in reputed peer-reviewed scientific journals. Statistical associations constitute valid basis for creating hypotheses but not to arbitrarily establish "scientific truths" least of all to create nationwide scares.

Its sad to see generalizations such as these not backed by unbiased scientific studies publicized in such an irresponsible manner by media of national reach. Scare tactics it is i.e., plain terrorism.

Sent by Ernesto Bustamante | 6:00 PM | 1-8-2007

I had heard about a lot about HPV when the vaccine was first introduced. However, at the time, I also heard they were planning to administer it only to females, so I'm glad to hear someone recommending males getting as well. I am a gay man, but still found the interview enlightening and was reminded that I would like to discuss the issue with my doctor.

I especially appreciate the practical nature of this story. Much of the news we take in on a daily basis is abstract in the sense that it doesn't directly affect the average listener. I liked hearing from someone who had a personal involvement in the story and was helping to arm the listeners with information that they could actually use and that they need to protect themselves.

I didn't realize that doctors have long known about HPV, but were withholding information from patients due to an irrational and untested fear of panic. Its too bad that it took the approval of a vaccine to finally shed light on the subject. It saddens me to think of how many more lives could have been improved or saved if this issue was more widely discussed in the past. Id like to see Rough Cuts continue to expose the roots of issues like this.

In response to Jane Gassner's comment, I would like encourage caution when presenting opposing viewpoints to medical studies. The debate over climate change has left me very skeptical of studies that contradict one another. In these cases, I would like to hear more background on the specific studies cited to help listeners decide which to trust. I believe its nothing but a waste of my time for someone to report news that contradicts itself.

Sent by Michael O'Laughlin | 6:05 PM | 1-8-2007

Dear Michel,

Most recently I went through a very intensive 6 week treatment of chemotherapy and radiation for Anal Cancer. I am a very healthy 52 year old woman and yoga instructor and, like your guest, Tamika was shocked at learning that I had cancer. This uncommon cancer is becoming more common among women in the 45 to 60 year age group (this is the cancer Farrah Fawcett had/has)as it also shares the HPV virus as a cause. Like cervical cancer, it can often go undetected and can become deadly if left untreated. Luckily for me and for other women I have now met, it was discovered through routine colonoscopy before it reached a difficult stage to treat. Now that I have learned more about this cancer and HPV, I realize there were symptoms that could easily be brushed off as little nuances connected with aging and menopause. This is another cancer that people need to be made aware of as it is becoming increasingly more common. I'm afraid that the word ANAL is one that people are not ready to hear and it needs to be a word that we can roll off of our tongue more easily. Many young women need to become aware of this cancer as another associated with HPV. I would be happy to help get the info. out.

Sent by Andrea Nova | 6:08 PM | 1-8-2007

Thought the topic and the participants were good. However, no one answered the question regarding men receiving the vaccine. I have a son (10) should he be vaccinated. What can men do to preclude transmitting this disease? Maybe another panel in two segments with professionals and one without professionals would permit for a greater and meaningful discussion. This would also enable greater information.

Sent by Wilfred | 6:11 PM | 1-8-2007

So far, so good. I like:

The "first person" interview/report.

The overall format.

That it's available in short Podcast format.

On the HPV report:

As a guy, I was interested - but that's because I'm a MARRIED guy who loves his wife.

I was aware of this Virus, but I'm an educator who has seen some very detailed assemblies.

Sent by Bill Fenstermaker | 6:13 PM | 1-8-2007

I really liked the segment. I especially like the fact that it comes from a first person perspective. I am looking forward to even more interesting topics for both male and female.

Great Job!!!

Sent by Kenneth Anderson | 6:16 PM | 1-8-2007

I really liked the format of the new series. Talking to real people about an issue gets to more of the things that I'm interested in hear about. Unfortunately, your HPV podcast also showed one of the great detractors for this type of interview in that the information given was very lopsided. Reality is that HPV has over 60 common strains and that these cause way more than just cervical cancer. While I appreciate the articles focus on cervical cancer--that being by far one of the worst possible effects of the virus--I also would have appreciated just a slight bit more in terms of factual evidence. One of my biggest beefs with mainstream news media is that they give you the 10 second barely informed "facts" about an issue. If this is to truly be an in depth interview/podcast, reporters are going to have to carry a lot more of the onus for researching the issue and ensuring that listeners are aware of additional information and pertinent/salient facts. The ladies interviewed for HPV are very much focused on the cervical cancer side of the issue. With a different title to specify that the interview?s focus was narrower and/or a little clearer and more direct acknowledgment of the other varieties/effects of the virus I would have rated this a 10.

Sent by Keith Kirkland | 6:18 PM | 1-8-2007

RoughCuts seems to be an interesting amalgamation of traditional reporting and community involvement. In many stories, I believe that this technique will be intriguing and spark user involvement. However, if the segment is going to make such an unqualified, inflammatory assertion as: "Every single sexually active person is going to get it at some point in their life." - it makes the story unbelievable.

If you want us to take the story seriously, you need to cite an authority and define your terms. What qualifies as "sexually active"? What qualifies as "intimate" contact that spreads the virus? Where can men go to be tested?

Most of the people I know are committed to monogamous relationships and don't even kiss anyone other than their spouse. This story lacks an authority figure that would make the alarmist statistics believable and lacks the details that would tell the listener whether or not the story is personally relevant.

Sent by Gregg | 6:22 PM | 1-8-2007

After hearing previous segments about HPV and the Gardasil vaccine with traditional experts (doctors, etc.), I appreciated the new perspectives from two women who had HPV and are working to educate others.

Sent by Anonymous | 3:29 PM | 1-9-2007

I was aware of this topic before I heard the podcast. My gynecologist tested me for this in 2005 and fortunately I was negative for the virus, even though my current partner has had genital warts in the past. Because of this, I took exception to the statement that everyone who is sexually active will have it. I agree that the CDC figure of 50% is low, but it is not the 100% that Tamika claims.

