[Question #2568] HPV and transmission

42 months ago
I am a 37 y/o woman who has only ever had one sexual partner, who I have been with for over 12 years. He did have previous sexual partners before me.  I recently had an abnormal pap smear and a positive HPV test. Four years ago I had an abnormal pap smear and a negative HPV test, the abnormal cells cleared up on their own. Since I had normal pap smears in between I haven't been tested for HPV between 2013 and 2017. Since he is the only partner that I have been with, I am assuming he gave me the HPV infection. My concern is that since four years ago I was HPV negative, and now I am positive, could he have cheated on me in these last four years?  Could we have been together for the previous 8 years and not transmitted the HPV and only transmitted it in the last couple of years? Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Welcome to our Forum.  I'll be pleased to comment.  No person should ever take a diagnosis of HPV infection as an indication of infidelity.  While we are still learning about HPV, some of the things that we can now say with confidence include that  in many people HPV can be present for many years and can occasionally "re-activate" from latency.  Further, the tests for HPV, particularly those in use 4-5 years ago do occasionally missed and infection.  Further, current HPV tests sometimes look for a larger number of different HPV types than earlier versions did.  Finally, as your partner has had other sex partners prior to your current relationship, it is very likely that he had HPV before your current relationship began.  80-90% of sexually active Americans will have HPV infections and while monogamy may reduce the likelihood of infection slightly, the reduction is not much.  Thus, trying to be open minded, there are several possibilities:
1.  Your prior abnormal PAP smear may have been due to HPV which was not detected by the HPV test you had.  Certainly, it would be normal for a PAP smear which was abnormal due to HPV to resolve without therapy on its own.  This is the usual occurrence.
2.  Your partner may have had HPV and it has re-activated and you acquired it, leading to your abnormal PAP smear
3.  There could be an element of infidelity BUT I would urge you to deal with this possibility through direct conversation if there are other reasons for considering the possibility but not to assume that your recent test result is an indication of infidelity.

I hope this information is helpful to you.  In most people HPV-related PAP smear abnormalities can be observed with repeat testing over time.  Please feel free to follow up if there are other questions or if parts of this reply is unclear.  EWH
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42 months ago
Dr. Hook,
Thank you for the response. I've had no reason to believe there was infidelity, and with everything I've read about HPV I thought there could be other reasons, I just wanted to be sure, so thank you for putting my mind at ease. 

My only other question was your final statement that in most HPV positive people an abnormal Pap smear can be observed with repeat testing. Did you just mean that the atypical  result would be observed with repeat Pap testing to make sure it does not turn into cancer? 

Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
I'm sorry, I think I was typing too fast at the end of my reply.  In most people with HPV-related PAP smear abnormalities, the abnormalities resolve over time without treatment.  The proper management for most recently diagnosed pap smear abnormalities is to repeat the PAP smear periodically.  If the infection progresses it can be treated at that time and most regress and resolve without therapy. 

I hope this is clearer and apologize for the confusion.  EWH
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42 months ago
That cleared it up and makes sense. Thank you again for the information and the quick response.