HPV doesn't cause anal fissures. You can be pretty confident you and your partner have had genital HPV infections. Almost all sexually active persons are infected at least once by the time they have had 3 or more lifeltime partners. However, having been mutually monogamous for a few years, any infections either of you brought into the relationship probably are long gone. Anal fissure is an extremely common condition, experienced by a high proportion of entirely healthy people. There is no reason at all to suspect that HPV has anything to do with your partner's problem. Her intermittent constipation is a far more likely explanation -- but even that may not be the problem. Most anal fissures occur with no known cause. Certainly I and Dr. Hook have never seen patients in whom anal fissures turned out to be caused by HPV.

So "the best course of action" is for your partner to follow her doctor's advice about management of her fissures. But to not worry at all about HPV as a possible cause.

I hope this information has been helpful. Let me know if anything isn't clear.

Best regards--  HHH, MD

There certainly is continuing active research on the biology and immune response to HPV. The success of immunization has stimulated more such research, not less -- nobody is resting on their laurels over vaccines. However, curative treatment is a very difficult challenge, and absent some major breakthrough I don't expect such therapies will be available in the next 10-20 years. 

Most people don't have all that much anxiety about HPV. (If they did, people would be clamoring for the vaccine, but only a modest of those who should be vaccinated have done it.) My advice is to look at HPV just as for millions of other bacteria and viruses that are part of the human conditition -- normal to catch, normal to carry (sometimes permanently) that mostly are not harmful. Take common sense precautions against the uncommon serious outcomes (vaccination, pap smears for women, early care for symptoms) and then not worry about it. Aside from those things, sexually healthy people don't give much thought to HPV, and that's the right perspective. I encourage you to try to achieve it.