I've enjoyed the podcasts so far - keep up the good work.

Sent by Anonymous | 3:38 PM | 1-9-2007

In my opinion, it has taken much too long for people to become concerned about this potentially killer virus. As someone who was diagnosed with pre-cancerous changes on my cervix due to HPV at age 18, some 20 years ago now, I have been thrilled about the current campaign to finally bring HPV to the general public's awareness. With the news that there is finally a vaccine for the worst strains, I am relieved to know that my daughter will not have to go through what I went through.

When I was diagnosed, I was told that the HPV operated similarly to the virus that causes herpes (HSV): 1) There is no known cure 2) The virus will always be in my system, while it may lay dormant for years, it can come back at anytime 3) You can have it and spread it without any knowledge of either. This information has held true for me, after several invasive treatments my infection has pretty much remained in "remission," only occasionally showing up as slight abnormality that disappears upon greater scrutiny. To my knowledge I haven't transmitted it to anyone ... but then there is a chance that I have and we just don't know about it....

Sent by E. Alexander | 4:10 PM | 1-9-2007

Hello Michel & team-

I just want you to know how much I really enjoy the new podcast. As a nurse, I really enjoyed the 1st person perspective on HPV. You captured my attention & interest in keeping the topic real & not too medical. Kudos to your team!

Sent by Nikki Miskowicz | 4:13 PM | 1-9-2007

Good luck with your new Rough Cuts. I enjoyed the first one, would also enjoy more expert opinion.

Sent by Jim Hathaway | 4:15 PM | 1-9-2007

In general, I dislike the human-interest-as-lead. It's such a commonly used hook, I've come to hate it. If I'm listening to one of these stories, I sometimes tune out; if I'm reading, I scan ahead to the hard edged info: statistics, expert opinion and analysis.

Sent by Dan Ryder | 4:18 PM | 1-9-2007

There is no coincidence between Gardasil and HPV and this "flood" of information just being disseminated. The fact is, HPV has been around for a long, long time. I first learned of it 12 years ago in college when a friend of mine became infected with genital warts. She ended up having HPV on her cervix and had abnormal pap smears for over a year. Not only was it physically painful for her, it was also very emotionally scarring. I spent many hours with her while she cried and described her feelings of revulsion and disbelief that it could happen to her.

Ultimately after 2 aggressive treatments on her cervix, the virus disappeared. I do not believe she has had another encounter. She goes for regular paps and has been healthy ever since that scare. I am *THRILLED* to see all of this publicity surrounding HPV and truly hope someone will eradicate this prevalent and sometimes deadly virus. I hope young women will be encouraged to have the Gardasil vaccine and educate themselves on HPV and how it can be prevented.

Sent by Rachel M. | 11:08 AM | 1-10-2007

This is not a health scare. I am a Labor and Delivery nurse in a large hospital which also has a very busy gynecologic oncology service. The number of young and middle-aged women with abnormal pap smears and cervical cancer is horrifying. I have no problem accepting the statement that "every sexually active person is going to get it". I myself am positive for HPV and follow it closely.

Sent by Lisa Buck RN | 11:15 AM | 1-10-2007

I know why its taken so long for this information to come to light. Its a sexually transmitted disease, an STD. And it causes the most problems with women, the least important, most scorned human beings that are sexually stigmatized for any issue regarding STDs, anything at all that might suggest sexual desire, sexual identity, sexual freedom or sexual activity.

If a man gets an STD, if it can be cured, then its an embarrassment, a funny story that you tell the guys in private. That time you caught the clap in Tiajuana, when you went on that bender in Old Mexico.

But if a woman gets an STD, she in no way can be considered clean. Her Vagina is permanently tainted, as well as her character. Because the connotation is that you cannot catch an STD from just one partner. You have to sleep with 50, no 100 men to catch any kind of STD. And we all know what kind of girl that is.

Enough said.

In fact, if you are a woman and you even know what the acronym STD means, you are considered a suspected slut. There is still a tremendous sexual double standard regarding men and women and sexually transmitted diseases.

And that extends from regular culture and right into the OBGYNs office.

That is why no one wants to bring that up. Half don't want you knowing how common it is, it might remove the shameful stigma that might be preventing you from having or enjoying sex. (see Conservative Campaign to misinform about the efficacy of Condoms and HPV) The other half don't want to bring the wrath of the Conservatives down upon them and loose funding or votes for being a party to removing that stigma.

I am not always happy about Drug Companies, there are a lot things they do that really piss me off. But I am very happy that Merck developed this vaccine and fought for its release as a child hood vaccine.

Sent by Stephanie | 11:17 AM | 1-10-2007

I really liked the emphasis on the first person mode of communication and dialogue. As a male/man, i still found the segment informative and interesting. Although I agree with Gregg (comment 1-8-2007) that perhaps a little more needs to layed out as to exactly what kind of contact can transmit the virus, I do not mind the "every single person" comment made by one of the contributors. The speakers are not politicians watching their every word its the lack of polished that made the story intriguing and involving for me. One thing i would have definitely liked to hear was just a little about how the virus affects men (you know, the other half of the listeners) i think that just a minute on that would help incorporate the interests of a wider audience.

Sent by Grey | 11:23 AM | 1-10-2007

Thank you for bringing more attention to an oft-neglected topic. Having studied HPV for a health promotion fair in nursing school, I felt that there were some important facts about HPV that were left out, but would be important or at least of great interest to a person hearing about HPV for the first time. For example, one of your guests mentioned genital warts, but there wasn't a clear enough explanation that HPV is the cause of genital warts. From a public health perspective, cervical cancer is of the greatest concern (and why the vaccine is not promoted for boys and men, even though they are carriers). However, the listener will want it reinforced that skin to skin contact means any skin or mucous membrane (throat, anus), not just the genitals.

