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University of Medicine and Dentistry of New Jersey–School of Osteopathic Medicine Stratford, NJ

I thank Dr Cymet for his kind words about the JAOA supplement on human papillomavirus (HPV) vaccines (J Am Osteopath Assoc. 2006;106[4 suppl 1]: S1–S20).

I believe that the idea of nonsexual transmission of HPV detracts from the real issue: HPV infection is a sexually transmitted disease with serious health consequences. Condoms offer no protection. The article that quotes a 14.8% prevalence rate in virgins used vulvar swabs in premarital testing of Chinese women who claimed to be virgins and who had intact hymens (Pao CC, et al. Eur J Clin Microbiol Infect Dis. 1993:12:221–222). Unfortunately, such identification is not conclusive and HPV can be spread through "outercourse."

Debates about transmission detract us from the real issue. We need to keep our eye on the ball. Human papillomavirus is a sexually transmitted disease. That is why vaccination is the right strategy.

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