Thursday, February 28, 2008
Let’s Talk About Sex, Baby
BY ALISON JOST

Most 20-somethings can readily recall Salt ’n Peppa’s 1992 hit rap song, the chorus of which declared: “Let’s talk about sex, baby/Let’s talk about you and me/Let’s talk about all the good things and the bad things that may be/Let’s talk about sex, let’s talk about sex.” In the decade and a half since the release of the song, American culture has become ever less prudish (if that seems possible), regularly alluding to sex on primetime TV and overtly featuring sex on cable networks and in pop music.

Nonetheless, there are some areas in which talk of sex is overlooked, downplayed, or outright suppressed. In the formats in which we least need it (TV, radio, the internet), sex is abundant, but in the areas where it ought to be given attention, sex is shushed. I have in mind the marketing of Merck’s two year-old vaccine, Gardasil. The vaccine inoculates girls and women, ages 9 to 26, against four common strands of the human papillomavirus (HPV), which together are responsible for causing 70% of cervical cancer cases. Advertisements for Gardasil, now common on network television, use a full minute of air time to communicate this message. Unfortunately, this is all they communicate. The Merck ads talk rather cryptically of HPV’s relation to cervical cancer, and all the while studiously avoid mentioning that HPV is a sexually transmitted disease, is easily communicable, and can be passed between partners even without their actually having had intercourse. The virus is so common, in fact, that the CDC estimates that 80% of adults will contract at least one strand of HPV in their lifetimes. For most people, the body’s immune system rids itself of the virus without incident, but for some women, HPV leads to the growth of irregular cells in the cervix which, left untreated, can lead to cervical cancer.

These facts are straightforward enough. Why, then, Merck’s exclusion of the fact that HPV is a sexually transmitted disease? The outcry from conservative religious factions when the vaccine was released seems a likely contributing factor. Members of the religious right denounced Gardasil at the time of its release, predicting that immunizations in preteens would encourage otherwise abstinent girls to engage in sexual activity. Although even the most conservative organizations eventually recognized the vaccine as a potentially lifesaving health measure (they remain staunchly opposed, however, to mandated vaccination), their initial protests almost certainly affected Merck’s marketing campaign. Whatever the factors that shaped the campaign, Merck’s decision to dissociate sexual intimacy from HPV and cervical cancer propagates a woefully incomplete account of a pressing public health issue.

Admittedly, conservative groups’ ideological opposition to the vaccine has received plenty of criticism. Nearly all of the criticism, however, has focused on the ways in which certain factions have hindered the passage of state legislation that would mandate that middle school girls receive the vaccine. What critics do not seem to have picked up on is that the abstinence-only agendas of these groups, in their ability to affect what is said (or, rather, not said) in ads for Gardasil, also negatively affect women in their late teens and 20s. Let me explain briefly what I mean.

As a woman approaching the outer age limits of qualifying for the vaccine, my not having the full story about why Gardasil is important has delayed my getting the three-shot series far longer than if I had been presented the whole picture. The same, I think, can be said for most of my friends. Because I spend my days researching issues in health and health care, I have been able to piece together for myself all of the details about the interrelationship of HPV, sex, cervical cancer, and Gardasil. But this took a good bit of digging online, and no single site – not even the CDC’s – makes all of the statistics and details readily available. For teens and young women whose only exposure to information on Gardasil comes from Merck’s TV ads, I fear that the omission of the role that sexual intimacy plays in the spread of HPV minimizes the likelihood that women in their late teens and early 20s will get vaccinated. For women who do not have the time or resources to research health measures that would impact them, Merck’s ads may be one of the few channels through which information about HPV is communicated. Although minor girls may receive the complete story about HPV through public school health classes, there remains a large population of women in their 20s for whom this information has never been made clear.

Merck needs to reconceptualize its marketing of Gardasil to include the fact that HPV is an easily acquirable sexually transmitted disease. Ideally, this information would be communicated in all of their marketing materials, television ads especially. Some will contend that eleven and twelve year old girls are too young to receive information about sex and HPV through advertisements. Perhaps, although it’s debatable. One compromise might be for targeted ads to air on late-night television (after “family viewing” hours are over) and on cable channels with a younger viewership, like MTV and VH1.

Merck would do well to get behind so many pharmaceuticals’ claims that their products are for the benefit of the public’s health and that for-profit motives are secondary. If the American public can handle sitcoms in which sexual antics drive the storyline, they can handle public health ads with crucial sexual health information. Let’s talk about sex, baby – let’s talk about HPV.

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