The invisible std monster strikes

July 25, 2010 9:08 PM

Do I have to tell him now? (nsfw)

My doctor just told me my pap smear came back slightly irregular, and went on to say that in most cases this sort of thing clears up on its own in a year or so. He didn't tell me it was from HPV, which is what I found out online - most probable cause for these abnormalities. So in all likelihood, I have HPV.

Looking up info online, I see that this is an exceptionally common kind of sti, and that this particular kind I have has no externally visible symptoms. Where I live, STD testing is only done for chlamydia and gonorrhoea... they don't test for HPV in men, and women just get the pap smear. So the only way to be diagnosed is to find out at my annual physical. I have to go back for regular re-testing to monitor it and hopefully it will go back to normal within a year or two.

So my problem is that I'm dating someone exclusively in a new relationship... but we're currently in a long-distance relationship for a few months. There's something about us together that says to me we will be together for a very long time, but we're still getting to know eachother and it's slow-going while we're long-distance. Last time we saw each other, we had unprotected sex - I'm on birth control and we thought we were clean.

I don't know what I should do, or how serious this is... the fact my doctor didn't care to mention it was related to HPV is downgrading the seriousness of it and I can't get a good measure of things. I read that I can't get reinfected from the same strain once it clears up, so in a monogamous relationship this problem is very likely to go away on its own... is there any point to requiring that we revert to condoms between the two of us in a monogamous relationship?

The responsible thing is obviously to tell him right away... but that's a very uncomfortable thing to do in my situation. I really don't feel like this is something I can just bring up with the boyfriend while we're in a LDR, and we only get to text infrequently, have the odd phone call or when I'm home visiting once a month - needs to be at a time when we're together and can talk, and get over any awkwardness that ensues. I have no idea how to proceed with this either.

Thanks

posted by anonymous to health & fitness (41 answers total)

I always err on the side of telling people about STIs. I want to make ALL my sexual health decisions so I expect others want to make theirs too. If you tell him then it's HIS decision if he needs to worry.

I know it's uncomfortable but it's best to talk about it BEFORE the next time you have an opportunity to have sex so he has time to think about it, do some research and make a decision while not in the heat of I-missed-you-sex.
posted by Saminal at 9:12 PM on July 25, 2010

You should do the obviously responsible thing and tell him right away. Because...

Most people with HPV do not develop symptoms or health problems from it. In 90% of cases, the body’s immune system clears HPV naturally within two years.

* But sometimes, certain types of HPV can cause genital warts in males and females. Rarely, these types can also cause warts in the throat -- a condition called recurrent respiratory papillomatosis or RRP.
* Other HPV types can cause cervical cancer. These types can also cause other, less common but serious cancers, including cancers of the vulva, vagina, penis, anus, and head and neck (tongue, tonsils and throat).

http://www.cdc.gov/std/hpv/stdfact-hpv.htm
posted by ericost at 9:13 PM on July 25, 2010 [2 favorites]

Just a few things. There is no medical test for HPV male in males. In all likelihood, if you haven't been with anyone between your last pap and a monogamous relationship with him, you could have very well gotten it from him. I know it seems difficult to approach, but given the fact that you said you see yourself with him for a long time, a candid conversation about your sexual health is mandatory, respectful and will probably be a lot easier than you think. Just blurt it out. If he isn't understanding then dump him. Besides that, there isn't a reason to go back to condom-sex if you've both gone through a full STD panel and you've told him about the HPV. Assuming it even is HPV, make sure to get your doctor to confirm that. As far as I know HPV is just one of the things that can make a pap come back abnormal. I also have never heard of it "going back to normal within a year or two" but I suppose the virus could be too low-level to be detected after a while. Good luck and don't go crazy Web MD'ing and worrying over it.
posted by Juicy Avenger at 9:18 PM on July 25, 2010

The responsible thing is obviously to tell him right away... but that's a very uncomfortable thing to do in my situation. I really don't feel like this is something I can just bring up with the boyfriend while we're in a LDR, and we only get to text infrequently, have the odd phone call or when I'm home visiting once a month - needs to be at a time when we're together and can talk, and get over any awkwardness that ensues. I have no idea how to proceed with this either.

