HPV: Do I stay or go?

February 1, 2013 7:35 AM

The woman I'm dating has HPV. What now?

I've seen previous questions about this, but they concern male/female transmission. I want to know about female/female.

We've been dating for a few weeks but aren't girlfriends yet. She informed me before anything happened that she had HPV, the genital-warts causing kind, and that it's a type not covered by the vaccinations as she'd had them before this. I've had Guardisil FWIW.

I've been taking time to think about whether or not I want to continue things. I absolutely do not want to get it, knowing myself it would be a big hit to my self esteem and take awhile to get past. I also have a friend with HSV1 and I've seen the stigma and poor reactions he gets in the dating world and don't want to put that on myself.

but I do want to continue things with her... I think. My questions are:

- Will we ever be able to have sex without barriers? I don't like them. At all.

- Will we ever be able to make out with tongue? Share drinks?

- What other things will we not be able to do that I haven't considered?

- If you have experience with this not related to the questions above, please feel free to share anyway. Thank you.

My main concern is that we will not be able to have a "normal" sexual relationship without risk to me. I don't like "please wait while I retrieve the condom" sex, and I read barriers don't work 100% anyway... Is continuing with her basically ensuring I get it too? Things are amazing and look promising with this person... should this be a deal breaker?

posted by anonymous to human relations (14 answers total)

Of course there's always going to be a chance you'll contract HPV if she has it. I'm not clear why you don't believe it's covered by the vaccination, she had a break out before having the vaccine? Had the vaccine then had symptoms?

I'd just like to point out that she KNOWS she has it, so you are aware of the risks. Most people catch STD's from people who didn't know they had them, and HPV is very very common. (Not to mention everything else you are at risk for. 16% of the world's population between the ages of 15 and 49 have herpes type 2.)

You can insist on a full screening for both partners before intercourse, but not all STD's are tested for. Agreeing to have sex will always come with a side of risk.
posted by Dynex at 7:53 AM on February 1 [1 favorite]

She should also have vaccination, if possible. Technically there are different strains, and she can protect herself against those other strains. Knowing for sure if her strain does not match your vaccination would help.

The strains covered by Gardasil are the primary cancer- and outbreak-causing strains, however.

From the CDC:

• "Approximately 20 million Americans are currently infected with HPV."

• "HPV is so common that at least 50% of sexually active men and women get it at some point in their lives."

• "Each year, about 12,000 women get cervical cancer in the U.S. Almost all of these cancers are HPV-associated."

In the end... only you can make these choices. You can if you like conduct your sex life to screen all partners with HPV, and also with different strains of herpes, or I suppose with HIV as well. I would encourage you to talk about this with a nurse practitioner or a doctor or other trusted health care worker at a woman-friendly and gay-friendly practice.

I personally have never in my life met anyone who's blinked an eye at a partner having either HSV or HPV, but I suppose these things do happen.
posted by RJ Reynolds at 8:02 AM on February 1 [3 favorites]

You're going to get a lot of people coming in here to urge that it's not a big deal. There's a lot of weird defensiveness around this issue.

However, it is perfectly normal to balk at having a partner with HSV or HPV, I know several people for whom that is a dealbreaker. In addition, the failure to isolate/test/use safe sex practices with people who do have it is one of the things that is spreading it to the insane proportions it currently has.

I think the question should be: does this look promising enough that you think you have a chance of being with this woman for the rest of your life? If so, then mazeltov, consider going for it. But if not, then consider that in your next relationship, /you/ will be the person with this problem, and it will be the other person having to choose whether or not to be in a relationship with you.
posted by corb at 8:20 AM on February 1 [9 favorites]

Former sex educator before I've had my coffee here. Your prospective GF may have low risk (non cervical cancer causing, wart causing) HPV. I say "may" because, unless she had the DNA test (which insurance rarely covers for low risk strains, without an abnormal pap), the diagnosis was made subjectively based on a physical exam. I have a friend who is asexual and celibate (like, it would be a miracle!) who was diagnosed with genital warts when trying to get jock itch cream after training for a triathalon. He had heat rash. It went away when he took offer the compression tights.