People are often alarmed when they hear about HPV for the first time and will want to know "what to do." For many, abstinence is not a realistic answer. And what if they are already exposed or infected? Awareness of the virus and its method of transmission is not as useful to the public as the same information about HIV/AIDS or the flu. As such, HPV presents a real challenge to from health teaching standpoint because there aren't a lot of good answers. The vaccine is only effective if a person has not been exposed. Given HPVs prevalence, one has to assume exposure at the onset of sexual activity, so it is offered primarily to girls. While there is a test to detect HPV, it is not recommended for women under 30 unless they have an abnormal Pap. There is no test to detect the virus in men, as far as I know. Even if there was a test, there is no treatment apart from treating the warts and/or abnormal cells. We cannot yet treat the virus itself. Because of HPVs characteristics, public health teaching about the virus is focused on actions: pap tests, reducing the number of sexual partners, and the new vaccine.

The personal story approach is effective because it turns what could be a dry collection of statistics into a compelling story arc. However, without more of the basic factual information people want and need, the segment will have limited usefulness.

Sent by Adriana Arcia, BSN RN | 11:33 AM | 1-10-2007

I first heard about HPV and its link to cervical cancer more than 10 years ago on a Christian Radio Station. At the time I thought that it was just some moralistic propaganda, but I checked some independent sources and found that most of what was said was true. I think part of the reason that people havent been aware of HPV is that our entertainment industry is quite willing to base stories on cancer being caused by chemicals released by uncaring corporations, but is less willing to base stories on us giving ourselves cancer through sexual promiscuity.

Sent by Brad Gamble | 6:34 PM | 1-10-2007

Three months ago I went to my OB/GYN for my annual exam. A couple of days later I received a phone call telling me I had HPV. I asked how long I had it, that it didn't show up on my last exam? Was is missed? I was told that Kaiser never tested for it before. Now they do. I was told that I could have had it for at least 20 years! It was cast off as nothing to really worry about. For the past five years Ive had abnormal paps. Ive had cone biopsy. I'm not supposed to worry about it, though, because it is so common and "can" lead to cancer. I'm in my 50s now. I'm not going to worry about it but I am going to email this page to my daughters and have their mothers talk to their daughters about it.

Sent by Susan | 6:37 PM | 1-10-2007

Hi Michel, thank you for the information. I have a wife and daughter I will be sharing this with.

My wife has had a lot of problems related to her ovaries and uterus....I am thinking she could have been misdiagnosed.

Sent by Sherwood | 6:39 PM | 1-10-2007

How I found out about "Rough Cuts":

When I was cruising NPR free podcasts on Apples iTunes website. I had been subscribing to "Wait, Wait, Don't Tell Me" for a few months, and wanted to see what else was available from NPR to download. The topic for this pilot sounded interesting, so I subscribed and got my first podcast yesterday.

About the recent show: The HPV topic was very relevant for me a 46 YO mother of two teenage girls. I too, like Tamika, found out about the virus from my doctor, and had no clue what it was. 16 years ago, between the births of my two children, my pap smear was positive for a pre-cancerous lesion on my cervix, and the doctor cited HPV as the culprit. I had a laser procedure to remove the lesion and luckily have had negative paps from then on. It was a little disconcerting, though, as the knowledge that I contracted a STD made me upset as I wasn't terribly active during my single days, and telling my husband was difficult. I came of age during the "Our bodies, ourselves" time, where engaging in casual sex had far less complications than it does today. The fact that condoms would not help in preventing the transmission of HPV is all the more troubling.

Comments about the show: It was very informative and non-threatening and I think would appeal to young and old. I'm going to send it to my daughters iPods for a listen.

It was great that you discussed the vaccine. However, you should have emphasized that the vaccine does not give 100% coverage (only about 60% of the HPV strains are covered I think), which I don't recall being mentioned.

And, I don't recall if you discussed what (if anything) one can do to avoid transmission or what role men have and/or what any implications there are to mens health. I believe that would be good to add.

I liked Tamikas compelling story. She is wonderful to discuss it so openly and hopefully help the next generation of sexually active women to be more informed about HPV.

Thanks, and I look forward to the next show!

Sent by Myra | 10:43 AM | 1-11-2007

I have to agree with Jane. I've been skeptical about the vaccine ever since first hearing about it. It just strikes me as something that somewhere down they road they will find out it has some equally-as-bad side effects as what they were trying to guard against. The drug companies will not be happy until we are all on something. We've seen too many of these "wonder" drugs ultimately end up being not what they were supposed to be.

Sent by Nancy Orchard | 10:48 AM | 1-11-2007

I second Wilfreds suggestion of a second segment of professionals, public health experts, womens medicine providers, pharmacists. With so much political correctness floating around not to mention wishful thinking parading as facts it is prudent to anchor a "news and information" piece to the best facts/statistics available. I depend on NPR to do that. I note when they do not.

Sent by Martha Kelly, physician assistant | 11:02 AM | 1-11-2007

I believe this is a tremendously important topic. I didn't know of HPV until I was asked to participate in a study at my university one year during my check up. Within the year I was diagnosed with HPV. I had it for 4 years before it disappeared. Yay!

I was terrified for months though. I had no idea what I was in for. I thought I was going to develop cervical cancer at age 21. I did a lot of research myself and talked to a lot of doctors.

Interviews like this would have helped during the first few months.

I too was embarrassed that I had contracted an STD. An STD that causes cervical cancer. I hated telling my dad.

Now I know. Interviews like this and including other sexually transmitted diseases, womens health issues, and reproductive health issues are highly important. Especially in this time when Roe v. Wade, gay marriage and other human rights are being violated based on a minority's ideas of what if righteous -- even if they themselves do not follow their preachings.