You're not giving yourself enough credit: you do have some idea how to proceed. As you said, the right thing is to tell him. And you mentioned a couple different ways you can tell him: over the phone, or in person when you're visiting. Just starting the conversation at all is more important than the exact way you go about telling him.
posted by Jaltcoh at 9:20 PM on July 25, 2010

I think you should call your doctor up and ask if you have HPV. Do not diagnose yourself. He said you had a "slightly irregular" pap. That is all. If youre going to talk to your bf about this, say "I had my annual pap and it was slightly irregular. I dont know what that means but lets use protection to be on the safe side."Calling it HPV before you know what it is isnt a good idea and will only cause needless freaking out over something that may ultimately be nothing.
posted by MXJ1983 at 9:29 PM on July 25, 2010 [26 favorites]

I stressed out over an abnormal pap test, but was retested and the first one was (I'm told) a false positive. The doctor also told me that a yeast infection can obscure results. Just thought it might help to know that there are other reasons for an abnormal result. Can you get retested right away?
posted by sillymama at 9:38 PM on July 25, 2010 [1 favorite]

So in all likelihood, I have HPV.

I played that game once. It turned out, I did not have the STD.

My limited advice for your circumstance is that you should not self-diagnose. It can lead you into all kinds of unwarranted stress that is not fun at all.
posted by red clover at 9:41 PM on July 25, 2010 [2 favorites]

Yes, tell him. You're most likely fine (especially if they didn't immediately schedule for a colposcopy), but he deserves to know anyway. I believe that people should be able to make their own informed decisions when it comes to something as crucial as their health, and you have no right to take that away from him.
posted by halogen at 9:41 PM on July 25, 2010

There was a really good Savage Love podcast linked here recently that addressed this exact topic, especially how to tell people. There are many different HPV viruses, and it's most likely that your partner has been exposed to some of them already; depending on his age and/or experience, he could benefit from the vaccine (and so could you).

Anyhow there's already some good advice here, but certainly don't approach telling your bf about this as some big scary deal. Educate yourself first so you can answer his questions as accurately and honestly as possible. No one likes the thought of HPV but it's not high on the scale of big scary deals that people in sexual relationships deal with.
posted by hermitosis at 9:42 PM on July 25, 2010

Whoa nelly! Abnormal things come up all the time in pap smears, and many of them are not STI/D related. In fact, just last year I had an abnormal pap smear. I had to get the colposcopy, which was awful all around, and the doc said it was nothing to worry about. I just had my follow-up and was all-clear and free of any abnormalities and STD/Is, including HPV. For all you know it could be cancer (dun dun DUN), but it's probably nothing.

Tell him that you had a funny lady check up, and you'd like to hear back from your lady doctor about what it is before any sexy stuff happens. Totally no big deal. The likely hood of you (a heterosexual lady in a monogamous LDR) getting an STI/D is pretty low as it is, so it's probably nothing. Since you ARE in a LDR, you should wait on telling him until you hear back from your doctor anyway. It's not like there's a possibility you could infect him in the meantime.
posted by two lights above the sea at 9:55 PM on July 25, 2010 [1 favorite]

I had an abnormal pap in April. My follow up last month was abnormal, too. My doc told me not to worry about it, even after the 2nd test. When the first test came back abnormal, they sent the sample out for additional testing, which showed no HPV. If your doctor did not tell you that you have it, chances are, you don't have it. Call the office and ask, if it will give you peace of mind, but having been there, I'm willing to assume that the reason your doctor didn't mention HPV is because the test did not indicate it. And I know it's scary getting abnormal test results, but don't freak yourself out about things you read online. Abnormal paps are really common, and it doesn't automatically mean that you have an STD.
posted by Ruki at 10:13 PM on July 25, 2010

My new girlfriend is HPV-positive and has had a precancerous lesion excised. She told me. I'm not particularly worried. I'm glad she did, though.
posted by ten pounds of inedita at 10:16 PM on July 25, 2010

Yeah, don't tell him you have HPV until you actually know you have HPV. If you want to disclose immediately, tell him you had a slightly abnormal pap smear, that these things are most frequently but not exclusively caused by HPV, that they're running more tests, and that you wanted him to be in the loop. Anything more than that is jumping to conclusions.
posted by KathrynT at 10:36 PM on July 25, 2010

Get confirmation from your doctor - NOT the internet. As other people have said above, pap smears can come back abnormal for LOTS of reasons. I've had abnormal test results that went back to normal after a month, and the doctor told me that "stress" can even cause it to happen. Find out what's really going on, and THEN make the big decision, if it needs making.
posted by lriG rorriM at 10:53 PM on July 25, 2010 [1 favorite]

If he has it and doesn't know it, he could end up passing it on to another woman who might eventually die of cervical cancer as a result. Do you want that on your conscious? If not, tell him.
posted by Jacqueline at 1:12 AM on July 26, 2010

Just tell him what you told us.
posted by crunchland at 2:08 AM on July 26, 2010

MXJ1983: "I think you should call your doctor up and ask if you have HPV. Do not diagnose yourself. He said you had a "slightly irregular" pap. That is all. "

I'll second this advice.
posted by InsertNiftyNameHere at 2:50 AM on July 26, 2010

nthing all the others who have said don't self-diagnose, for heaven's sake speak to your doctor!

