There are nearly 200 identified strains of HPV, but the worst of them are strains 16 and 18. They are solely responsible for 70% of cervical cancer cases and they can cause various other cancers for both sexes: anal, oral, throat, tonsil and tongue. Beyond them, another 10 strains are considered high-risk, or cancerous. 40 others can produce skin warts or a recurrent respiratory tract papilloma, a disease which covers the larynx in small polyps and blocks breathing. The remaining strains are relatively innocuous, but HPV continues to be a sufficiently multifaceted virus.

The good news is that, in general, the body can eliminate the virus within 1-2 years of infection, and only the persistent infections are problematic. The bad news is that, over a lifetime, you can catch the same strain multiple times, and you can have multiple strains at the same time. Fortunately, the lesions which lead to cervical cancer develop slowly, over 10 to 15 years, and the disease can be detected and prevented with regular Papanicolaou tests. In Romania, however, only around 8% of the female population has had a PAP. The other kinds of HPV infections, such as an oral infection, are rarely detected before the cancer stage.

*

There was a moment in the piano bar when I came to fully believe that the guy across the table simply wanted me to understand that he had HPV. Looking back, I can’t explain it, but I knew that this confession on fear and illness had managed to come through to me, to cross the boundary between us which was represented by a sticky table and two glasses of wine. My current granular memory doesn’t help. Nor does the unease I had back then.

I think I remember that he was going on about Michael Douglas and he told me it wasn’t a joke. A few weeks before he was admitted to an ENT section for a few days, in a room with several other men. He had a sinus infection, they had throat cancer. I imagined how he’d have looked at them, having read a study that HPV, not smoking, is the leading cause of throat cancer. Then he gave me a strange look of anticipation as he started a sentence which ended in a plea, his voice growing even softer than before: “I got scared, you can imagine.”

I nodded, but I couldn’t imagine it.

I couldn’t imagine it when we’d gone from being on the defensive to confessing. I couldn’t imagine the specter of a contagion there, between us, the shadow that closeness between any two people can bring about. I couldn’t imagine that now, beyond a medical perspective, an emotional one was needed, and that the binary language of dating which I’d been practicing for years—seduction or unresponsiveness—would ruin any such chance. I couldn’t imagine how the fear of illness involves not only a realistic self-evaluation, but also a declaration of belonging to the world, involves you saying: I’m like all of you, more vulnerable than I’d like to be.

When I got home, on my phone screen there were three text bubbles, like the last breath under water. All from him: I liked our discussion. / Especially the part about HPV. / It was intense.

The only thing I remembered feeling intense about that night was my desire to go home and go to bed. I went to sleep without writing back.

*

After not writing back to him, I was left with a nagging thought: but what if I had liked him? I didn’t know the answer because I’d never thought about it, because up until then, I’d never spoken about HPV at any of the interesting dates I’d been on. Come to think of it, I’d never spoken about HPV on any date.I’d gone out with a man who was closed-off to my ideas and open about his illness, and because I didn’t understand and I didn’t like this kind of interchange—the opposite of what I’d come across until then—I took the liberty of sweeping any decorum of social responsibility under the rug.

I was starting to believe that the reason everyone remained silent about this virus which everyone had was because no one had an antidote. And at this thought, I began to despair.

In her book, On Immunity, American author Eula Biss observes that, since the natural and social sciences began to conceive of the human body as a complex system within other larger systems, people began to feel an overwhelming sense of responsibility for their own health. Biss quotes anthropologist Emily Martin: “The first consequence might be described as the paradox of feeling responsible for everything and powerless at the same time, a kind of empowered powerlessness.” You are just a body dependent on other bodies. Like in a democracy, says Biss.

My empowered powerlessness as concerns HPV was the threat of an invisible thing materialized only by shreds of information and underscored by two beliefs. One was the fact—unverified, but inarguable—that I don’t have the disease. The second followed the first, and it was the vaguely articulated idea that, being exceptionally healthy, everyone around me was exceptionally responsible for keeping me that way—me, more so than anyone else. The fact that, up until then, nobody had made an antidote for HPV, to me was a personal insult on the part of science, intentional negligence.

*

It’s true that, today, there is no antidote for HPV—a medication which, once in the body, would eradicate the virus—but there is a gatekeeper, preventing it from entering: the vaccine.

The first HPV vaccine was invented by two researchers from The University of Queensland, Australia, and it appeared on the market in 2006 under the name Gardasil. Gardasil is tetravalent, meaning it protects against four threads: 16 and 18 (the most likely to cause cancer) and 6 and 11 (the most likely to cause skin warts). It was manufactured by the American company Merck, known in Europe as Merck Sharp & Dohme (MSD), and was approved in 2006 by the Food and Drug Administration (FDA), the federal agency for medicine in America. One year later, in 2007, the FDA would also approve the vaccine Cervarix, produced by a competitor on the market, GlaxoSmithKline (GSK). Cervarix was bivalent, protecting only against 16 and 18.

Dozens of countries quickly included one of the two vaccines in their national immunization program. Between 2008 and 2010, Romania attempted a campaign to do just that, purchasing 330,000 vaccines. The Ministry of Health initiative then brought on a maelstrom of accusations, ranging from the suspicion that the vaccine was insufficiently tested, to the fear of adverse effects, to the speculation that the whole program was a big pharma experiment on the local population. In the first year, only 2.5% of the targeted population’s families accepted immunization, and between 2010 and 2011 the Romanian state began destroying the vaccines they’d purchased because they were beginning to expire.