Female sex workers

HPV (cervical cancer)

What is HPV and cervical cancer?

  • The cervix is the part of the uterus connected to the vagina.  
  • It is a very sensitive area that changes considerably in the cycle of a woman’s life (puberty, pregnancy, menopause, ..).  
  • This is the place where cervical cancer may develop.
  • Cervical cancer is caused by the human papilloma virus (HPV). 
  • There are various types of this virus, but HPV 16 and HPV 18 increase the risk of developing cervical cancer.

What causes HPV and cervical cancer?

  • HPV is transmitted by sexual contact. 
  • This virus is transmitted during sex (touching, rubbing) on the skin or the mucous membrane.  
  • The use of a condom cannot prevent this entirely.  
  • The more different partners you have, the bigger the risk to get an HPV infection.  
  • Usually, your body deals with the virus itself so that it disappears within a year.  If this is not the case, abnormal cells may occur in the course of ten to fifteen years.  
  • Most of the time the cervix heals spontaneously.  
  • Sometimes it causes cervical cancer.

What are the complaints?

  • In case of an HPV infection, you usually have no complaints.  
  • Very rarely you have complaints such as the loss of blood after sexual contact, pain and/or a burning feeling.

How is the infection diagnosed?

  • During a gynaecological check up a cervical smear is made.  Your cervix is made visible with a speculum and with a brush a few cells are removed.  In the laboratory these cells are examined and checked for HPV.

Treatment

1. Most cervical cells are normal

  • For women who work in the erotic sector, this smear test is repeated each year.  
  • For women who don’t work in the erotic sector, the smear test is repeated every 3 years because they are less at risk of developing an infection with the risky HPV types.

2. Minor to moderate abnormalities: 

  • Sometimes the smear test shows cervical cells with minor abnormalities.  
  • These abnormalities usually disappear spontaneously within a few months.  
  • To check this, another smear test is necessary.  
  • After six months the smear test is checked again to see whether the cell changes are still there.  The cells are also checked for HPV. 
  •  If the abnormalities remain, you will be referred to the gynaecologist for further examination. 

3. Serious abnormalities: 

  • Serious cell abnormalities may be an indication for cervical cancer.  
  • Further examination and treatment by the gynaecologist are certainly necessary.

To the gynaecologist!

  • If the smear test shows that there are abnormalities in the cervical cells (i.e. cells that look different than normal), you are referred to the gynaecologist.  
  • Usually, these cells are not malignant, but they may become malignant in the long term.  The risk of developing cervical cancer is small, but regular tests remain important.
  • The gynaecologist will examine the cervix closer. He/she will remove some tissue from the cervix and examine it.  
  • According to the result, the gynaecologist will propose a treatment.

HPV vaccination

  • A vaccination has been developed recently to protect against a few types of HPV. In Belgium there are two vaccinations on the market, i.e. Gardasil (HPV types 6,11,16,18) and Cervarix (HPV types 16,18). From scientific research it appears that vaccination is recommended for girls between the ages of 14 to 26 who have not yet had sexual contact.  In Belgium this is possible at the school or by the family doctor or gynaecologist!.
  • If you allready have had sexual contact, it is best to discuss the vaccination with your family doctor or gynaecologist.

Important to know:

  • Even if you are vaccinated, it is still necessary to have a smear test.  
  • The vaccination does not protect against all HPV types that cause cervical cancer!

More information