Now Ive talked to my sisters and friends about HPV, posted about the vaccine and told my story to anyone who wants to hear it.

I'm looking forward to this show. I love NPR, All Things Considered, Wait, Wait...Don't Tell Me and the news bites.

Sent by Kristen Owen | 11:05 AM | 1-11-2007

Like the above commenter, I dislike the scare tactics that are used these kinds of stories. Yes, a lot of people will get it, meaning its common. I was diagnosed with HPV several years ago and my doctor told me we needed to follow it, but not get hysterical. She said that 60% of HPV incidences clear up on their own, with 30% developing into cancer. Mine went away on its own.

The key to good reproductive health is to see your doctor regularly and have regular paps. Sexually active people who are not in monogamous relationships should always use condoms. Also keep in mind that, even if you are in a monogamous relationship, HPV may not show up until years after it was contracted. The important thing is to get tested and follow your doctors advice if tested positive.

Sent by S. Macdougal | 11:09 AM | 1-11-2007

Truly, though aware of the commercials, I have never bothered to even watch long enough to see if they were sponsored by attorneys or pharmaceutical companies - the assumption was that it was simply hype. Oh, the damage we do without intention...

Sent by Hart Parris | 11:10 AM | 1-11-2007

Thank you for the story. I was aware of HPV, prior to your segment. I appreciate that you used "real people" to discuss this matter, it helped to make it real and less clinical.

We need to make people aware of HPV, so that women without children are not forced to give up their ability to do so, because of a preventable STD. Thanks.

I look forward to hearing more stories of this nature.

Sent by D. Edwards | 11:11 AM | 1-11-2007

Where can we find more information for men regarding the virus? It sounds as if we are the carriers and don't have any lasting, harmful effects. We need to know how to detect the virus within ourselves to further prevent the spread of the virus.

Sent by Tim Bodiford | 11:24 AM | 1-11-2007

Still haven't had something I can personally relate to after three programs, so its becoming increasingly difficult to offer any sort of useful feedback. Of the three shows so far, though, I thought the subject matter in this one was more interesting.

I'm glad that you mentioned the last of an "expert" guest was intentional at the end of the program. Personally, I prefer a mix of personal backstory and expert feedback, so I did miss hearing a doctors perspective. I'm sure your guests did their homework and knew all about how the virus had affected them personally, but I don't think their information (however accurate) would provide the same weight as someone from the Centers for Disease Control, for instance.

The fact that I preferred this particular story over the other two in no way means that I think you should solely focus on health/science topics. Id probably fall asleep half-way into the second one. I like that you've mixed it up a little, though, and hope you continue to do so.

Oh, and Id still like to see the "diverse" part come in to play with the guest selection... Unless the person in the other thread who said "diversity" was just a euphemism for "African American" was right on the money as far as this show goes, I think its time to mix it up a little. I don't mean "stop having African American guests," but rather "have African American guests AND a white guy... or an Asian woman... etc..."

Thanks for this show,

Sent by Justin Stanley | 11:33 AM | 1-11-2007

Great piece. I'm lucky to live in an area where Gardasil is readily available and awareness is high, and I got my shot last October. One thing I thought was a bit misleading: the piece implied that the vaccine is available to men, which I believe is untrue.

Sent by Sheila Parr | 11:36 AM | 1-11-2007

As with Michael O'Laughlin, who posted a couple of days ago, I am a gay man who was already aware of HPV and its associated risk for anal cancer in men. I found, though, that I had to educate my doctor on this issue. It's a sensitive topic for a man to suggest to his doctor that he might need a pap test. I don't know whether insurance plans cover pap tests for men. I don't know if my own plan does. I have not done anything with my knowledge other than mention it to my doctor, and I have never been tested for HPV.

Sent by Bruce Simmons | 12:05 PM | 1-11-2007

Thank you for taking our advice on this new program!

I knew about HPV before listening to this program - I knew it caused cervical cancer in some cases, that it was an STD and that there is now a preventative vaccine, so I learned nothing from this program. While I liked the 1st person approach to the program, it lacked the depth of some of the other NPR programs I love. I don't know what else there should have been, as I don't know what else there is to learn, but I hope that there will be more to it than just a couple of people's experience with whatever the topic of the day/week is.

Good Luck.

Sent by Liz | 2:59 PM | 1-11-2007

I found the program very interesting and liked the focus. I missed a bit of information from a doctor before or after the interviews.

Sent by Ethan Spooner | 3:02 PM | 1-11-2007

First, I haven't read all the comments, so I don't know if any of this has been addressed...

This show had more questions than answers.

1. I can get HPV through skin-to-skin contact and not necessarily sex? Does that mean I can shake the hand of someone who has HPV and get it, like a cold? Or does there have to be some kind of genital contact?

2. Are there always genital warts involved?

3. To restate Gregg's question from Jan. 8: If a person is in a monogamous relationship, is HPV something to worry about? Usually married couples don't worry about other STDs, should they worry about HPV? If both people are faithful, is it an issue?

As for the show itself, I am a bit confused in regards to the demographics for this show. I realize Michel is African-American, and this show was developed with "African-American stations", but does that mean this will be a African-American talkshow? That wasn't how it was originally described.

The original blog stated it was going to focus on "diverse and new voices", which is a good thing. Being a WASP, I was interested in hearing about other people's Christmas traditions and how they deal with it as a minority (i.e.: race of Santa). But then we got to this HPV show, which was interesting, but again, only African-Americans were on the show. Why? All women can get cervical cancer from HPV. Michel talks about how "African-American women don't get access to this information." What about other races? Why was this show also focused on race?

Will we hear from other people? Asians? Native Americans? Hispanics? Whites? Buddhists? Catholics? Protestants? Wiccans? Teachers? Alligator Wrestlers?

To lay it on the line: Will this show truly be "diverse" or is that just a code word?

