Should I have unprotected sex with a girl with HPV?

May 11, 2010 5:34 PM

I am a man. Should I have unprotected sex with a girl with HPV?

I met this nice girl - we are both 30. We have been using condoms every time so far. But, since condoms are no fun for us in an exclusive relationship, we both got tested for STD's in preparation to not use the rubber. (She is also starting the pill.)

She came up positive for HPV. I understand that this is self-eliminating over a period of time - a few months to many years perhaps - no treatment exists. I also understand that it is rare for men to have serious complications from HPV. I understand that that the worst side of this can cause serious cancers in the rectum and penis and the lighter side of this is just warts in the penis area or throat.

Is having unprotected sex with this person a bad or dangerous idea or is this one of those "everyone gets it" things? What are the real risks here regarding contracting this and/or having issues from this?

Using condoms with her long-term is a deal-breaker for me, so this is a go or no-go decision for me.

Thanks.

posted by anonymous to health & fitness (20 answers total)

According to the CDC: At least 50% of sexually active people will have genital HPV at some time in their lives.

It is very common.
posted by ocherdraco at 5:37 PM on May 11, 2010

In Canada, there is a vaccination for young girls that actually anyone can get. My OBGYN gives it off label to men as well. Would you consider spending the $600 (in Canada) and trying to find someone to vaccinate you?
posted by gillianr at 5:38 PM on May 11, 2010

Get the vaccine. It's available for men in the US -- recommended ages 9 to 26, but you shouldn't have too much trouble getting it -- and discuss the safety of having sex with an infected woman with your doctor at that time. HPV can also cause problems in men, although it's far more rare; and men can carry the infection without symptoms and then infect later partners. Protect yourself and your future partners by either having protected sex or getting vaccinated.

Do note the vaccine is 3 doses over six months, and discuss with your doctor when you can go condom-free.
posted by Eyebrows McGee at 5:46 PM on May 11, 2010 [3 favorites]

Throwaway email address?
posted by questionsandanchors at 5:48 PM on May 11, 2010

Depending on your age (under 26?) and your sexual history (few partners with whom you've had condomless sex?), I strongly urge you to consider being vaccinated for HPV. Either Gardasil or Cervarix is approved for use in men. If you don't meet those criteria, it is extremely likely that you've already been exposed and/or infected to the most common strains already.

There is no screening test for HPV infection in men, and it tends to be asymptomatic, but as said above, it is projected that approximately 50% of sexually active adults are infected at some point in their lifetime. While complications of HPV in men are very rare, they can include a variety of cancers (1,000 men in the US are diagnosed with penile cancer, and 1,700 men in the US are diagnosed with anal cancer, each year, as direct complications of HPV infection). So, if you're in the demographic where the vaccine might provide protection, it's a really good choice for men as well as women. If you're not in that demographic, then unprotected sex with this woman is unlikely to significantly impact your odds of infection and/or complications. Be aware that HPV screening is not a typical part of an STI panel (it's often only performed on women after an abnormal pap smear result). Therefore, you may well have had unprotected sex with one or more infected women in your past, without realizing it.

That being said, I honestly wouldn't let this be a dealbreaker. I don't know how strongly you feel about this woman, or about being condom-free, but given that HPV infections do tend to resolve on their own after some period of time, would you be willing to maintain condom use until she tests HPV negative (which could be a fairly short, or somewhat longer, period of time depending on when she was infected)? To me, that seems like a safe and reasonable intermediate, especially if you aren't in a demographic where the vaccine will provide significant protection.
posted by amelioration at 5:51 PM on May 11, 2010

Just keep in mind, condom or not, if you ever have a new partner, you should let them know that you've been exposed. Condoms do not fully protect against HPV, so in some respects, the horse is already out of the barn. Yes, it's common and yes, some people shrug it off, but for a woman it introduces a whole other level of medical care that she may or may not be willing to risk.
posted by katemcd at 5:53 PM on May 11, 2010 [1 favorite]

You seem to be forgetting someone here. What about the risk to all the women in the future that you sleep with? Cervical cancer is caused by HPV, though not all strains of HPV lead to the disease. You seem highly averse to the idea of using condoms. If the relationship with this girl doesn't work out, and you get HPV, you're going to have to use a condom with every girl for the rest of your life -- unless you want to give them all HPV.
posted by unannihilated at 5:55 PM on May 11, 2010 [17 favorites]

Piggyback question: Should I, a 28-year old sexually active gay male, get the vaccine?
posted by HotPatatta at 6:17 PM on May 11, 2010

I'm with katemcd and unannihilated. You gotta tell any woman you sleep with in the future that you've been exposed. And any man, because they are now linking the same HPV strains that cause cervical cancer with anal cancer.
posted by kensington314 at 6:23 PM on May 11, 2010 [1 favorite]

Are you nuts? No, no you shouldn't.

