The hazards of HPV

February 9, 2012 1:24 PM

Dating and STD question. Snowflake details inside.

I'm out of a very long relationship, and I'm trying to date again. Early on in that relationship, my partner had an abnormal pap smear, and they found a polyp on her cervix. Long story short, she contracted HPV, whether from me or someone else, I don't know. I've asked doctors to test me, but because I'm male they tell me there's no point - fair enough, because I assume I have it and there's no treatment. So, obviously I tell someone I'm going to sleep with that I probably have HPV. But other than that, what are the practical considerations I need to take into account? What are the infection risks? What kind of measures do I need to take to reduce infection? How do I be a responsible sexual partner in this circumstance?

posted by anonymous to health & fitness (18 answers total)

You'll need to always wear a condom if you're in doubt whether the other person is HPV positive and keep an eye out for warts. Unprotected sex will put women who have not been immunized at greater risk for cervical cancer.
posted by aught at 1:30 PM on February 9 [2 favorites]

As a guy in a similar situation to yours recently and having talked to my PCP about this same topic recently: the stats on HPV are pretty damning . . . if you've been even occasionally sexually active the odds are more likely than not that you and any potential partner are already infected.

Bottom line--it's obviously worth bringing up in conversation but there's not much you can do, save celibacy.
posted by eggman at 1:30 PM on February 9 [1 favorite]

Speaking as someone who has had HPV that turned into cervical cancer... I wouldn't tell prospective partners that you think you have HPV. Some huge majority of women have it anyway. It's not the same as other STDs in that it's extremely widespread plus men generally have no way of knowing that they have it (and just because your former girlfriend had an abnormal pap early in your relationship, doesn't mean that you were the one to give her HPV).
posted by amro at 1:30 PM on February 9 [3 favorites]

I've read that up to 30% of sexually active college students have the virus, so I just assume that everyone I have sex with has it. (As amro says, if you haven't had warts -- and many carriers NEVER get them -- there's really no way of knowing one way or the other).

I don't see any reason to share this, but wear a condom anyway (even though condoms are only semi-effective for HPV, since there's still skin contact where the condom doesn't cover).
posted by coolguymichael at 1:48 PM on February 9

I've tested positive for HPV as well; and as understand it (after doing much research), the odds are that 85% of the people who've had sex with more than two people in their life also do, and may not even know it.

As I understand it (you'll note I'm putting a crapton of disclaimers in here, that's to underscore that I'm not a doctor), HPV is kind of like the common cold in that there are a whole lot of different STRAINS of HPV. Some do nothing. Some cause genital warts. But some affect women by giving them the lesions that turn into cervical cancer if you let it go long enough. (Those same kinds don't necessarily do anything to men, either.) So that's why doctors pay close attention to women who test positive for HPV, that also have abnormal pap smears -- because maybe the two situations are related. But, maybe they're not. Who knows.

Also, there's some evidence that if you test positive for a given strain of HPV, that your system can fight it off within a couple years. So your partner who may have contracted it possibly gave it to you....but then it wore off, and wore off you as well.

So if you were a guy who tested positive for HPV, it wouldn't necessarily be easy to tell whehter it was the kind that put women at risk for cervical cancer, or whether it would....do nothing.

In terms of what to tell future prospective partners: well, I do try to mention that I've tested positive for it, but then I add that from what I understand it's extremely common, and that even so I'm going to insist on condoms anyway because it's just good common sense for other reasons anyway. Haven't run into a guy who had a problem with that (and in fact, my last ex was a little miffed that I DIDN'T - I honestly thought I had, and then when we finally had the "we're monogamous so maybe we should give up condoms" talk, and I "reminded" him of what I'd "already" told him about HPV, he said "uh, no, you never told me that." So -- I'd read up on it, use a condom, and mention that you were exposed but that it's common but that you're gonna use a condom anyway just in case.
posted by EmpressCallipygos at 1:49 PM on February 9 [2 favorites]

How do I be a responsible sexual partner in this circumstance?

I strongly disagree with some of the above answers. Just because it's widespread doesn't mean you are the one who should make the risk-assessment decision on behalf of your future partners - tell them what you've told us and let them make their own risk assessment. Not everyone is at the same risk, not everyone makes the same choices.
posted by cairdeas at 1:50 PM on February 9 [14 favorites]

There's also a lot of misinformation about HPV in this thread, but that's not surprising because there are still so many unknowns about it. Even doctors spread misinformation about it sometimes. In a situation like this where so much is unknown, and you're talking about the health of another person, and a virus that could give them cancer, I think it's best to err firmly on the side of giving them as much info as possible.
posted by cairdeas at 1:54 PM on February 9 [1 favorite]

So if you were a guy who tested positive for HPV, it wouldn't necessarily be easy to tell whehter it was the kind that put women at risk for cervical cancer, or whether it would....do nothing.