Sent by wydok | 3:15 PM | 1-11-2007

I just listened to the roughcuts story about HPV. I thought that the interview was very interesting and engaging.

I had heard of HPV before, from a series of television commercials about the new vaccine.

I think that the guests were very real and accessible. I'm not sure that not having a doctor on the show was a good idea. I think having a knowledgeable OB-GYN would have provided some more technical details as well as maybe an explanation as to if they talk about HPV with their patients.

Sent by Bob Harwig | 4:55 PM | 1-11-2007

I just heard about the HPV virus on your show and found it very interesting and informative. I never knew about this and will get a Pap smear pronto. Also I would like to make a suggestion. My husband was diagnosed with prostate cancer 4 years ago and had to have his prostate removed and receive radiation treatment. This cancer (as all are) is a terrible thing that can happen to a man as well as the person he is involved with.

I knew so little about it and thought that there wasn't much press about this problem. EVERY guy should be told of the horrible consequences he faces when he does not get checked for this problem. Could there be a show about this? I think it would save lives.

Thank You

Sent by Joan Kiley | 4:58 PM | 1-11-2007

I enjoyed your podcast on HPV. As a male with HPV I was aware of much of the information you provided, but I was nonetheless interested by your guests and their unique perspectives. Excellent choice of vetoing the typical doctor or health official, to provide a more personal (and therefore tangible) interview. Keep up the good work!

Sent by M. Barankin | 5:00 PM | 1-11-2007

I'm a male who is very interested in health issues. I was very pleased to hear of the HPV vaccine when it received approval a few months ago, and I thank you for dealing with this important issue. HPV represents a very large and very preventable health problem in our country and in the world.

I agree that the "real person" approach was more accessible and less clinical than having somebody with a bunch of abbreviations after their name on your air, but I'm concerned that medical accuracy and completeness suffered in this story. First: according to the National Women's Health Information Center, 50% of Americans are expected to get HPV sometime in their lives. Your guest's contention that everybody who is sexually active will get it is incorrect and could prevent listeners from taking steps to avoid the virus. Second: Most men who have HPV (and about 50% of men will during their lifetime) have no symptoms but can still transmit the virus. This alone is an excellent reason to be vaccinated. Third: There's no cure for HPV. Once you have it, you have it forever, and the vaccine won't work for you. Finally, your guests painted a pretty bleak picture for prevention... "Well, you'll definitely get it unless you abstain from sex completely." That's wrong and destructive. I suggest checking out JAMA's HPV patient page to understand risk factors and ways of preventing the spread of HPV: http://jama.ama-assn.org/cgi/reprint/287/18/2452.pdf

Accessibility is good, but accuracy is vital.

Sent by Bill Bensen | 5:08 PM | 1-11-2007

Thank you for this conversation on HPV.... it leaves some questions unanswered, but it also gives me as a patient a list of questions for my own doctor.

Sent by Edie Henderson | 5:14 PM | 1-11-2007

I just saw this at the bottom of the story:

"Her understanding is that unless two virgins become sexually involved and remain completely monogamous (forever!) one would be exposed to some form of the virus."

Well, that's good to know. It doesn't happen often, but it does happen.

Sent by wydok | 5:32 PM | 1-11-2007

I've been meaning to write this comment since the show first aired. I am a male listener and podcast subscriber. I am twenty-five years old, and I must say that (according to me) people my age DO know about this. So, Yes I too knew of HPV's existence before your program. I also knew that men get the disease. In my age group, I find that we have all had some years of sexual education, and talk of STDs/AIDS and the tests which detect them, is common--at least in my circles. I must, however, add that HPV--unlike other STDs -- is not taken seriously. (especially by men)

I would like to defend Michel Martin, the journalist/mediator. In various postings, she was criticized for comments made during the program. I remember the comments in question differently. Tamika was a guest. This point was made clear. It was NEVER said that Tamika represents NPR or that Michel Martin or the CDC agree. The guest, Tamika, was the one who said "Every single sexually active person is going to get it at some point in their life." I acknowledge, that it is a bit much, but this GUEST is not a journalist, she is an activist. Her job--as discussed on the program--is largely to promote awareness (which is greatly needed in this world).

The format of the show, in my opinion, as is allows for an open discussion. Rough Cuts -- specifically to try to be different -- did NOT bring on medical experts and researchers and government spokespeople. This activist has the right to say that everyone in the world will get it. It is our job as an active audience to take that information, assess what has been said, and correct the problem. If you understood what was said, there should be NO fear or panic from her comment. Most of all, this woman was doing her job... She got your attention, didn't she? --that's called awareness

I believe that the New Yorker, some time ago (spring 2006) published an article about the steps toward approval of the HPV vaccine. I remember it as being highly informative, and I suggest looking through your back issues to find it. I couldn't find it on the web site.

What I think is more dramatic is the fact that though we have this vaccine and America (and the world) is not being vaccinated. This vaccine should have been bigger news than Viagra--if the facts are right and it can truly prevent some 90+% of cervical cancer in women.

The reason so many people were outraged by the dreary commentary of Tamika, was because she is right. We CAN all get this, even when we're "safe."

This is a disease. Disease is serious, and needs to be treated as such.

PUBLIC dialogue is necessary to prevention. This dialogue needs to be opened by more than just NPR and the New Yorker. We, as an audience, need to use our knowledge, no matter how little and speak openly with our friends, lovers, partners, and family.

Our president, even if the religious right finds it scandalous, needs to implement programs which allow for access to the vaccine for ALL of America's children. We have the information and the technology, now we need to use it.

Sent by Donald Bond | 11:09 AM | 1-12-2007

[Re: wydok's post above]

Yes, two virgins can meet fall in love and have a lifetime of safe monogamous sex... but let's be real, that's not the problem. The problem is that millions of people can have this, and not know, and now it's preventable. Let's do something about it.

