Let's talk about the last thing in the world the mother of a 13-year-old boy ever wants to think about: her young son's sex life.
If you're lucky, your 13-year-old doesn't have a sex life yet. And if you're smart, you've taken that opportunity to get him immunized for the human papilloma virus.
Take it from someone who had an awkward kitchen-table conversation with an incredulous teen who thought his mom was plain out-of-her-mind for insisting he get a series of three shots in the arm, months apart, for a disease generally associated with women. It's not an easy chat.
First and foremost, 13-year-olds generally don't give a hoot about the news that less than a year after the Centers for Disease Control and Prevention (CDC) recommended that boys get vaccinated against HPV, the American Academy of Pediatrics (AAP) joined the call to protect boys against the virus that causes a large number of cancers of the mouth, throat, head and neck, plus the penis and rectum.
The last two cause a squirmy boy to snap to attention. Those are the ones that bring home the idea that HPV isn't solely about what some teens like to refer to as "chick cancer."
The main contention was that the boy in question was still a free agent. "But Mom, I don't even have a girlfriend yet."
The AAP's guidelines call for routine vaccination between ages 11 and 12, the full range for high effectiveness is between ages 9 and 15, but the vaccine is most effective at any age if it is administered before the onset of sexual activity.
My real hurdle had been jumped long before, as a young parent, when I decided to always talk openly with my kids about sex for the express purpose that they not start too early in their lives or without the knowledge of how to do it safely.
I'm the odd bird in this respect because I actually went ahead with it. Though 89 percent of parents say they believe that talking to their preteens about sex is important, few actually bring themselves to have those admittedly difficult conversations, according to a 2010 paper published in the journal Perspectives on Sexual and Reproductive Health titled "Parents' Perspectives on Talking to Preteenage Children About Sex."
Though well intentioned, many parents surveyed found themselves unable to follow through. Thirty-nine percent reported feeling uncomfortable, 37 percent thought someone else could do it better, and 32 percent gave the answer most parents worry about whether they're talking to kids about sex or not: fear that the conversations themselves might encourage kids to have sex.
It's just too bad that there's no vaccination against that parental qualm. If there was, I'd be rolling up my sleeve -- because what parent in their right mind doesn't fear that confronting such a complex issue with so young a child will give some sort of implicit permission?
The worry that the vaccine will encourage promiscuity is a huge roadblock -- the biggest factor in the decision not to vaccinate, according to a Yale study of parental attitudes toward the HPV shots.
And it shows. According to a March study in the journal Pediatrics, in 2011 just 35 percent of girls 13 to 17 had been fully vaccinated and more parents reported not intending to vaccinate in 2010 than in 2008 when public awareness of the importance of such vaccines was lower. The CDC reports that in 2011, only a meager 1 percent of boys had completed the full series of shots.
Parents would be glad to learn that initial research shows that getting the vaccine isn't altering kids' sexual behavior. A study published in Pediatrics last October found that of nearly 1,400 girls, there was no evidence that those who were vaccinated beginning around age 11 went on to engage in more sexual activity than those who were not vaccinated.
More likely than not, the desire to protect their child's innocence -- or well-being, in the case of those suspicious or downright scared of all vaccines -- will lead more parents to needlessly ignore a potential prevention.
But with nearly a third of children 14 to 19 already infected with HPV, that's an awful gamble to take. I'd rather roll the dice on my son's protection coupled with hearing his family promote safe sex well into the future rather than pretend that not talking about it at all will be inoculation enough.
Contact Esther Cepeda at firstname.lastname@example.org. Follow her on Twitter@estherjcepeda.