That said, it's not that bad and you can't be sure you don't have it too. Gardisil vaccinates against a very small percentage of the extant strains of HPV and it zeroes in on the dangerous ones. The dangerous ones don't cause warts: it's either one or the other. Also, something like 80% of people in their 20's have at least one HPV strain at any one time (source: CDC). It's really impossible to know your HPV "status," because it's only called for to do the expensive testing if there's an abnormal pap (and *that* only happens with the other kind of HPV, the cervical cancer causing, "high risk," kind that doesn't cause warts). Otherwise, no reason to worry. All people women with multiple partners are basically assumed to have it for public health reasons. You could have gotten this strain and developed immunity without symptoms already. Or maybe you have it actively and don't notice the symptoms -- really common with low risk strains! Most reassuringly, young women seem to clear the virus within two years according to studies -- I remember dimly reading recently that men are the ones it sticks around for (men are recently getting oral and anal cancers for this reason, if they contract the cancer causing strains). As for prevention, barrier protection helps, but it's really not that great at preventing the spread of HPV, especially with non penetrative contact. HPV is transmitted skin to skin, not by body fluids. Roughly the boxer shorts area is fair game, is what we used to educate people.

I don't know what to say about HSV1. By the time people are middle aged, almost everyone has it -- estimates range between 50 - 90% in western countries. Most people get it as children (pretty sure my crayon eating career is what got me my HSV1). My husband doesn't have it and his doctor has actually remarked on how strange that is.

Maybe I'm cavalier, but I kind of think both these viruses are just conditions of modern life, passengers everybody seems to be picking up. Nothing anybody can do about them, everybody's got them and they're no big deal. What you want to test for are things that ARE a big deal: HIV, chlamydia, gonorrhea, syphilis, hepatitis (you need to ask for this test, but it's worth doing -- I have a friend dying of hep c right now).
posted by sweltering at 8:31 AM on February 1 [31 favorites]

HPV is so widespread that, even though I have never shown any symptoms, I assume that as a guy in his mid-thirties I have it (or had it--something like two thirds of infections spontaneously clear within a year, ninety percent within two), or have at least been exposed to it at some point, and that all of my partners have as well.

The correct way to manage HPV risk, in my opinion: 1) Gardasil (it's not 100% clear from your question if you are a man or a woman, but I've heard that physicians serving the gay community will administer it off-label to men, too; note, as mentioned upthread, that this only covers "high-risk"/cancer-causing strains, and you can still contract other HPV strains after vaccinaiton) 2) regular pap smears and 3) DON'T WORRY ABOUT IT.
posted by pullayup at 8:35 AM on February 1 [1 favorite]

If you don't want HPV, you go.
posted by rr at 8:48 AM on February 1

Genital warts don't seem like a big deal to me. They're not awesome, obviously, but they're not life-threatening in any way, and in no world would I let the possibility of getting them get in the way of a good connection and good sex. I would happily date someone with genital warts, and I wouldn't worry much about using barriers. My main concern would be future lovers' reactions if I picked it up, but I'm not sure I'd want to be sharing fluids with anyone who can't think rationally about them, anyway.
posted by rosa at 8:54 AM on February 1

Nthing the "hpv is common" chorus. Nthing the "it is up to you, and understandable if you read all this and still don't wanna go there" chorus.

And I'll add this anecdotum - I tested positive for HPV back in 2007, after an abnormal pap smear; my doctor ascertained the symptoms were very slight, and we took a "watch and wait" approach. Then in 2008 I was dumped, and spent the next couple years in "involuntary celibacy" - and in 2010, not only had a normal Pap smear, but my doctor tested me for HPV for shits and giggles and I tested negative.