Sent by Donald Bond | 11:15 AM | 1-12-2007

Why was this important segment so short ? It left me with a long list of unanswered questions. Is this program "Serious Issues Light?"

Sent by Alan Prostick | 12:08 PM | 1-12-2007

I was aware of HPV before listening to the show, as a young woman who was diagnosed and treated for it. At age 22 my pap came back abnormal and I underwent an outpatient surgery to remove the precancerous cells. Even though I have been personally affected by this situation, I don't agree with the flood of advertising and media attention devoted to promoting awareness of the virus and (of course) the vaccine.

Like other listeners, I am extremely skeptical about the coincidence of this story and others with the launch of a new vaccine that will make Merck tons of money, seeing as how every girls parents will now be scared into giving it to her. Cervical cancer has long been a health concern for women, and we have in place a system to screen for it already. The manufacturers of the vaccine still recommend regular pap tests to catch other forms that the virus vaccine does not protect against.

It seems we should be encouraging women, especially young women who are more susceptible to the virus, to continue their annual screenings for cancer and other health issues instead of scaring people into getting a vaccine that may or may not help them. Not that I think getting the vaccine is a bad idea, I think every woman who is eligible should talk about it with their doctor, but this whole media push, the commercials on TV, the advertisements in the bathroom stalls, and now on NPR, disgusts me.

Sent by Samantha | 2:22 PM | 1-16-2007

I have really enjoyed this program. HPV is something I have been tested for and knew about, but it made a great deal of difference to know how it personally affected someone so much like me. I love the way Ms. Martin conducts her interviews. I think the casualness and the feeling of being among "Friends" when listening to the program is very appealing.

I am a military wife stationed with my husband in Germany. He just returned from a one year in Iraq. It was a long and painful separation for both of us. Now he is home and we are so thankful and blessed to have him safely with us.

I do not think that most people realize just what sacrifices military families make. I would enjoy a segment on this topic.

Sent by Maria Mendelson | 2:26 PM | 1-16-2007

Hey Michel,

I'm happy there's a new show on NPR starting - I already added it to my podcast schedule!

As a 21-year-old college student, I believe I'm the audience you're trying to target with your show, but I hope I don't surprise you when I say that I don't love the informality of not having "traditional panelists on the show."

The beauty of most NPR shows is the way in which they can interview a popular figure or common-person (interviews with Mos Def and Iggy Pop come to mind) without the interview seeming either formal or informal - they sound just right. In my opinion, to make something fresh one mustn't cut out the experts (in regards to the conscious absence of doctors or medical experts on your HPV segment), but should artfully include them in the conversation with the non-experts. The challenge is not in making the conversation seem like one that would take place in the back of Starbucks, but in skillfully weaving that conversation with the one that would take place in the doctors office.

For example, Tamika's claims that "everyone will get HPV" and her ignoring of the question of whether men should get the HPV vaccine in addition to women are two very notable and important examples in which having an expert on the show would have much improved it. Having experts on the show does not stifle the conversation - rather, it allows it to be more complete.

Thanks very much and I'm sorry if I came off as too critical - I do like the show!

Sent by Farzon Nahvi | 3:20 PM | 1-16-2007

I downloaded the first three podcasts just to see whether I was interested... and when I heard the show on HPV, I stopped, went to my 21 and 25 year old daughters and sat through the podcast with each of them. I was dumbfounded to learn that condoms did not provide protection, 95% of cervical cancers are caused by HPV and the virus is ubiquitous and of epidemic proportions.

My eldest daughter is already infected, courtesy of a boyfriend who didn't think HPV was "worth mentioning" even though he knew he was infected! Men need to be getting the message that HPV is potentially life-threatening (at least for some women) and they need to take responsibility for their part in spreading the disease.

My 21 year old daughter was also shocked with the information you presented and is arranging 1) to get an exam immediately and 2) to get vaccinated ASAP, presuming it's not too late to do so.

My wife, my daughters and I THANK YOU for this eye-opening program!

Sent by John Trewolla | 4:22 PM | 1-16-2007

I think your show is fantastic and plan on putting it on my list of shows to listen to.

Great job!

Sent by Dr. Darin Burdman | 6:45 PM | 1-16-2007

Thanks for the great story. I had my first abnormal PAP test at 15, and a follow-up LEEP surgery removing the tip of my cervix.

My mom's gynecologist, who was also my doctor, was very cold and critical of me during this time. I refused to see him after the procedure. Parents need to build a nurturing environment to talk to their children about ALL sex, including non-consensual acts such as rape. I wasn't able to talk to my mother or my Dr about being raped. Instead I got the cold shoulder from my family for contracting HPV.

Sent by Erin | 2:39 PM | 1-17-2007

As many have mentioned here, I too found the piece on HPV very interesting and informative. Unfortunately, as others have also mentioned, the claim that everyone will eventually have HPV (although a great scare tactic) diminishes the credibility of the piece. It also left many questions unanswered.

Hearing straight from people who are directly affected by HPV made a powerful impact. But I feel that the perspective of a physician/specialist in this arena could have resolved some of the unanswered questions.

Lastly, I was saddened to hear that the "solution" in preventing HPV is abstinence. Abstinence is an ineffective and unrealistic strategy. Perhaps it is the cold truth that only by avoiding sex, we can avoid HPV. But there has to be other realistic precautions.

All in all, thank you for the new pieces. I have enjoyed the few I have listened to so far.

Sent by Aaron | 2:54 PM | 1-17-2007

I like the show. I have a few comments. Mix more music throughout the story. Weave more host narration through the guests' stories to sum things up. Talk to the listener more. The story should be the meat of what I'm listening to not an interview.

Sent by bryan w. | 3:08 PM | 1-17-2007

The first person experience on the HPV segment was excellent. Didn't sound overly medicinal or researched but instead it sounded like life.