Also, what katemcd and unannihilated said.
posted by sadtomato at 6:31 PM on May 11, 2010 [1 favorite]

Did you really say "JUST warts in the penis area or throat"? Because unless you're being tongue-in-cheek, that's a pretty big issue to brush aside with a "just."

And I'm thirding: straight women get HPV from asymptomatic men, as a general rule. Some of them then go on to develop cervical cancer, which can kill them or render them unable to have children. I'd advise you to think long term on this one.
posted by ErikaB at 6:33 PM on May 11, 2010 [4 favorites]

HotPatatta: Yes!
posted by gillianr at 6:36 PM on May 11, 2010

Using condoms with her long-term is a deal-breaker for me, so this is a go or no-go decision for me.

Most women clear HPV in months. Is months of using a condom use long-term enough for you to consider it a dealbreaker? If so, I guess you should break up with this woman with whom you were considering a monogamous relationship.
posted by desuetude at 7:06 PM on May 11, 2010

Do you know whether you already have hpv?

No. Because there's no test for men.

Do you know whether you've already been exposed?

Yes, because condoms don't prevent the transmission of hpv.

You can tell all your future partners you've been exposed. But really you should have been telling then that from the first time you had genital contact with anyone who'd had genital contact with someone else.

People shouldn't be having sex, with or without condoms, with anyone who's ever had genital contact with anyone else, if they're not ok with with being exposed to hpv.

That sucks. Which is why everyone who can should get the vaccine, and all women should have access to good ongoing screening and health care for cervical cancer.
posted by Salamandrous at 7:49 PM on May 11, 2010 [15 favorites]

And I'm thirding: straight women get HPV from asymptomatic men, as a general rule. Some of them then go on to develop cervical cancer, which can kill them or render them unable to have children. I'd advise you to think long term on this one.

What what now? At the very least, he should already be telling women he sleeps with in the future that he's been exposed. If a woman has had sex with a non-virgin, chances are quite high that she's already been exposed. Let's not threaten the conscientious asker with consequences that don't only apply to him. He's doing the right thing by asking these questions. Threatening him with, "You should never sleep with any other women again unless you want to maybe kill them or make them infertile," is extreme and misses the pervasive reality of HPV as well as the strong, readily available screenings in place to catch complications.

Also: don't drive a car unless you maybe want to get into a car accident.
posted by incessant at 9:48 PM on May 11, 2010 [1 favorite]

I worry about HPV about as much as I worry about oral herpes, which is not at all. It's out there; I've almost certainly been exposed; but as a guy HPV just isn't the biggest fear in the world. I'm not saying to go and purposefully catch it and spread it to as many people as you can -- but like Salamandrous says, you already can't get tested for it, and you are already possibly exposed.

The smart approach would be to wait for her to clear it on her own, and/or get the vaccine yourself. In all honesty, my decision would be about how much I liked her and thought the relationship had long term potential. If she was rocking my world and I could imagine introducing her to my mom, I'd toss the condoms and not look back. Maybe that makes me a bad person in some people's eyes, but it's my honest balancing of the risks and rewards. Your balancing act may be different, and that's ok, too.
posted by Forktine at 9:52 PM on May 11, 2010

It's the common cold of the sexual world. Would you avoid her if she had a cold?
posted by eas98 at 7:42 AM on May 12, 2010

As Salamandrous said, if you've had sex with any other girls, you probably already have HPV and just don't know it. Condoms don't fully protect against it. Given this, you don't even know for sure that you didn't give her the HPV she has now. Only you can say whether this is a dealbreaker for you. Anecdotally, when I had several abnormal paps and was involved with new sexual partners, it was never a dealbreaker for any of them.
posted by booknerd at 8:29 AM on May 12, 2010

You like her now, what about the future? You are increasing your chances of getting it and giving it to someone else down the road. And if you two have children while she has an active HPV flare up, it's not good for the baby. A friend of mine is dating an otolaryngologist. He has to scrape the throat of this toddler every time she gets a HPV flare up because it manifested in her throat.

Wear a condom.
posted by stormpooper at 2:00 PM on May 12, 2010 [1 favorite]

I'm late to the party on this one, but she should ask her OBGYN about a genetic analysis of her particular strain of HPV, if it's available, her insurance covers it and/or she can afford it, etc. The strain matters: not all strains are covered by the vaccine, not all strains cause cancer, not all strains cause symptoms in men, and the strains that do cause cancer are generally different than the ones that cause things like warts. Even knowing the strain won't give you the 100% full picture, since some infected people just never show symptoms, regardless of strain, but it's something, and will leave you better-informed about things like what your potential risks are, and how effective either of the vaccines might be likely to be.
posted by andrewpendleton at 6:15 PM on May 13, 2010