Meaning: often, HPV can go away. There's evidence that the reason some people keep testing positive for it for years is because there are so many strains of HPV, that people keep catching different strains one after the other if they're sexually active. Kind of like how you catch colds again and again - you're just getting exposed to a different cold virus that's different from the one you already have an immunity to. So, in theory, a couple who is mutually monogamous could infect each other with whatever strain of HPV they both manage to be carrying, and the virus could run its course....and then, after a few years, their systems could both each clear it.
posted by EmpressCallipygos at 9:03 AM on February 1

Have her get tested for it again.
posted by jbenben at 9:21 AM on February 1

I'm going to paste this here as it seems like a lot of people aren't RTFQ:


I want to know about female/female.

We've been dating for a few weeks but aren't girlfriends yet. She informed me before anything happened that she had HPV, the genital-warts causing kind, and that it's a type not covered by the vaccinations as she'd had them before this. I've had Guardisil FWIW.

So, two women both of whom have had Guardisil; One of whom has HPV and the other who doesn't want HPV.

I'm going to agree with some of the other posters that if you don't want to risk having HPV, you probably don't want to continue dating this woman.
posted by Flamingo at 9:25 AM on February 1 [2 favorites]

Let me just say since no one's addressed this yet:

- Will we ever be able to make out with tongue? Share drinks?

Hi, I am a queer lady and if I were you, I would go ahead and do both of those things, like yesterday, and not worry about it. According to the CDC's HPV fact sheet, HPV can be transmitted through oral sex. Not through making out. Go forth and make out. Before you do that, it might help you to read through that fact sheet.

And from EC's comment upthread:

So, in theory, a couple who is mutually monogamous could infect each other with whatever strain of HPV they both manage to be carrying, and the virus could run its course....and then, after a few years, their systems could both each clear it.

Yeah, I want to emphasize this for truth. Mutually monogamous doesn't mean zero risk! There is no such thing as zero risk to you! But the consequences are quite possibly not bad at all -- not, I don't think, worth a big hit to your self-esteem. Think about this: the woman you're dating, she is still worthy and awesome even though she has wart-causing HPV, yeah? If you agree, then the same would be true of you, even if you contracted it.

Your level of risk is hard to calculate and it's not zero no matter what, but depends on a lot of things. How often does she get outbreaks? Does she get treatment for them? Do they respond to treatment? What kinds of sex are you interested in having? There are many and some are higher risk than others. My understanding is that the highest risk for two women is vulva-on-vulva contact, and while your mileage will vary, I'd think it would be easy enough to skip that kind of sex until maybe someday her system clears the virus, and to avoid sex during outbreaks.

For more thoughts on this (clearly I have a lot), feel free to drop me a mefi mail.
posted by clavicle at 10:15 AM on February 1 [1 favorite]

Yes, I'd like to second clavicle's important point. You don't get genital warts from kissing or any other mouth to mouth contact. Please go ahead and kiss her, if you plan to keep her as a girlfriend!
posted by treehorn+bunny at 10:34 AM on February 1

Per the Pink Book:

"Studies have shown that more than 90% of new HPV infections, including those with high-risk types, clear or become undetectable within two years, and clearance usually occurs in the first 6 months after infection."

So - The time until you could stop worrying about transmission may be less of a big deal than you may be thinking.
posted by lakeroon at 12:24 PM on February 1 [2 favorites]

Oral HPV contracted through oral sex can be a health risk, but this JAMA article says that "at least 90% of HPV-positive OSCCs [oropharyngeal squamous cell carcinomas] are associated with high-risk (or oncogenic) HPV type 16 (HPV-16)." You are protected against that strain through your vaccination and your partner probably doesn't have that strain anyway, since it is not wart-causing. From what I've read, people sometimes, but rarely, get genital warts in their mouths. Hope that helps.
posted by reren at 1:28 PM on February 1 [1 favorite]