ASLI SABAN, Cansu Taşdemir
Cervical cancer is the fourth most common form of cancer among women worldwide, making it a gendered disease. Over 90% of women with cervical cancer are human papillomavirus (HPV) positive. The virus can cause cancer of the cervix in women and transgender men, as well as cancers of the throat and penis. Human papillomavirus (HPV) has not been widely known by conversative societies. Talking about reproductive sexual health rights, venereal diseases are still taboo in various societies.
In Turkey, it is claimed that 32.4 million women are at risk of cervical cancer. Still, many women andgirls are not aware of or are not informed about the risk and causes of cervical cancer. Even though awareness sessions and services are provided by the government on HPV, such activities are limited in Turkey.
Cervical cancer impacts the social well-being, emotional, and mental health of patients negatively. Aside from being a woman in a conservative society and having a different approach on the relation of sexuality, it leads to the stigmatization of women in conservative societies. Thus, as many patients of HPV are single and have active sex lives, they have major concerns around talking about HPV with their families and friends and accessing medical treatment from doctors in their cities. These difficulties prevent women from going to a gynaecologist for a check-up. Most people in society have limited knowledge of the transmission, treatment, and types of HPV. For instance, unprotected oral sex also causes of oropharyngeal cancer which is also caused by HPV.
Early treatment saves lives in cervical and oropharyngeal cancer. Another challenge is the discrimination that women face in hospitals in accessing services. The dissemination of false facts on Sexual and Reproductive Health is another major challenge. Although HPV causes cervical cancer, people can live without decreasing their living standards after an early diagnosis and regular control with the help of their doctors. As there is no proper education, young people get information from unreliable sources. Thus, unrealistic ideas around symptoms and prejudices increase both HPV and HIV rates, and related stigmatization.
Although health specialists and doctors have emphasized on the need to take the HPV vaccine and on gaining knowledge of sexual and reproductive health, women and girls in Turkey are not aware of HPV and other infections such as herpes, syphilis, gonorrhoea, chlamydia, and trichomoniasis, as well as the importance of vaccinating themselves against HPV. Further, the HPV vaccine is not free of charge in Turkey. The Children and Women First Association backed a legal fight to make the vaccination free and accessible for all women and girls in society. However, vaccination is still not free in Turkey. Given the economic crisis, many women and girls are unable to pay for vaccines. The vaccines themselves are too expensive for most women and girls in Turkish society. Candan Yuceer, a Turkish doctor and member of parliament estimated that fewer than 1% of Turkish women and girls have been vaccinated against HPV. Women have launched an online campaign for free vaccines.
While harmful practices such as genital mutilation are still being discussed worldwide, nosteps are taken in countries like Turkey to address an infection like HPV that primarily affects women's health. The fact that unmarried women are not considered sexually active, and their sexuality is invisible in society, implies that the HPV vaccine is not accessible as "young unmarried women" face discrimination in SRH-related examinations. In Turkey, there is no comprehensive Sexual and Reproductive Health Education covering topics like sexually transmitted infections, genital organ health, and so on. Contraceptive methods, ways to protect against sexually transmitted infections, and information and advocacy on Sexual Reproductive Health and Rights can only be realized through non-formal education provided by non-governmental organizations. The lack and inadequacy of education and health policies have created significant problems in public health. It is important to address adolescent and early pregnancies and the violations of SRHR.
Non-governmental organizations have carried out several advocacy campaigns. However, there will be no progress unless adequate policies are established and implemented. Encouraging discussions on HPV, reducing the stigma around STIs, and expanding services such as vaccination will benefit the health and general well-being of women and girls.
All women and girls who want psychosocial support after receiving an HPV diagnosis should be able to access it easily and confidentially. SRH is an essential part of an individual’s well-being. Advocating for SRHR requires a multidisciplinary approach that plays a crucial role in social and rural development and in the prevention of illness.