Disclosing HPV: What Do I Say & What Should I Expect?

August 17, 2009 2:09 PM

I've tested positive for HPV, and I am mostly concerned about disclosure. The question isn't whether I will or not (I most certainly will), but how and what should I expect?

I just received a call today from my doctor informing me that my pap smear was abnormal because of the presence of “atypical squamous cells of undetermined significance" (ASCUS), which is somewhat common. She also told me I was positive for HPV, and recommended a follow-up with a gyn, which has been scheduled. This is one of those things that could be absolutely benign or could be the first signs of cancer. My question has nothing to do with the whole cancer thing though. I now have to disclose the HPV to my male partner, and I’m just wondering what to expect.

Though we are not exclusive, he is actually the only person I have had sexual contact of any form with for over 18 months. I don’t think the same can be said of him, but I don’t know for sure. This is one of those things I could have given it to him, or he could have unknowingly given it to me. Even though we are both tested regularly and I receive annual paps, we will never know. Given how common and possibly benign it can be, and since I am absolutely confident that this would not have been something he knew about but did not disclose, I am not upset at the idea of him transmitting this to me. I do not know if he will be as understanding. I have never had any warts, lesions, or any symptoms until this pap smear, so I’m hoping this will just cycle out of my body in a couple of years without any symptoms, and the same will go for him.

So, those of you who had had to disclose HPV, how did it go? If it was to a male partner, how concerned was he? How much educating of your partner did you have to do? For those who were on the receiving end of the news, how did you feel about the HPV disclosure? What was important for you to hear? If it was a recent development, could you treat the who-gave-it-to-who thing as a non-issue? Lastly, how do you handle protecting your current & future partners? From what I’ve read, condoms may help but are far from a guarantee. It sounds like unless I’m celibate, I run the risk of transmitting it to someone, which makes me sad. Not because I plan to be abstinent, but because if things don’t work out with my current partner, then I will have to have this unpleasant conversation again. I still have a lot more reading and research to do myself, but hearing about personal experiences is always very enlightening for me. Throwaway email: [e-mail] Thank you very much, hive mind.

posted by anonymous to human relations (9 comments total)

Given the prevalence of HPV (over 25% of women in the US) it's hard to get too surprised when you find out your partner has HPV. As a guy, personally, it's one of those things I don't worry about.
posted by pombe at 2:25 PM on August 17 [1 favorite]

Of all the STDs out there, HPV is a pretty good one to have (relatively speaking, I mean). It doesn't have a stigma like herpes, doesn't kill you like AIDS, doesn't have nasty effects - except for the cancer thing - like syphilis or gonorrhea, and is incredibly common.

A former partner of mine tested positive and called me up, though we hadn't been together for a few months. My only concern was cancer. HPV goes away, if I remember my research correctly - he wasn't really concerned about it and I really wasn't worried myself.

I will say, though: Don't play the blame game. There's no way to 'prove' anything, so focus on prevention and your health, not how it got there. Sex isn't safe. You play the game, you accept the risks. If you ever reach a point where the condoms come off, disclose that you at one time tested positive. Aside from that, I'd say there's no reason to bring it up.
posted by caveat at 2:42 PM on August 17

Ask your gynecologist what strain of HPV you've got. There are about 130 identified strains, which range the gamut in seriousness from "completely asymptomatic," to "causes mild warts, not necessarily genital," "responsible for the overwhelming majority of cervix cancer". Some of them go away completely, while some will be with you until you die.

Before you invest too much time and energy here, or make potentially embarrassing revelations, I think it's worth finding out whether this is a big deal at all. From the wiki page linked above, it seems that most of the tests done don't just return a simple "positive," they usually have information as to which strains were found, so this shouldn't be too terribly difficult.
posted by valkyryn at 4:52 PM on August 17

I did a research project on HPV a couple years ago, and I can tell you that it's not nearly as scary as you think.

First of all, HPV is incredibly common. Some doctors even consider it a marker of having lost your virginity, because the odds are so high of getting it. In addition to pombe's stat of 25% of women in the U.S. testing positive for it, I've seen estimates as high as 80% for lifetime prevalence. WebMD states "three-fourths of sexually active people between ages 15 and 49 have been infected at some point in their lives."

Second, even though modern medicine doesn't yet have a cure for HPV, your body's immune system can either fight it off completely, or fight it off so thoroughly that our tests can't detect it any more. Again from WebMD: "research has found that about 90% of women infected with HPV show no traces of the virus within two years."