There is no such thing as "a guy who tested positive for HPV" because there is no HPV test for men.
posted by enn at 1:59 PM on February 9 [4 favorites]

I'm a female who had an abnormal pap smear and was diagnosed with HPV in January 2010, but my last pap (summer 2011) was normal. I started dating someone in fall 2010 and told them about it before we had sex. He actually had been dating a woman prior to me who had the same issue, so we didn't worry too much about it since it's likely we both "had" it.

I was so worried about this when I started dating again because it really is a tough situation - you don't want to freak out a new partner by telling them you have an STD, but you also don't want to be irresponsible or not let them make a decision. HPV is so, so common and widespread and condoms don't completely protect you, but you should tell your partner. I would say something like: "I want to be honest with you because I care about you: it's very likely that I have or once had HPV. Are you familiar with it? Most of the sexually active population has had it at one time or another. It can be a big deal for women, but generally it's harmless. I definitely want to use condoms to keep us both safe, but I should warn you condoms will not protect you completely."

Good luck!
posted by anotheraccount at 2:03 PM on February 9 [1 favorite]

Yes, tell partners and let them decide. Most people either carry the virus or have had it and cleared it; always wear a condom (even though they do not provide complete protection) unless your partner decides that they are OK with the risks of getting HPV. Your partner may decide to get the HPV series of vaccines, if they have insurance that covers them -- they're still fairly expensive.

The only way to tell if you have HPV, if you're male, is if you develop warts. (And for what it's worth, the last time I researched this, the strains that cause warts in men are not the strains associated with cervical cancer in women.)
posted by fiercecupcake at 2:07 PM on February 9

I'm married now, but I've had HPV for a while, including a good chunk of the time I was dating.* It wasn't a huge issue. It basically meant I couldn't have casual sex with total strangers — which, honestly, is overrated anyway.

I've always been up-front about it with potential partners, and let them decide how cautious to be. That's dorky and awkward and not fun, but it hasn't actually had a huge impact beyond that. In some cases, it's meant "Oh, well, we'll stick with handjobs until I decide I'm serious about you and it's worth the risk" or "Well, I'm on the pill, but I still want you to keep using condoms" or something like that, but nobody who was actually interested in me as more than a one-night stand has been like "I totally wanted you to be my boyfriend, but this is a dealbreaker and you need to go home right now."

Your mileage may vary. Some people will think it's a dealbreaker, and that's their perogative. But the important point here is, if a well-informed adult says "I know the risks — let's fuck," then you're not under any obligation to turn them down. Don't feel the need to be like "No, for your own good, I insist on doing XYZ even though you want ABC," because that's paternalistic and weird.

Other useful facts:

• There's a vaccine available for people under 26. If you're getting serious with someone who's young and fairly certain she's never been exposed, she might as well look into getting vaccinated.
• There are multiple strains. The ones that cause visible warts don't cause cancer, and vice versa.
• You can also get HPV orally and anally, and that can lead to cancer too, though it's very rare. But you might as well know the warning signs there. Basically, if you ever start bleeding out your ass on a regular basis or have a sore throat that never goes away, see your doctor — but you probably would have done that anyway, right? These really are very rare cancers, though, and the vast majority of people with HPV never get them.
• If you use a condom, it reduces the odds of transmitting HPV, but it doesn't actually offer total protection, because the virus can live in skin cells in your groin or down at the base of your penis where the condom doesn't cover.

Think of this like tips on safe driving. It's not like ZOMG SOMETHING TERRIBLE IS BOUND TO HAPPEN NOW. Your risk for some bad shit, and your partners' risk, has gone up a bit now that you have HPV. So pay attention and be informed but seriously try not to freak out about it. MeMail me if you want to talk more.

*Or, at least, I contracted it a good while ago. No idea whether I've cleared the infection or not. As others have said, there is no generally recommended HPV test for men, so there's no way for me to know. But whatever, I'm married now and it's much less of an issue.
posted by nebulawindphone at 2:21 PM on February 9

HPV can clear.

