[Question #2934] Past HPV Worries

42 months ago
Hello Doctors,

I had two small GWs around 5.5 years ago. I had them treated with a cream and then when after a couple of weeks that had not fully worked, frozen off and to my knowledge have had no recurrence since the original outbreak.

At the time I was in a relationship, we discussed them when I discovered them and the relationship continued for another couple of years before coming to a natural close.

In that time I had not given the GWs much thought as they had cleared up pretty quickly and I had not had any recurrences. I began dating again and when it seemed like a sexual relationship was going to develop I went to a clinic for advice where I was told not to worry if I was not having an active outbreak, and that there was no need to disclose the past outbreak (this was around 3.5 years after clearing the original GWs). 

I was still feeling anxious over this, so I paid to have a HPV DNA test (which was a cervical swab) which came back negative for all HPV types it tested for (around 20 types including those that commonly cause GWs). I asked the doctor who administered it if the swab should be taken from the area that the GWs had appeared before but he said no as that area would test negative if there was nothing present at the time.

My issue is regarding disclosure - I am currently experiencing terrible anxiety and guilt about not having disclosed to new sexual partners that I had this past instance of GWs, although I have been advised by several medical professionals that it is not necessary to do so.  Could you please offer your own advice and thoughts  (and hopefully reassurance) on the matter. 

Many thanks in advance.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Welcome to the forum. Thanks for your confidence in our services and for your question, which reflects both admirable concern for your and your potential partners' health and perhaps a fairly sophisticated understanding of HPV. I'm happy to help.

Most HPV infections are cleared by the immune system the HPV infection that caused your genital warts probably is long gone. Although there is always a potential for recurrence -- DNA may persist at levels not detected by testing -- it's not the norm and you probably won't have any future problem. You can safely assume you have also other HPV infections, in addition to the one causing your warts: most sexually active people have multiple infections, the majority of which never cause warts, other symptoms, or abnormal pap smears. Your negative test suggests that these too have been cleared. However, there is no guarantee that active infection will not recur in the future.

Disclosure of past HPV infections is somewhat controversial, but my opinion and advice lean away from it. First, since your sexual history and past HPV story are pretty average, the chance you will infect a future partner is no higher than from any other partner he might choose. (I'm assuming male partners, but these thoughts apply equally  to female partners.) Indeed, maybe lower than for most of his potential partners, since your recent DNA test was negative. Second, your future partner(s) will have had their own past HPV infection(s), assuming you don't restrict your partners to men who have never had sex. Third, even if past HPV reactivates and is transmitted, most infections remain inapparent, so your partner would never know. Fourth, given past HPV infections, he could well be immune to a new infection with whatever type(s) you might have. Fifth, there's really nothing practical to be done to prevent transmission, and all things considered, HPV isn't serious or important enough to seriously impact romance and sexual health and happiness. Even consistent condom use is only partly protective, and most relationships quickly move away from condoms as commitment develops.

All this assumes disclosure for the purpose of HPV prevention. Some couples routinely disclose past partnerships and STDs in the name of openness and commitment -- but that's a relationship issue, pretty much independent of health issues.

Don't get me wrong. I'm not suggesting a cavalier attitude toward HPV. Some infections are dangerous. But most serious infections are easily prevented by vaccination, and potentially serious outcomes almost entirely prevented by standard pap smear recommendations plus prompt attention to symptoms like new genital bumps or unexplained sores.

As implied above, consider vaccination (if you are under age 26) to prevent infection with the 9 most common and potentially serious HPV types with which you haven't already been infected.

I hope these comments are helpful. Let me know if anything isn't clear.