HPV disclosure help

July 10, 2016 6:40 AM

A few years ago I had a low-risk HPV infection. I want to have a good speech memorized for when I disclose this to a potential partner.

A few years ago I had an HPV outbreak (warts) which has been treated and I have been symptom free for over a year. I know all the statistics and I know some doctors (including my own) say you don't need to disclose HPV status, especially when it has likely cleared, but I would not feel comfortable having sexual contact without being honest and up front about about it. So i have decide I am going to disclose even if some people reject me.

I want to have a "speech" memorized to deliver to a potential partner when sex seems to be a logical next step. I'm probably going to be very nervous so I think that knowing what i'm going to say in advance will help. I'd like to have some statistics with sources and some idea of how to structure it, not necessarily memorized verbatim. Also i'd like some advice for how you would like this delivered if you were on the receiving end of this talk. For example, where should I deliver it, after how many dates, and should I leave afterward? What would make you feel comfortable? If it matters, I am a man dating women. My intention is to be as transparent as possible but also not scare someone off by explaining badly and also not to understate the risks.

posted by toadman to Human Relations (15 answers total)

I am sure that 70-80% of sexually active adults will have HPV at some point so you might want to say, "I am a sexually active adult".

My ex ( who was my partner at the time) revealed to me, after LOTS of unprotected sex mind you, that he'd had warts in the past. I freaked out and rushed to my nearest GUM clinic, where i was gently informed that i had probably encountered HPV myself already, most strains don't even cause warts or visible signs, and that i was at no increased risk from having had unprotected sex with this specific individual, and that as it had been over 2 years since he had been infected his body would have cleared it to a "subclinical" level by now anyway. I am too old to have had the HPV vaccine.

And given what i was told at the GUM, yes i would feel uncomfortable if someone had a speech prepared about HPV, because unless they'd had the warts recently and were still potentially infectious, i'd be thinking they didn't know much about sexual health.
posted by intergalacticvelvet at 7:15 AM on July 10, 2016 [4 favorites]

I would bring it up maybe after a few dates, but before you get nekkid. That conversation is easier to have (and more dignified, I think) if no one's hands are in anyone's pants. Some ideas...

"I have enjoyed our time together and think you're attractive/hope for more/want to hook up/whatever. Before we do that, I think we should talk about precautions... A few years ago I had an HPV outbreak (warts) which has been treated and I have been symptom free for over a year. Do you have any questions about that?"

1. This convo should be had re: STDS and/or birth control in every relationship I think
2. Your partner may have something to bring up re: their situation, too!
3. Be honest. I would be livid if a partner lied or did not disclose something like this.

Good luck!
posted by ShadePlant at 7:56 AM on July 10, 2016 [7 favorites]

It seems like a better use of your time would be to see if your doctor can retest you to confirm that the HPV has cleared before you start preparing dramatic speeches.

If a partner all of a sudden ramped up into a big speech on their STD history and then it turned out that they just wanted to disclose they had HPV in the distant past I would be unnecessarily freaked out. Women are generally more familiar with the ins and outs of HPV given that more strains affect them, you could easily fit a simple disclosure into a general conversation about safe sex. There's basically no way to prevent HPV transmission during sexual activity anyway; a doctor once told me that if you've had sex with someone who's had sex you've contracted HPV at some point. The most worrying strains of HPV are the ones that cause cervical cancer and even then between the Gardasil shot and regular GYN visits it's relatively easy to deal with. HPV is just not that big an issue, and you treating it like it's the end of the world is probably going to raise more concerns than the HPV itself.
posted by fox problems at 7:59 AM on July 10, 2016 [8 favorites]

you want a way of saying this that reassures the kind of person who would freak out if they learnt of it later, but also avoids dismissal from those who think they know it all because they went to the clinic once (and as we learn from this thread, those can be the same person).

i think shadeplant nails it - frame this as part of a larger conversation that's not just about you, but about what's coming up.
posted by andrewcooke at 7:59 AM on July 10, 2016 [4 favorites]

I disagree with the people here that are saying that you don't need to say anything because HPV is really common. If my partner had an outbreak of warts caused by HPV a few years before meeting me and didn't tell me before we started having sex, I'd feel upset and start to wonder what else he wasn't telling me. If I was getting serious about someone, I think disclosing HPV or any other STI is like talking about other important things you should talk about like birth control, mental health issues, kids, previous divorce(s), etc.

