HPV and sex

April 2, 2009 11:48 AM

HPV and sex question....

It's been close to a year since I found out I had HPV (no genital warts) and an abnormal pap smear. I took the vaccine right after finding out, but it's not as effective when you already have HPV so I will continue to get tested for any changes every 6 months that could possibly lead to cervical cancer. I've only had unprotected sex with one person and that was my ex-boyfriend. How do I continue having a sex life without feeling guilty for passing on my strain of HPV on to other partners (women and men)? I'm single, 23, bisexual, and don't want to be in a monogamous relationship. How do I go about having sex when I can pass this on through giving, receiving, and intercourse especially when I have a high risk HPV? Is it something you would inform people you've slept with or plan on sleeping with? How would you go on with your sex life?

posted by anonymous to human relations (14 comments total)

HPV is quite common. The vaccine only protects against certain strains, anyhow.

Additionally, a nontrivial percentage of HPV infections appear to clear on their own.

You can ask your physician for actual numbers for the above statements I've made.

Additionally, you might ask if you can find out which strain of HPV you had; if it's protected against by the vaccine, you might encourage future partners to get the vaccine (when you have the general sex-practices talk, which of course you're having anyways).

Otherwise you've got the standard set of best-practices-- always use barriers when not in a monogamous relationship. You might see how much condoms reduce the rate of HPV infection (I dont' know where to get data on that, sorry), particularly for varieties that are wart-free.

Additionally several varieties of STD are harder to pass woman-to-woman (dunno if your strain of HPV is one of them), but of course you should be sure any women in your life (including yourself) get regular paps.
posted by nat at 11:57 AM on April 2

It's worth mentioning that HPV can infect areas not covered by a condom (vulva, scrotum), so while condoms reduce the chance of passage, it by no means prevents transmission.
posted by honeybee413 at 12:01 PM on April 2

If you currently have an STI, you have to tell your partners before you engage in potential transmission behavior with them. That sucks, but it's behaving like an adult. Fortunately for you, HPV is common and may disappear on its own, so you have some "good" (ok, less bad) facts to be armed with when you tell people.

Again, luckily, HPV does frequently go away on its own, especially in people under 30, so if possible get re-tested. If you come up clear, I don't think you need to tell people you used to have HPV, and now you don't. (Others may disagree.)

Here's an HPV forum (note appropriate name) that I completely haven't checked out at all, but it might be helpful in terms of hearing other peoples' dating strategies.
posted by chesty_a_arthur at 12:01 PM on April 2 [3 favorites]

Lots of general information about HPV here. While I think you should tell your partners, it's not something I would worry a lot about if I were your partner; HPV is pretty common. The main concern as I read it is cervical cancer in women, so your female partners may worry more than your male partners. It would also help to know which strain you have as it seems like different strains cause different things (e.g. the cancer causing ones are not the same as the genital warts causing ones).
posted by pombe at 12:25 PM on April 2

I have to disagree with pombe and say that if your female partners worry, so should your male partners, assuming they'll sleep with more women at some point.

And tell people, please. Sometimes it sucks being an adult but wouldn't it suck more if somewhere down the line someone got cervical cancer because you didn't pony up and tell the truth?
posted by cooker girl at 12:53 PM on April 2

When you go back for your yearly pap, you might find out that it's cleared. Some docs want to do one every 6 months until it goes away. If it doesn't clear on its own, you might have another type of procedure done (LEEP).

So yes, right now you have to tell folks your status.
a) It's way more common than you think
b) Most people will choose to go ahead with safer sex anyway.

Then, once you're clear, you're really clear - you don't have HPV at that point.
posted by barnone at 1:23 PM on April 2

Disclosure + barriers with absolutely every single sex partner. HPV can infect the throat, and lead to cancer there, as well as infecting the genitals, so you absolutely must use dental dams/non-microwavable saran wrap/other barrier of choice when engaging in cunnilingus, either as the performer or (and especially) as the recipient. Be clear with your partners that condoms do not provide full protection from HPV infection, as the virus can infect tissues not covered by a condom.

Continue being tested, because HPV infections can clear. But until you're clear, full disclosure + 100% barrier protection is absolutely the only ethical behavior available to you if you want to continue to have sex, monogomously or not.

Finally, while there's a lot of press about the risk of cervical cancer as a result of HPV, cervical cancer is absolutely not the only damage that an HPV infection can cause. While you may not have developed warts, someone else might with the same strain. There are multiple other cancers that can be caused by HPV.
posted by amelioration at 1:34 PM on April 2

I know it might be gibberish, but my OB/GYN told me that more than 75% of sexually active women have HPV.

It really isn't that serious. Maybe I'm a bad person, but I don't know if it is completely necessary to tell partners if you're testing clear in the future.
posted by banannafish at 1:41 PM on April 2

I have another opinion to offer.

