[Question #11916] HPV
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11 months ago
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I'm pretty sure I have HPV. I had a genital wart about a year ago which went away after treatment from a dermatologist.
In the research that I've done regarding HPV, I've discovered that it seems to be mischaracterized in mainstream culture quite a bit. Some of what I've learned includes:
1. There are over 100 strains of the HPV virus, 30 of which can affect the genitals.
2. Most sexually active people who aren't vaccinated will become infected with at least one strain of the virus.
3. Some strains of the virus cause symptoms in the form of genital warts. But most strains cause no symptoms and so most people do not even know they have HPV.
4. The strains that cause genital warts are harmless from a larger health perspective, whereas some strains that present no symptoms can potentially lead to certain cancers if routine screening is not undertaken.
Is what I've said above correct?
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Edward W. Hook M.D.
11 months ago
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Welcome to our Forum and thanks for your questions. Congratulations on the thorough research you’ve done. I agree with all that you’ve said. My only addition to your point 4 is to state that among those HPV strains associated with cancer the vast majority of infections are controlled by the immune system and resolve over a period of months to become undetectable. A minority of infections ( less than 5%) caused by these strains may persist and go on to cause the precancerous lesions which are detected by routine screening.
You’ve done your research well. EWH
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11 months ago
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It seems that the position you hold on this forum is that, overall, HPV is not a serious issue. Genital warts are, at most, a cosmetic nuisance. Because HPV is so prevalent, disclosure with sexual partners isn't necessary.
However for some reason I feel like I'm ‘worse’ for having genital warts as compared with someone who has HPV but presents no symptoms. Is this irrational?
After all, HPV strains that cause genital warts don't lead to cancer whereas strains that have no symptoms can. So the fact that I've had genital warts shouldn’t matter. Is it irrational to make a distinction between symptomless HPV and HPV that presents symptoms?
In terms of disclosure, I have been in a monogamous relationship for about 5 months now. We initially used condoms but now my partner prefers not to and so we haven't been using them. I know condoms can help reduce the risk of transmission but also know that they are not as effective when it it comes to HPV. I'm wondering if I should disclose to my partner that I have HPV, and if we should go back to using condoms?
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Edward W. Hook M.D.
11 months ago
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Thanks for your thoughtful reply. I thought we might be headed in the direction of discussing disclosure. There are a number of other variables to consider here.
1. Part of the reason disclosure, while desirable in a perfect world, is not always essential include that:
A. If your partner had other partners before your current relationship began, unless she is vaccinated, she is quite likely to have been already infected. If HPV is detected at her regular sexual health check up, there would be no way to know where it came from
B. She is already exposed- what's done is done
C. Unfortunately not everyone has the same knowledge and understanding of HPV that you do. As a result, sometimes disclosure is misunderstood and leads to relationship tensions (or worse)
Whatever you decide, in my opinion, after several months of regular sexual contact, condom protected or not, she has been exposed to any infection you might have (and vis versa), so what's done is done.
Do you know if she is vaccinated or not? EWH
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11 months ago
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I don’t know if she’s vaccinated. I’ve taken some time to look at some other Q&As on this forum pertaining to this topic and it just seems like there’s no right or wrong answer when it comes to disclosure. It depends on the particulars of the relationship and the people involved. Overall, most sexually active people have HPV and don’t even know it. There’s a subset of these people that are ‘unlucky’ and develop symptoms in the form of warts, which are harmless. In the overwhelming majority of cases, HPV is harmless. Mainstream media seems to misconstrue the facts of HPV, which leads to inaccurate stigma. However, everything that I’ve learned on this forum hasn’t made it any easier when it comes to choosing to disclose to my partner or not. I’ve come to the conclusion that it probably doesn’t make a significant difference either way. Can you sway me one way or the other? In your opinion should I disclose, or would it be better not to?
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Edward W. Hook M.D.
11 months ago
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I cannot, and will not try to sway you in one direction or another in terms of disclosure of your own history of HPV to your current partner. This is a personal decision and there are many variables involved. Here are some things to consider:
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-what’s done is done. She has been exposed to you, but, your warts were treated and there is no evidence that you are potentially infectious at this time.
-Her vulnerability to infection, if present, is highly dependent on whether or not she has been vaccinated or not.
-, Only you are in a good position to discuss your and her past histories, and to anticipate how she might react to the fact that in the past you have had genital warts
As you point out, there is no right or wrong situation and circumstances vary. You will have to sort this out on your own, based on how you think your partner might react to your past history. As a generalization wedding partners or potential partners are going to have a discussion regarding their past sexual histories, partners, vaccination, etc., the sooner such conversations occur the better.
As you know, we provide up to three responses to each clients questions. This is my third and final response. The thread will be closed shortly without further responses. Clearly, you have thought a lot about this and have a good understanding about HPV. I wish you the best going forward.
EWH