HPV still contagious?

April 2, 2010 8:00 AM

Help me understand this specific HPV situation regarding an intimate female friend. (I'm a guy.)

My friend says that she has abnormal pap smears--but that she has cleared the HPV virus. How can she know that she's cleared the virus, and is this likely?

Right now, we're not having sex, we're limiting genital contact, and I'm not performing oral sex on her. But I'd like to--without wondering whether or not I've caught it or cleared it or I'm contagious for next three to twelve months to infinity.

What are the questions I should ask her about procedures, tests, etc., so I can sanity check what she's told me and better understand her HPV status and whether I can still catch it from her?

posted by zeek321 to health & fitness (10 answers total)

From my understanding of it, there is no perfect test to say whether the virus is or is not still in her system. If her HPV tests are still coming out positive, then she hasn't cleared it. If they are coming out negative? She has probably gotten rid of the virus, but not for certain. So unfortunately she can't 100% "know that she's cleared the virus."

On the other hand, when you ask whether it's likely that she could have cleared it, I would say absolutely. The CDC tells health professionals to counsel patients that HPV usually goes away on its own. But the same site also notes that there is no effective treatment to make it go away, so you basically just have to wait for your immune system to do the job.

A lot of people worry more about getting genital warts than a virus that has the potential to cause cancer. If she has had abnormal pap smears but no visible warts, it is likely that the strain of HPV she had is not the type that causes visible warts at all. So if you did become infected, it's highly unlikely that you would even notice. And then you, too, would most likely clear the virus on your own without ever knowing you had it.

And on top of that, odds are you've already had HPV if you've been sexually active with other people. From the CDC's "What women with a positive HPV test should know" info sheet: "Most sexually active people will get HPV at some time in their lives, though most will never know it because HPV usually has no signs or symptoms."

What questions should you ask her about procedures and tests? I'd say ask if she's had HPV testing done at her last few pap smears, and for how long they've been coming back normal. (I'm assuming at least one has come back normal, or she probably wouldn't say that she has cleared the virus.) A longer time might ease your mind.

All that said, if this is "an intimate female friend" and not "a steady, long-term, monogamous partner" -- please do use barrier protection when you're intimate with each other. Herpes is another untreatable disease you can catch from genital contact or oral sex, and that one doesn't go away on its own like HPV usually does.
posted by vytae at 8:26 AM on April 2, 2010 [1 favorite]

(Also please note: condoms don't protect 100% against HPV or herpes, because the infection can be outside of the area that is covered. But they do help make transmission less likely.)
posted by vytae at 8:29 AM on April 2, 2010

If she's having abnormal pap smears her body hasn't cleared anything.

Nobody really knows if our bodies clear the HPV virus at all. A lot of the time, people will have symptoms, the symptoms will be treated, and then they won't have symptoms ever again. So some people have speculated that means that the body clears it. But that's all it is, speculation. They don't know for a fact.

There are tests that can detect the presence of the HPV virus inside the vagina, and also, I think, experimental ones that can detect it inside the mouth. But even if no HPV is detected, that doesn't mean it's "gone". It could just be at a level too low to be detected. But, I don't know what this means for its contagiousness.

I would say to ask a doctor, but over my years of going to a lot of different doctors, I have found that doctors are often wrong/give you bad information about this sort of thing (and a lot of other things, actually). I think you should ask an HPV researcher about this.
posted by Ashley801 at 8:30 AM on April 2, 2010

Clearing the virus means that there are no signs of abnormal cells. It does not mean that she no longer has it at all, she might always have it but that doesn't mean it will shed (and be contagious) or that it will resurface again in the form of abnormal cells, lesions, or warts. Or it might really go away when it clears from pap smears. We don't know yet. Either way, 2+ clean paps in a row (she probably gets them every 6 months or more often if there was a more serious problem) usually mean it's not there in any meaningful way anymore.

You should ask her if she had low- or high-risk HPV. Low means warts but no cancer (usually), high means she might get lesions that could lead to cervical cancer but no warts (usually).

It is good that you are taking steps to minimize the spread, but honestly if you are 29 and have been sexually active for a while, you are probably already a silent carrier.

Use condoms and dental dams/saran wrap, but also know that most young sexually active people have HPV and that it isn't that big of a deal, especially for men since the cervical cancer issue is moot. There are some studies recently that link HPV and oral sex to the prevalence of throat cancer, but again you probably have already been exposed.

If it's the asymptomatic high-risk kind, I would just carry on as usual, and with your next partner just tell her you might have been exposed to it. Most likely she will already have it anyway.
I hope I am not sounding blase here, but this isn't one of the big-deal STIs. Better not to have, and good to monitor, but slow-moving and usually clears up by itself.
posted by rmless at 8:37 AM on April 2, 2010

So if you did become infected, it's highly unlikely that you would even notice. And then you, too, would most likely clear the virus on your own without ever knowing you had it.

I just want to point out here that while this is true, that doesn't mean it's not a big deal (not that you were saying it wasn't, I just want to emphasize it). If the OP's lady friend is having abnormal pap smears because of HPV, then she had the strain of HPV that causes cervical cancer. Even if that probably won't have consequences for the OP, it could very well have serious consequences for anyone he has sex with next.
posted by Ashley801 at 8:40 AM on April 2, 2010

Thanks, all. The message I'm getting is that this is not a big deal, and it is, and there's probably a pretty high chance that she'd pass a strain of HPV to me that can potentially cause cervical cancer in women, and that I'm probably already infected with a few strains, etc., etc., and usually this stuff clears within 24 months, but even so, there's lots of uncertainties.

Hmm.
posted by zeek321 at 9:14 AM on April 2, 2010

I just wanted to add one more thing. I am far from an abstinence-preaching person. But while I don't think the cancer causing strain of HPV is so common and harmless you should just not worry about contracting it or spreading it -- it is true that millions of women have it. And don't know about it.

So, if you end up deciding not to have sex with your lady friend out of worry about contracting this (which I wouldn't judge you for), it would make very little sense to turn around and then go have casual sex with a bunch of other women. Especially condomless sex (though, as was mentioned above, HPV can be transmitted even with a condom).
posted by Ashley801 at 9:18 AM on April 2, 2010

Please rely on quality health information from experts to learn more about this, not AskMe. Here's a CDC link to info on HPV:

http://www.cdc.gov/hpv/WhatIsHPV.html
posted by tristeza at 9:18 AM on April 2, 2010

Also, if you find a cooperative doctor, you could get the HPV vaccine. There's a movement to advocate vaccinating guys for both the carrier and throat cancer reasons.
posted by mercredi at 9:28 AM on April 2, 2010

This pretty much answered my questions:

http://www.cdc.gov/std/hpv/pap/default.htm

An HPV test is different from a pap smear, they can be done simultaneously, and there are several combinations of combined results from the two tests which have different implications. Now I can ask my friend what her results were and when she got the tests, and that will help me decide how much risk mitigation I want to do.
posted by zeek321 at 9:58 AM on April 2, 2010