On the one hand, certain strains of HPV can lead to a higher risk of cancers in the throat, cervix, and rectal regions (or wherever you've contracted it).

But on the other hand, if you have had sex, you probably have HPV. That's how widespread it is. I think the rate was something like 80% of all sexually active people will have it, and 25% of sexually active people have it at any one time. Most people do not display symptoms or only have one outbreak, and many people clear the infection on their own.

It isn't non-trivial, but putting it on the severity of herpes or syphilis or HIV is like equating the common cold to the bubonic plague. Some people do end up with serious medical issues due to the common cold. But an awful lot don't.

I dunno, it is a tricky issue because the people you're having sex with probably have it, but they may not know anything about it so they would freak out if they found out you have it. If I were you, I would tell any virgin partners you have for sure. And if you have a particularly nasty strain that is causing frequent, recurrent outbreaks, it's also something worth mentioning. But once you're pap smear's clear? I think the area is more gray.
posted by schroedinger at 2:03 PM on April 2

Wow, do I immensely disagree with the folks saying "it's so common, you probably don't have to disclose." Yes, there's a reasonable likelihood that your sex partner is already infected with one or more strains of HPV. Yes, a large percentage of the population is infected with one of the many, many strains of HPV. However, the likelihood that your partner has the same strain you have? Much slimmer. And guess what? The more strains you get infected with, the more risk you're at. Never mind your partner -- do you want to get another strain? And what if the partner that comes along when you figure "hey, 75-80% of folks are already infected, I won't say anything" is the one who is in the minority?

HPV may be common, it may clear on it's own regularly, but it's not like there's a cure if it doesn't. And just because it doesn't always lead to serious medical issues doesn't mean you have the right to make the decision about whether to take that risk for someone else.

Once you're testing negative, I agree that there's no reason to disclose.
posted by amelioration at 2:19 PM on April 2 [3 favorites]

I have pretty much the same statistical profile as you, and what I did, after I found out a couple of years ago, was basically to just tell people whenever we got to the point where it was clearly relevant. Post-making out, but pre-anything else, basically. I'd tell them, "Before we go any further, you should know I had an abnormal pap x amount of time ago, and that it said I have HPV. It's not a huge deal to me because almost everyone who has sex has it, but I want to be honest with you so you can make your own decision on where to go from here."

I usually just threw all that out in one breath and waited for them to say they wanted to think on it, or weren't interested, or didn't care and wanted to get laid. As far as I was concerned, once I'd done due diligence and told them, I just accepted whatever decision they made or provided more info if it was requested. This is a tactic I settled on after months of being really freaked out and agonizing over how to handle it. For what it's worth, I never had someone run away after giving them that schpiel, and have never had someone I slept with come back at me with a negative attitude over how I handled it. Even within a very gossipy clique, it never got back to me that shit was being talked or anything, so I feel pretty confident that I've been doing the right thing.
posted by booknerd at 3:16 PM on April 2 [4 favorites]

I would absolutely inform anyone, particularly male partners. There's no good HPV test for men, unless they get warts. You could, through silence, cause their future partners to develop a disease and potentially get cervical cancer, and they would have zero way to even know until they pass it on to a woman and she starts developing problems.

I mean, someone gave it to you. If you found out their ex didn't think it was important enough to disclose and through that you were infected, how would you feel?
posted by Kellydamnit at 4:09 PM on April 2

I'm going to take the so-called immoral/insensitive position, and say that when it comes to something as infuriatingly common as HPV, it really makes no sense to bother disclosing your 'std' status. For goodness sake, you're not a leper; you're just like any other person your partner may have slept with and may sleep with in the future. And guess what, every one of them may have had some strain or multiple strains of hpv, whether they knew it or not. So if your new partner already has it or just so happens to get it from you, whose fault is that? I'm going to venture that it's your partner's fault. If he/she decides to have sex, he/she has voluntarily taken a risk. Honestly, what there needs to be is less of an emphasis on placing all this stigma on the shoulders of certain individuals and a whole lot more emphasis on educating everyone as much as possible about the prevalence of things like hpv. What if you were to sit down and have a talk with a potential sex partner about the widespread presence of hpv and all its potential risks - in general? What if you never used the first person singular at all in this talk? Would that be disingenuous? If they shrug their shoulders, and say 'oh well,' then there you have it. They are willing to take the risk, and should something unpleasant occur health-wise later down the road then they should take responsibility for their own decisions.
I mean if it was hiv, i'd see this differently, but I don't think it's absolutely necessary that this particular std warrants any special statement of disclosure.
posted by afabulousbeing at 11:36 PM on April 2

Most people will clear HPV within two years. There are conflicting opinions as to whether it can "reactivate": some scientists believe that once you've cleared it , it's gone and you would only test positive again if you were infected with another strain, while others believe it can go dormant and come back. It is very possible--indeed, quite normal--for someone to test positive and then later test negative.
posted by Violet Hour at 1:34 AM on April 3