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Interview with Dr. Marion E. Richman

10/19/2022, 11:00 AM Getting to talk to a family medicine practitioner was an extraordinarily helpful way to kick off developing our health communication plan, which we have called HPVAX. HPVAX stands for Harlem Partners for Vaccination, Action, and eXamination, and aims to tackle the incidence of preventable HPV-caused oropharyngeal cancer by promoting the HPV vaccine and preventative measures among 18- to 26-year-old men who have sex with men (MSM) in Harlem, New York City. 

Dr. Richman started by affirming to us that the 18-26 age group is notable because young adult men simply don't visit the doctor as much as men of other ages or their female counterparts. Health maintenance, especially sexual wellness, spurs women of any age to visit the gynecologist, for example, or seek contraceptives. Among men, Dr. Richman commented that general health maintenance was difficult because there aren't as many explicit asks for young adult men to visit the doctor regularly. For those who do visit the doctor, STI screening is offered; HPV screening is offered but isn't usually explicitly requested. 

We continued our interview by asking about HPV vaccine awareness in that age group. Dr. Richman informed us that primary care physicians start offering the HPV vaccine at age 9, but many people get it at 11. The vaccine isn't offered as much to men through age 45 because doctors don't always see the risk factors for men. For example, men (especially straight men) aren't getting regular pap smears. Dr. Richman couldn't remember having many conversations about HPV with young adult men, especially because doctors think of HPV much more for women than for men. Therefore, they aren't screening men as much, and they only deal with HPV once men come in with genital warts or a voice change. 

 The conversation took an optimistic turn when Dr. Richman mentioned an ad campaign called "Tell someone you love" about HPV. There is less opacity around the virus than there was ten years ago, but still, Dr. Richman said that she still isn't really seeing men from the 18-26 age group come in for primary care. She said, too, that it's a "hard sell" to give any extra vaccines these days, especially with COVID, because people have "vaccine burnout". She asserted that as a primary care doctor, she has to triage and prioritize what is really going to harm the person. She asks herself, if you have to give only two out of five vaccines, which will you get? She must negotiate and choose personal anecdotes to tell; those stories go a long way. Our conversation closed on a bittersweet note: "You are making me aware that I also have gaps in my knowledge," said Dr. Richman. While this wasn't the goal of our conversation, this remark underscored the importance of asking these questions: though difficult to untangle, these health issues need attention.

[Posted by Maya Osman-Krinsky]

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