Sent by Alisha Majette | 4:56 PM | 1-22-2007

As a woman who has survived HPV-caused cervical cancer and has an 18 year old daughter, I have been very eager to see that she is vaccinated against HPV. I have been stonewalled by all healthcare providers - the pediatrician refuses to stock the vaccine because of inadequate insurance reimbursement (I have a standard Blue Cross policy), the gynecologist I took her to see specifically to access the vaccine does not carry it and insists that the pediatrician is the appropriate provider. My complaint to the pediatrician that his withholding this vaccine is unethical fell on deaf ears. I'm thinking of visiting a clinic for the uninsured, who seem to have more access to preventive care than the insured! I read an article recently that said that uninsured children are more completely immunized than insured children. This is an alarming observation for what is frequently referred to as the richest country in the world. Where are our priorities?

Sent by Monika Burke | 5:11 PM | 1-22-2007

A fundamental reason the profession of journalism has sunk so low in the public's esteem -- in fact, in the esteem of many former journalists! -- is this "bottom-up" method, where the journalist takes no responsibility for researching among the many "experts" to discern fact from spin from bias from downright fiction. Cover fewer stories if you must, but do not revert to "truthiness" -- instead, strive to discern Truthfulness and to report it comprehensively. You are performing a public service that is vital to the effective functioning of a democracy. And, thank you for all you do.

Sent by H. Young | 4:01 PM | 1-23-2007

This was my first Rough Cuts podcast.
Women's health issues - great. I am a woman. However...
I found myself wondering if the facts were true. Does everyone Really get it? And found myself even more doubtful when I heard cervical cancer used to be the "number one killer". Not sure that's true and don't believe it. Guess I'd rather hear it from a doctor or documented source. There is so much untrue urban legend stuff floating around the internet and podcasts, I want NPR stuff to be true, I don't want to have to wonder. I enjoy many other NPR podcasts, but I don't think this will be on my list if the others are like this one. Thanks, Mel

Sent by Mel Dion | 5:18 PM | 1-23-2007

My twelve year old daughter has had the hpv shot. Its a three treatment shot. We were very well informed by our doctor what causes hpv and that the shot is not 100% effective. The ages the shot is given is ages 9-26. I think it is good that there is a chance that hpv can be prevented or that there is a chance it can be stopped. I have a ten year old daughter and she will be getting the shot also. I hope more parents read about hpv and understand the reason for it. Maybe in the future there will be a shot for men too.

Sent by Earla | 1:21 AM | 2-6-2007

I think the 'political/religious' stigma attached to the eradication of HPV in women is very dangerous. Holding off on making the vaccine widely available 'because it may encourage promiscuity' is really wrong-headed thinking in my opinion. I also think that the truth concerning HPV has been cloaked in a 'veil of propriety' as solely a female health issue and needs to be elevated as a general public health concern.

Sent by Ed Gallagher | 6:17 AM | 2-6-2007

That this treatment is being legislated and mandated concerns me most. Yet another sad chapter in the collapse of public health. Other questions to ask: who benefits? who can afford these treatments? who can afford insurance? what is the recourse for reactions to the treatments?

Sent by mieke | 4:28 PM | 2-6-2007

Corruption? Yes. We only need to read "The Virus and the Vacccine"(2004)-Schumacher; a well cited, well researched book on the SV-40 virus that was included in many polio vaccines long after (30years) it was shown to be linked to tumors and cancer, and long after they were not allowed in Europe. SV-40 has clearly been associated with cancer and the corruption of the NIH and the FDA. A virus the same size as HIV, but cannot be protected against to a high probability using a condom? Is it the friction that causes the desease, and is it so selective that it only effect girls in public schools? Let the buyer beware, because drug companies are immune to prosecution by the Federal government, and they pay to be immune. There is also no recourse or compensation to citizen's that have had drugs administered through public schools, who certainly have immunity themselves. These companies only care about money and whether it will be proven that there is a link between the vaccine and cancer, and whether us peasants can be compensated for this. A link to cancer, that the NIH and FDA will forever claim does not exist no matter what the evidence, will be hard to get compensation for, and the juries are not getting any smarter. We have raised a generation of selfish lemmings that have no empathy unless the television or an i-pod tells them to. I would have to say that anybody who wants this vaccine is either crazy or so self centered and stupid that they are unable to read. Just read,turn off the tube, and any radio programs that refuse to give this fair play.

Sent by Robert Kunferman | 5:03 PM | 2-7-2007

I think you should interview both ordinary women AND recognized experts in the field. Almost no one, however,is stating an important fact: Gardasil only prevents HPV caused cervical cancers in virgins, regardless of age. Both of Merck's "PSA's" were factually incorrect and misleading; I have been calling their HQ about these spots since August, 2006. Amber Ladeira, reader of Scientific American for 40 years.

Sent by amber ladeira | 12:03 PM | 2-8-2007

It is true that if two virgins marry and remain faithful for life, there is zero risk for all STI's. That is the case for me and my husband of 35 years. It makes for great security and sexual satisfaction. I am a family physician who has been in practice for 32 years. By the mid 1980's doctors were becoming aware of the association of HPV with cervical cancer but testing for viral types and the natural history of the disease was not widely known. However, by the 1990's this information was known and available at the CDC. However, it took pressure from several sources to get the CDC to state the poor effectiveness of condoms in preventing HPV. When I discuss pap smears and STD's with my patients I discover that they "believe in" condoms, even if they do not use them. They widely assume that condoms are 100% effective in preventing all STD's even though they know they do not prevent all pregnancies. Either they have not been educated correctly, or they simply believe what they want to believe. I discuss abstinence and secondary abstinence as the only effective means of preventing STI's and cervical cancer. I recommend mutual testing before marriage if both partners are not virgins. I hope that the new vaccines against HPV will eventually decrease the number of cervical cancer cases. We will not really know their effectiveness until those who have received the vaccine are tested 5 to 10 years after beginning sexual activity. The package insert in Gardasil proposes a need for a booster vaccine in 10 years because the effectiveness of the vaccine has been shown to decrease over time. That is an important thing for those receiving the vaccine to know. This may not be a one time thing. Hopefully more effective vaccines will come along over time. That is one of the reasons not to rush into mandating this vaccine for young girls. We are also hoping there will soon be adequate data so that young men can also be immunized. Meanwhile, it is best to encourage abstinence as the best way to guard one's heart from disappointment and one's body from disease, while preparing for the joy of a mutually committed relationship (marriage).