Pap smears are notorious for false positive and false negative results (which is why they will usually send you for a colposcopy - at least where I live - if a certain level of abnormal cells is detected).

I don't want to give you a hard time but to be honest I'm flabbergasted by the conclusion you've drawn based on one irregular Pap smear result. I understand that you're worried but really, speak to your doctor or go to your local free sexual health clinic. Educate yourself - and not by using Google or asking other people on the internet who clearly don't know what they're talking about either - ask your health care professional!
posted by rubbish bin night at 3:51 AM on July 26, 2010 [1 favorite]

There are lots of reasons why women can have irregular pap smears, and HPV is only one of them. Get tested and don't jump to conclusions until you know the results.
posted by emd3737 at 4:20 AM on July 26, 2010

This may be too flippant, but as someone who has HPV, my approach is to not tell. Over 60% of sexually active Americans have it. It's asymptomatic (except for the few strains that can in some cases cause cervical cancer) and incurable. It's transmittable even if you use safer sex techniques.

I refuse to never have sex again simply because I have an extremely common STI that (in my case) is probably never going to go away and is going to cause no significant quality of life issues for my partner, who probably already has it anyway.

(I might think about it if I were in a situation where I was with a woman and I knew she had no other sexual partners and no access to medical care. But I can't think of a situation where that would ever be the case. Maybe if I was dating a virginal lesbian astronaut?)
posted by Sara C. at 6:00 AM on July 26, 2010 [1 favorite]

I have had two irregular pap smears. I do not have HPV. You are getting way ahead of things here. Call your doctor back and ask him about the likelihood of HPV, framing your concerns for your partner.
posted by kimdog at 6:07 AM on July 26, 2010 [1 favorite]

he could benefit from the vaccine (and so could you)

The HPV vaccine is not a cure for HPV. It usually is not recommended for people who already have HPV, especially if they are older than their early 20's.

I'm also under the impression that Gardasil isn't recommended at all for men (yet?), and that virtually no insurance plans cover it for men.
posted by Sara C. at 6:09 AM on July 26, 2010

Definitely get an actual diagnosis, not an internet diagnosis. Tell your partner only then; right now all you can really say is that you had an abnormal pap which can be a bit scary, and you are trying to get that clarified.

And honestly, for all that I'm all rah-rah about honesty and openness with things sexual, I'm more with Sara C on this one. HPV is so common; men can't be tested (hell, for all you know, you could have gotten it from him); and there are usually neither treatments nor effects. If you do tell him, don't do it in that "omg I have something huge to tell you" like you might if you had just given him weeping pustulent sores or something.
posted by Forktine at 6:19 AM on July 26, 2010

The likely hood of you (a heterosexual lady in a monogamous LDR) getting an STI/D is pretty low as it is

Except in the case of HPV, where a large percentage of the population already has it without knowing.

Having said that - nthing the recommendation to talk to your doctor. Don't go scaring your BF with a "I HAVE AN STI! OMG!" phone call before knowing 100% that you actually have one.
posted by antifuse at 7:26 AM on July 26, 2010

So in all likelihood, I have HPV.

If you're between the ages of 20 and 35, this is statistically true regardless of any other details. It's incredibly, incredibly common, and can also be transmitted non-sexually.
posted by schmod at 7:29 AM on July 26, 2010 [1 favorite]

That seems like a fairly major assumption. I've had a bunch of Pap smears in my life and am running at about 50% abnormal readings. If it had looked truly worth pursuing, your doc would probably ask you to come in for a follow-up smear; I've had follow-ups requested about a third of the time, but they've never gone so far as requiring colposcopy. (My mother died of metastasized cervical cancer, which isn't hereditary but does tend to make doctors request more follow-ups.) In my experience, the most common reason for abnormalities is not HPV, but either sample-gathering error or lab error. Paps throw a lot of false positives, as the commenters above have said.