If you're a woman who is being regularly blood tested for HPV (my doc told me that her practice starts this around age 30), then you have the chance to know that you've cleared it.

Since men aren't tested, you have no way of knowing whether you ever actually had it and, if you did, whether you cleared it. Honestly I don't see a reason to assume that you haven't. (Unless of course you're having warts, in which case disclose that, follow the MDs advice about safer sex, and rest a little easy knowing that the strains that cause warts are not the ones that lead to cervical cancer).

The super responsible thing to do would probably be to tell future partners that you've been exposed to HPV. Frankly if a woman is given pause by that, she either needs better sexual health education or to only be sleepin with virgins. The only logical pragmatic assumption is that anyone who has ever had at least one sexual partner who has ever had at least one prior sexual partner has been exposed to HPV; condoms do not prevent transmission.

The other good news is that cervical cancer is very treatable if it's detected within a reasonable amount of time. The women who die of cervical cancer tend to be those without access to basic health care services/health insurance.

It reflects well on you to take this seriously. But I think it's fair to relax. My gynecologist friend said that HPV is like a cold that your cervix catches - usually it clears up on its own, and occasionally it can get worse and require intervention to prevent potentially dire complications. I loved that analogy.
posted by Salamandrous at 3:26 PM on February 9

The super responsible thing to do would probably be to tell future partners that you've been exposed to HPV. Frankly if a woman is given pause by that, she either needs better sexual health education or to only be sleepin with virgins. The only logical pragmatic assumption is that anyone who has ever had at least one sexual partner who has ever had at least one prior sexual partner has been exposed to HPV; condoms do not prevent transmission.

Just want to point out one last thing, OP. The prevalence of the cancer-causing strains of HPV specifically is different from the prevalence of "HPV" overall. Those specific strains are not so prevalent that everyone has been exposed to them, or would need to logically assume they have been if they've ever had sex.

The women who die of cervical cancer tend to be those without access to basic health care services/health insurance.

Unfortunately, assuming this is taking place in the US, we have hundreds of thousands of women without access to those things.
posted by cairdeas at 4:00 PM on February 9 [2 favorites]

(Oh, and something else I'd like to add: you can tell from my comment above that I don't think HPV is a dealbreaker, but if you knew you'd been exposed and purposely didn't tell me, and I found out later? I would feel like you didn't tell me because you wanted to get me into bed first, regardless of what your real reasons were, and my trust in you would be irreparably damaged. So: disclose.)
posted by fiercecupcake at 4:40 PM on February 9 [2 favorites]

self-serving shout out to this hairpin article that, although written for people with cervixes, might explain a bunch about hpv vs. cancer: thehairpin.com/2012/01/a-scenic-guide-to-your-abnormal-pap-smear
posted by damsorrow at 5:59 PM on February 9

You tell a prospective partner that a former partner had HPV so you could possibly be a carrier, and recommend she find out about the possibilities including confering with her PCP. Tell her that you'll wait for her to decide how she wants to proceed before you two consider unprotected sex. She will learn what others upthread have written about, and can make her own decision at her own pace. Quite likely, she'll prefer barrier protection until you two become exclusive and see settling in for a while. Or she may make a different decision. Let it be her call.
posted by TruncatedTiller at 6:02 PM on February 9 [2 favorites]

I'm a part of the "don't disclose right away" camp.

You're incredibly thoughtful for considering it- but frankly, HPV is so prevalent and overhyped/stigmatized that disclosing it so early (before you sleep with someone and are exclusive) is going to make the other person uncomfortable and unnecessarily bring forth a whole lot of judging. As other people have said, a LOT of people have it or have been exposed to it, and the vast majority of the time it goes away on it's own with no permanent damage.


If you get to be exclusive with someone- it's a conversation you can have for the purposes of trust and honesty and full disclosure. But it's not HIV, or herpes, or an std that you're likely to give to them and ruin their life with- I think you can relax.
posted by sarahnicolesays at 6:05 PM on February 9

> Speaking as someone who has had HPV that turned into cervical cancer... I wouldn't tell prospective partners that you think you have HPV. Some huge majority of women have it anyway. It's not the same as other STDs in that it's extremely widespread plus men generally have no way of knowing that they have it (and just because your former girlfriend had an abnormal pap early in your relationship, doesn't mean that you were the one to give her HPV).

Agreed on all points (and I also had cervical cancer.)
posted by desuetude at 10:39 PM on February 9