Third, the types of HPV that are high-risk for causing cancer are not the same types that typically cause visible warts, which may help ease your mind and your boyfriend's. Getting this diagnosis does not mean you're going to get a crazy-looking skin issue down there.

Fourth, the virus can sit around latent for a long time. You might have had it for years, or you might have just gotten it. There's no way to know who you got it from, so it's really not worth worrying about (although I know that's easier said than done).

In regard to talking to your boyfriend, I would suggest visiting a few reliable websites and arming yourself with facts. Print out a few information sheets to give to him, so he can review the stuff on his own time. I think the important points to hit are (a) you haven't been cheating on him, (b) you just found out about this now and haven't had any symptoms, (c) it's really common, and (d) there is no cure, but most people clear the virus from their body eventually by themselves. In addition to WebMD, Planned Parenthood has some very well-presented, reliable info on their website.

Going forward, I would ask your doctor if you can get the HPV test each time you get a Pap smear for the next few years. Talk to him/her about disclosing with future partners. For my project I interviewed several nurse practitioners who didn't even think disclosure was necessary because the infection is so common and mild, but that part will be up to you. However, it might ease your mind a couple years down the line when you've gotten several negative results in a row on an HPV test.

Finally, this might be a good time to talk to your boyfriend about being sexually exclusive. It's good that you know that condoms don't 100% prevent the spread of HPV, but they also don't 100% prevent the spread of other STIs like herpes, either. If he's out and about, that's something you need to be aware of and consider when you decide whether you want to be having sex with him.
posted by Inconceivable! at 4:53 PM on August 17 [2 favorites]

when i was diagnosed with HPV, i told my ex because i assumed it was he who gave it to me (and at the very least, i was relatively sure he had it if i did and could be spreading it to new girlfriends). but in reality, it could have been any unprotected encounter that anyone has had. so, there is no proof either way for anyone. a friend of mine was just diagnosed and has been monogamous for three years and it's a crapshoot of where it came from. regardless, it's here to deal with. and, if you're lucky, you'll get that negative hpv test back at some point (i got mine only a year after my diagnosis).

as for transmitting it to others, you're right that celibacy is the only SURE way of not giving it to anyone, but protecting yourself is just as good as anything, i'd say. i would certainly disclose the information to any partners you have in the future and discuss what works and what doesn't for the both of you. some people don't feel like HPV is a big deal and don't particularly care about safety against it, i've found. do your research is the best advice i can give. studies are often really inconclusive about hpv.

as far as telling your partner: i gave my ex the breakdown of what i knew about it. he did his own research and pretty much has decided it's not a big thing (to the point that i don't believe he discloses it to people he has sex with). i would certainly disagree with that, but...

good luck with telling your partner. if you go in armed with knowledge and can assure him it's no one's fault, than i believe you'll be fine.
posted by itsacover at 6:10 PM on August 17 [1 favorite]

I said it once before in a nearly identical thread, seriously, don't sweat it. Something like 85+% of people who have ever had sex, have HPV. The need to "disclose" is, in my opinion, similar to the need to disclose that you had a cold a few weeks ago and they might get it, hell, they might already have a cold.
posted by banannafish at 6:29 PM on August 17 [1 favorite]

Also: there is currently a vaccine for the nastiest (both wart and also cancer-causing) strains, though I believe it's only approved for use in women. But the fact that future potential partners of his may be vaccinated might reduce any anxiety he has about this.
posted by you're a kitty! at 6:59 PM on August 17

I was horrified when my pap smear showed ASCUS. In the spirit of being completely ethical, I did disclose to several partners. I think initially it made them slightly uncomfortable, but it didn't stop us from knocking boots. After I found out about the 80% stats many have referenced above, I stopped telling potential partners, as per bananafish's logic above. And after a few years, I thought - who knows, I might not even have it anymore. That pap was about 7 years ago. I think these days (given the advertising for the HPV vaccine), more people know what HPV is and you're likely to receive better reception than I did (which wasn't even all that bad) if you do decide to share the info.
posted by kitcat at 7:14 PM on August 17

You should know that men who have performed oral sex on over five female sexual partners are at significantly increased risk for throat cancer, apparently because at five partners, there's a good risk of getting HPV.
posted by orthogonality at 7:22 PM on August 17