Sent by Linda W. Flower, M.D. | 10:16 PM | 2-9-2007

HPV is a serious disease that should have been brought to light along with vaccine years ago. However, now that is has been brought to the attention of someone who can do something, take advantage of this opportunity!

Sent by Melanie Carson | 12:36 PM | 3-1-2007

I have been with my boyfriend for a year now, but we haven't had actual sexual intercourse yet. We have done sexual activities, but not sex. My boyfriend and are still virgins, but my mother insists on me recieving the Gardsil injection. I wanted to know if its still possible for me to have the HPV infection. Thanks!

Sent by Julie | 8:26 PM | 3-2-2007

Wow, how can parents and adults be so oblivious to facts. The fact is this virus is very real. As a victim of this virus I just wanted to say that it can happen to anyone. How long do people think it takes to work on a vaccine. It takes years and doctors and scientists have been working on this vaccine for about 12 years now. Why would you be so naive in thinking that your daughter has no chance of getting this disease. How many adults waited to have sex until they were married or only have had sex with one person their entire life... truth is as, sad as it may be, that in our world today that number is relatively low. This fact means that your daughter will probably have more than one partner and therefore has a huge percentage of getting HPV.

You can't protect your daughter from everything, not heartbreak, not the real world, so why not protect them from something you can. Help your daughter and get them vaccinated. And as you do talk to them about sex and boys and STDs cause maybe, just maybe, instead of sheltering them their whole lives... talking to them will help prevent them from making a mistake.

Sent by caroline | 6:27 PM | 4-2-2007

i was nervous.after taking medicines i felt okay.

Sent by priya | 11:52 AM | 4-5-2007

i would like to know that would i ever get any sexually transmitted diseasefm a faithfull relationship? my babe and i dont cheat on each other and i know that for a fact and obviously we do not condomise & the other reason for us not using a condom is that i find it very painful because i get dry quickly.any advice please? we are in our mid twenties

Sent by vera | 3:22 AM | 4-22-2007

im not sure if u deal with this kind of questions but if not i would really appreciate it if u could e-mail me the details of the person who can help me, i have been having this problem for almost 4 years the one problem that most women seem to have is not being able to climax, i have a great sex life with my partner we have sex just about everyday and not even once a day but i cant seem to hit the jackpot and i have told him about it and he tries to stumulate me in everyway and the sex is really awesone and i really love it but i just cant seem to come, any suggestions on how i can climax, on how my partner can make me come?

Sent by karen | 3:32 AM | 4-22-2007

Thank you for calling attention to this issue. As someone who had surgery to remove pre-cancerous growth on my cervix - caused by HPV! - I tell everyone I can to run to their doctor and get the HPV vaccine Gardasil. You do not want cervical cancer, and you do not want invasive surgery on your cervix - surgery that can potentially cause problems during later pregnancies - so please get the vaccine, which can prevent 70% of cervical cancers. Also, YOU CAN BE INFECTED WITH HPV IN YOUR THROAT, ANUS, OR VAGINA, WITH OR WITHOUT A CONDOM - HPV has been linked to colon cancer as well, so men should be happy about the vaccine too. And sexual activity besides intercourse can transmit HPV. Also, even if you have one strain of HPV already, the vaccine will protect against other strains. The vaccine is a no-brainer!

Sent by EmmyD | 7:23 PM | 5-7-2007

i am 17 and my xboyfriend just told me he has HPV. i really want to know if there is any possability if he got it and i didn't? i havent gone to the doctor yet i am scared to ask my mom and i dont know how to say it to the guy im involved with now. WHAT DO I DO??

Sent by N/A | 12:53 PM | 5-10-2007

I at 51 have been diagnosed with HIGH RISK HPV (I'M SICK ABOUT THIS)MARRIED FOR 26 YEARS AND ONLY ONE PARTNER I TRULY DID NOT EARN THIS!!! Now my second pap came back active for the second time in 6 months. I don't drink or smoke EVER!!! why is my body not fighting it off? And does it mean I will most likely get cervical Cancer?

Sent by Donna Beers | 9:59 AM | 8-8-2007

To N/A:

You have to tell your mom you need to see a doctor.

You have to tell your boyfriend about it too.

If you have HPV you have to tell future sexual partners about it before you get intimate.

It sucks, but that's likely what the person who infected your ex-boyfriend DIDN'T do. If you don't take it upon yourself to inform others, you are just helping the disease spread.

Sent by Sam | 4:50 PM | 8-30-2007

CAN A PERSON LOOSE WEIGHT WHEN THEY HAVE TO HPV?

Sent by ME | 4:17 PM | 12-18-2007

Very interesting dialogue, as a male 55 yr old, I was aware of std's, pap smears but not HPV. It appears that HPV's are a cause of many cancers not just cervical cancers.
The vaccine may be a shot in the right direction as would be fewer sexual partners, condoms, and abstinence if it applies. The vaccine does not eliminate all of the viruses thus other methods are required to help reduce the risks.
Males need to know they are carriers, and need to be responsible!!!

Sent by Rich L | 6:26 PM | 6-15-2008

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