I would call the doctor and talk through this, but I wouldn't mention it to your boyfriend until you had a positive diagnosis and a treatment plan.
posted by catlet at 8:18 AM on July 26, 2010

As a sideline here? Technically HPV gets classified as a "sexually transmitted disease" most of the time but it's not like we're talking about syphilis or gonorrhea, which are the kind of STDs for which we sit down with our partner and say "Hello, I just tested positive for x." HPV is so massively wide-spread, so frequently undetected and so unidentifiable in most people that this is not a similar situation. If, as everyone noted above, you even have it, thank you for speaking to your doctor.
posted by RJ Reynolds at 8:56 AM on July 26, 2010

nthing that I have had several abnormal paps, none of which were HPV. The problems eventually cleared up on their own.

I do think that it's worth mentioning to your partner, though. Why not talk to your doctor about what he thinks you should say to your partner? Perhaps he can give you some advice on the probability that it is or is not HPV and give you some tips for explaining any risks to him.
posted by Colonel_Chappy at 9:24 AM on July 26, 2010

antifuse: True (for HPV), and thanks for correcting/clarifying there!

HPV (the virus). Approximately 20 million Americans are currently infected with HPV. Another 6 million people become newly infected each year. HPV is so common that at least 50% of sexually active men and women get it at some point in their lives.
posted by two lights above the sea at 9:35 AM on July 26, 2010

men can't be tested (hell, for all you know, you could have gotten it from him)

Well, that doesn't exactly make it irrelevant to him. He might have another sex partner at some point in the future, in which case this could be useful for him to know.
posted by Jaltcoh at 9:44 AM on July 26, 2010

Well, as someone who recently had an irregular pap smear that turned out to Stage 1 cervical cancer, the only thing I'd do is see a gynecologist and have them take a closer look, then book another appointment for 3 months time, not a year.

Until then, telling your bf that you have HPV is completely bonkers.
posted by dzaz at 11:52 AM on July 26, 2010

He might have another sex partner at some point in the future, in which case this could be useful for him to know.

Not really, because he can't do anything about it.
posted by Sara C. at 12:16 PM on July 26, 2010

Not really, because he can't do anything about it.

He could disclose it to his future partner.
posted by Jaltcoh at 12:38 PM on July 26, 2010

He could disclose it to his future partner.

Who also can't do anything about it.
posted by Sara C. at 1:00 PM on July 26, 2010

Who also can't do anything about it.

How about not having sex with him?
posted by Jaltcoh at 1:09 PM on July 26, 2010

How about not having sex with him?

If every guy who had had unprotected sex with someone who might have had HPV were to be refused sex, there would be no dudes getting laid. Seriously: even if she gets a 100% clear diagnosis of HPV (which I kind of doubt -- abnormal paps are super common), there's no way to know if a) he already had it and gave it to her; b) he already had it but didn't give it to her; c) he didn't have it before but now has it from her; or d) he didn't have it before and didn't catch it from her. There's no test, and there isn't any way for him to know.
posted by Forktine at 5:41 PM on July 26, 2010

If every guy who had had unprotected sex with someone who might have had HPV were to be refused sex, there would be no dudes getting laid.

Sigh... OK, but no one is saying that. I didn't say they should be refused sex. All I said is that it could be relevant for the sake of full disclosure. Having information is not the same thing as using it as the sole determinant of your actions.
posted by Jaltcoh at 6:08 PM on July 26, 2010

And the issue isn't just whether to have sex. It's whether to use condoms.
posted by Jaltcoh at 6:11 PM on July 26, 2010

A few things:

1. Get it confirmed before you crazy-out.
2. There is no medical test for HPV male in males. In all likelihood, if you haven't been with anyone between your last pap and a monogamous relationship with him, you could have very well gotten it from him.

Yup, no medical test for males with HPV. BUT...I gotta disagree with the other part of the statement. HPV, just like other STI/STDs has a period between when you get it, and when it shows up.

Lets say you had sex before your last pap smear (not this one) with some dude that had HPV...you got it...but it won't show up for a few months. I know that the period is a few months, but I don't remember from any literature whether its 2 mos or 10 months. Someone on here may want to find a reference for that.
posted by hal_c_on at 8:30 PM on July 26, 2010

men can't be tested (hell, for all you know, you could have gotten it from him)

Actually, men can be tested.
posted by sero_venientibus_ossa at 4:38 AM on July 30, 2010

Not according to the CDC.
posted by Jaltcoh at 4:56 AM on July 30, 2010