[Question #1845] HPV and swinging

44 months ago
HPV and swinging
44 months ago
We are in our late 50s in age. We are married for over 30 years. We were monogamous until three years ago when we entered into the lifestyle. We met other couples and swapped partners . We did not use protection for oral sex, but we used condoms for intercourse 100% of the time. Two months ago, our wife had a positive Pap test for high risk HPV.  A colposcopy and biopsy showed no precancerous or cancerous cells. No prior positive Pap tests, follow up Pap in 6 months. We wonder if we should continue to swing. Would oral sex only be safer? Is HPV vaccination of any benefit at our age and after exposure?
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago

Thanks for your question.  In reading your question, I wondered if your wife had been tested for HPV in the past- typically in women with otherwise normal PAP smears HPV testing is not performed and so your wife may have had the infected undetected for some time.  Irrespective, the presence of HPV itself is not a concern. Recent studies show that HPV is relatively common on women over age 50, occurring in 10-20% of women and being more common among women who have had more sex partners over the course of their lives.  Many of these infections are thought to represent re-activation of HPV acquired in the past.  The HPV may resolve on its own over the subsequent 1-2 years, may persist, or rarely may progress to cause abnormal PAP smears.   There are no data however to suggest that, if the PAP smear (and/or colposcopy) is normal, that this is a reason for concern and all that needs to be done is to continue to have periodic PAP smears.  As for the implication of this finding for your continued swinging, I see no reason to modify your activities, either by ceasing to swing or by only participating in oral sex.  I suspect that others in your circle of friends may also have infection. 

I would not recommend HPV vaccination at this time. While there is no contraindication to getting vaccinated, the vaccine works less well as we age (this is true for all vaccines) and it is likely that you may already have had the infection.   

I hope these comments are helpful to you.  EWH . 

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44 months ago
Do you think that we should tell prospective play partners that our wife tested positive for HPV? Or is it so common that it is not necessary to disclose. We want to act ethically and not infect others. 
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
We typically do not encourage persons with HPV to disclose their infections to sexual partners.  As you have suggested, our rationale for this is that HPV is so widespread that most people have already been infected.  If anything, this is a more appropriate perspective for persons who pursue a swinging lifestyle than others.  .  EWH
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