[Question #3721] HPV in older, non monogamous people

33 months ago
Hello. I am a man in his late 40s and have two regular partners, who are also my age. They also each have two regular partners, and we all each have occasional other encounters as well. We're all happy, but I am afraid to ask my doctor about this because of being judged for infidelity.

Partner 1 just informed me that her gynecologist told her she tested positive for HPV. She does not have any visible warts or lesions. I do not want to put Partner 2 at risk of cancer. I use condoms absolutely 100% of the time for vaginal sex, but not for oral sex.

Partner 1 says that it is "no big deal" but I can't figure out whether or not it's a big deal. Partner 2 has asked me about getting vaccinated, but I can't figure out how someone our age can get vaccinated or if that would help.

Is there any way to test me for HPV? If not, how do I protect partner 2 without having to dump partner 1? What is the risk of each of these women getting cancer? If Partner 2 wants to get vaccinated, how can I help her? Is this actually a big deal?

We have each been together for quite a while and it would break my heart to have to leave anyone.
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Welcome to the Forum.  Thanks for your question.  I'll try to provide some perspective.  I must admit that I agree with partner 1.  In general, on this Forum we consider HPV to be more of a nuisance that a problem as long as persons follow sexual health testing guidelines and seek care for possible abnormalities.  Recent CDC data indicate that about 40% of American adults between the ages of 18 and 59 have HPV, reinforcing the fact that HPV is quite common and, when "clearance" of infection (i.e. the infection goes from being detectable to being undetectable among infected persons without therapy) is included, over 80% of unvaccinated sexually active Americans have or have had HPV.  Given the fact that both of your partners have other regular and occasional partners, it is appropriate that both have regular sexual health check ups which should include testing for other STIs as well as HPV tests.   In men testing is not currently recommended although some labs offer swab tests for the virus.  The reason further testing is not indicated in men is that the infections rarely progress and as long as you would seek dermatological evaluation should you develop a genital lesion.

Thus:
If your partners have routine sexual health screening, your continued sexual activity will not increase or change their risk for cancer.  It is likely that they may have already had HPV- most persons of your ages would have.

Your could get vaccinated if you chose.  Your insurance would not pay for it as insurance companies only pay for vaccination in persons under 26.  If you choose to be vaccinated it will cost you about $500.00 and as I said, since most persons your age have already had HPV, the theoretical benefits of vaccine are modest at best.

As I indicated, there are commercial labs which will test you for HPV. the meaning of a negative test is unknown. The meaning of a positive test is that you will know you have HPV but not where it came from or how long you've had it. 

personally, I think it is good for your partner to have told you of her infection and it would be appropriate for you to let your other partner know that you have another partner who has HPV but other than that, my advice is not to worry about it and certainly not to change what sounds like an otherwise healthy relationship.

I hope this perspective is helpful to you.  EWH
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33 months ago
Thank you, Ted. I wonder how much of my anxiety here is just around the fact that there are other things called "H?V" which are more serious. You really helped me out here.
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Glad we could help. Take care.  EWH---