I think saying "I am a sexually active adult" is too vague. I would say the same thing as you said in this post "A few years ago I was diagnosed with a strain of HPV that causes warts. I've been symptom free for over a year now. I really like you and I wanted to tell you about the HPV because I want you to be able to make the best decision for yourself. I'd be glad to answer any questions you may have or give you some time to think about it."
posted by Lingasol at 8:08 AM on July 10, 2016 [4 favorites]

I'm also a man who dates women. I like to bring it up between the point when it's clear we're going in that direction, but before we're actually there: I don't want to sound presumptuous nor spring it as a surprise. I'll say something like, "Heads up, I have both herpes and HPV, but I take suppressive medicine for both." When I was new to this I was very afraid of rejection, but in the years since only one partner ever freaked out (which just meant no penetrative sex), and many have said "Oh, me too." You'll find with experience that your current nervousness is overblown.
posted by ejs at 9:06 AM on July 10, 2016 [3 favorites]

Include half a sentence about it when you discuss contraception and what happens if contraception fails, which is of course a conversation you already intend to have. Much like contraception failure rates, I don't think it's necessary to spout a bunch of statistics, but you can say something like, "let's use condoms for now; I had symptomatic HPV X years ago and my doctor says it's basically a non-issue at this point but there's a number of reasons to use condoms for now, so let's do that."

The other reason to handle it that way is that you have no idea what they have and whether they know they have it or whether they are an honest enough person to say so. It's the best way to not get HPV again. You can revisit the topic of mutual testing if the relationship escalates.
posted by Lyn Never at 9:07 AM on July 10, 2016

Response by poster: Regarding re-testing:

- I have been told by multiple doctors (and the CDC and other reliable sources confirm) that there is no test that can be done on men to say "Yes, you still have HPV virus present in your body" or "No, you do not have any HPV virus present in your body." They can do a swab of an area where there was infection and test it, but it doesn't show up in a blood sample or anything like that.
- I have had those swab tests done on the areas where the infection was and those have come back negative for over a year, but the virus can lie dormant (apparently for decades). So really there is no way I can know one way or the other.. unless I have another breakout.
- I have had the full dose of Gardasil, which was completed over a year ago. I was advised to do this in order to prevent re-infection with other strains.

So I'm really not being lazy here. I have talked to my doctors over and over to try to get some kind of confirmation and they just tell me it's not a big deal and no they cannot tell me if I'm still infected. Frustrating, but that's how it is.
posted by toadman at 9:12 AM on July 10, 2016

Ok, so I have a cervix and a history of one irregular Pap that most likely indicated HPV (but no warts) and subsequent clear Paps (but no "you def don't have HPV" test results because, as the Op points out, that's not really how STD testing works). Here's how I do it: I lead with the good news.

"Yeah, I've been tested in the last year and pretty careful since then. Everything was fine on my last test. I had an irregular Pap that meant I probably had HPV a few years ago, like pretty much every sexually active person these days, but since it has not shown up since my body most likely cleared the virus."

I'm kind of fuzzy on when I tell people, but I probably do tell most people since it's not even a big deal imo. For me, I mostly like to hear that people do get tested and aren't just flying blind with an entire sexual history and not even a single HIV test or syph screening.
posted by Juliet Banana at 9:27 AM on July 10, 2016 [1 favorite]

When structuring your talk, I'd recommend thinking about what the other person might be worried about and preparing to address those concerns. The simple truth is some people will say no and that group probably wouldn't reconsider no matter how you say it. The rest will either be hesitant but willing to consider it for the right person or not too worried about it because they understand certain STDs are pretty common and someone who comes right out and says it is actually perhaps a safer partner than someone less educated on the topic.

From my perspective (and I'm just one woman, but hopefully it helps), here's what I would be concerned about:

- what are the risks to my health if I become intimate with this person?
- given those risks, if I decide to move forward, will this partner go the distance to keep me safe/protect me as much as he reasonably can?

Others might see it differently, but that seems like the most essential piece. I want to know how dangerous it is and, assuming it's manageable, I want to know my partner will keep me safe. As such, I'd recommend keeping it simple, straight-forward and practical, listening to their concerns and going from there. Be prepared with some information to explain the risks and if they ask some resources to do further research. Give them as much time as they need to consider it, and make it clear that there is no pressure.

