Misinformation and suspicion surrounding sexually transmitted HPV – along with the social implications of administering shots to young girls – significantly hinder worldwide uptake of the vaccine. The 2006 U.S. rollout hit a quagmire of public ignorance, suspicion and paranoia, and by 2020, just 61 percent of eligible U.S. girls had been vaccinated. In Japan, anti-vax sentiment led to an HPV vaccine ban, and in Denmark, the vaccine met similar resistance. Nearly twenty years after its introduction in higher-income countries, the vaccine is vastly behind its prevention potential; in lower-income countries, its trajectory has been abysmal. Hang-ups about sexually transmitted infections and baseless fears about the vaccine have made advocating its use a cause laden with stigma. In male-dominated cultures – and in the absence of an existing delivery system – a girls-only vaccine is often stopped before it can start. And yet, without a worldwide commitment to countering misunderstanding through trust-building, hundreds of thousands of women will miss their critical opportunity to beat this disease.

The potency of a vaccine against cancer-causing HPV – and the body’s ability to clear it – offers many women a fighting chance. But extinguishing this source of cervical cancer overlooks another sexually transmitted virus that’s been raging around the globe for decades: the human immunodeficiency virus (HIV). The lethal effects of HPV mixed with HIV can be like setting gasoline on fire. HPV infections in HIV-positive women last longer, progress more quickly, recur more frequently, and are harder to eradicate. Cervical cancer in HIV-positive women – many of them in lower-income countries – strikes younger, is more aggressive, and harder to cure. Women with HIV are six times more likely to die of cervical cancer. They face a particular threat in Africa, home to two-thirds of the world’s 40 million HIV cases. Without a concerted effort to overcome the dual stigma of HIV and HPV through education, appropriate medical care to all persons with cervixes, and a means to address the vulnerability of the continent’s child brides, Africa will remain at the core of the HIV-HPV inferno – undermining the quest for global cervical cancer elimination.