Have you talked to any friends about this? I think being able to talk confidently will help you here, sort of like how a really great doctor can make a patient feel safe and secure about something scary. It might feel awkward at first, but getting into a groove of discussing this, in person, with people you trust may help you feel more comfortable talking about it general.
posted by amycup at 12:30 PM on July 10, 2016 [1 favorite]

Everyone is different, but I myself would be most comfortable if you just didn't bring up what I consider a non-issue. If you feel you need to however, I would include it as part of a conversation about safer sex in general. Bring up birth control, ask about their feelings about using barriers for oral, say that you tested positive for HPV in (year) and that your doctor you've probably cleared it now (assuming that's true), and that HPV is really common and most people never know they have it. If they have further questions you can get into more detail after that. Heck, you could even bookmark a CDC information sheet about it to have on hand if they're nervous.

As for when to have this conversation, it kind of depends on how your relationship and conversations go. Because I like talking about sex, it would not be unusual for there to be an opening to talk about it very early on. But it's also fine to wait until it seems like sex might happen.
posted by metasarah at 1:43 PM on July 10, 2016 [2 favorites]

I was testing positive for HPV for a while, and had one or two irregular pap smears to boot, even though I play it safe. Usually I would bring it up when it looked like it was getting damn obvious that a dude and I both wanted to hook up, and I would weave it into my usual pre-sex speech:

"So, I just gotta say a few things beforehand: Number one, the last time I had an HIV test it was negative. Number two, you will use a condom and that is NOT negotiable. Number three, I did test positive for HPV a couple years back, but am asymptomatic now...."

I would go on to give a very quick repeat of what my doctor had told me about HPV, which was that a) nearly everyone who's sexually active has had a strain of it at one point or another, b) some strains cause warts and some do absolutely nothing, and c) there's a little bit of difference of opinion about how long it takes to clear your body, but generally it takes a couple years.

I don't recall a single instance of a guy backing out once he heard that about me (although I tend to pick pretty decent guys in general); most of them also already knew what HPV was anyway, and they already knew what I was telling them. Their reaction was mostly "'kay, thanks for telling me; now let's go to the bedroom."

And in my case it did clear out of my system in a few years and I'm testing negative again, although unfortunately that was likely due to a few years of involuntarily celibacy. :-/
posted by EmpressCallipygos at 2:13 PM on July 10, 2016 [2 favorites]

"I, like yourself, have had an HPV infection."

When we didn't know so much about HPV, and there was more shame involved in it having been detected, we told potential partners.

But now, your doctor is right. Disclosure is like disclosing a history of chicken pox. Completely useless at best, and kind of likely to reinforce the stigmatizing we should be moving away from.
posted by The Noble Goofy Elk at 4:23 PM on July 10, 2016 [1 favorite]

If someone disclosed a history of hpv (as opposed to a current breakout) I'd wonder exactly how detailed of a gynecological history he expected from me, though I'd respect that he was trying to do what he thought was the right thing, I think I'd be concerned that he was expecting me to be some a little more virginal or something. Maybe try to be clear about what level of disclosure you are expecting from your potential partner.

I also would not welcome any type of conversation that indicated that he expected to have some kind of input into my contraception/abortion decisions. I think that conversation is important and appropriate in a committed exclusive relationship. So I guess it depends whether sleeping with someone is part of your getting to know you stage of relationship versus a consummation of an existing commitment.

I guess what I am saying is that you should align this conversation to your sexual values. If you are looking for something serious with someone who shares your exact same (somewhat intense) position on transparency, and who expects to share any birth control and pregnancy decisions with you, then it makes sense to bring it up early to make sure you're on the same page. if it's more about executing a perceived duty on your part, say it in a low key way, once it's clear you're heading to the bedroom, and make it clear whether you want to start hearing about her pap smears and colposcopies.
posted by Salamandrous at 2:38 AM on July 11, 2016 [1 favorite]

Response by poster: Thanks, everyone. The take-away I'm getting is that I am over doing it with the transparency and you think it would be ethically fine to heed my doctor's advice to proceed as usual without disclosing. I'm not sure I feel comfortable doing that.. if only because I had such a hard time treating HPV symptoms myself. To be clear I have not had any kind of sexual contact with anyone (not even touching or kissing) for over two and a half years. So this is all pretty new to me. I am just trying to cover the basics as far as my responsibility to another person I may have contact with.
posted by toadman at 5:02 AM on July 11, 2016