[Question #4634] Potential partner with HPV+ not 16 or 18, gives me pause before having sex

27 months ago
I'm male, straight, early 50s, 6 partners in 6 yrs after long monogamy.   No STI symptoms, I screen regularly expecting a test exchange with a potential partner. No condom use after vasectomy (for peace of mind about not accidentally further procreating). New female partner, mid-40s, straight, just divorced from long monogamous marriage -- to a man having affair(s).  She made a special OB visit and got full STI screening.  Results clear except HPV positive.  Her prior exam and all previous did not produce HPV+ (thank you ex-husband’s mistresses). Strain is not 16 or 18, I guess her co-screening gave HPV+ and lead to lab test of existing sample for 16/18.  No symptoms, no warts, presumably one of the 11 other strains tested (as gleaned from my new learning here and a few other reputable sites, thanks ASHA).   No treatment, body will work it to non-active state, test in future and, I guess, make sure not a chronic type with higher risk factors.  I get this is all normal.  We so far engaged in oral sex several times, and ordinarily I was long ago ready for vaginal intercourse but for the HPV nagging me.  Of course, I know not whether I already carry any HPV.   My other partners were neither virgins nor sexually timid, several divorced philandering men:  I’m exposed to my otherwise STI-free partners’ partners, and so on. Still, I feel responsibility to future partners to not knowingly infect myself with a low-risk strain giving a positive HPV result even if I and they never show symptom, like I’ll unfairly spread this strain despite showing my clean STI tests.  So, this is a state of mind question, not a physical one.  Dive in and try letting this go, or hold back for her clean test some many months from now?  Oy.
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
Welcome to the Forum.  I'll be pleased to comment, Please realize this exchange will have as much to do with attitudes as anything else.  I say this not to diminish the importance of attitudes and applaud the way you are approaching this (and I presume, past relationships).  

My perspective.  For sexually active persons, HPV is a fact of life.  Most of us (over 80%) have or have had it and for most of us the infection is of no consequence- it will resolve without therapy or progression and in the relatively small proportion in who it persists, it is unlikely to progress to cancer. In a small proportion of persons it will slowly progress to genital tract malignancy which can be caught early and managed if we follow routine sexual health guidelines.  From your history it is more likely than not that prior partners have had HPV and that you do as well.  what is different here is that your partner knows this.  That knowledge should (hopefully) not impact the quality or evolution of your relationship.  My advice is that you should not worry about the fact that your partner knows of her infection and move forward as you would otherwise.

As an FYI, the FDA recently modified its approval for the HPV vaccine, increasing it to age 45.  This age cut off is arbitrary and will impact who pays for the vaccine but, for persons in your circumstance and hers, my recommendation is that, other than cost, there is little downside to HPV vaccination and I would strongly consider it. The vaccine, which covers nine different HPV types, is recommended for persons who may already have HPV.  

I hope these comments are helpful.  EWH
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26 months ago
I write now only to thank you, EWH, while reserving my space for seeking further clarification should that become necessary (doubtful).  No need to reply.  I feel fine about both the situation and the advice.  We're moving forward, as you put it.  I shall also investigate vaccine options and costs, particularly since she's still shy of 45. 
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
Thanks for your thanks.  

Just a comment about the vaccine.  The vaccine does work and as I mentioned recently the FDA shifted the age range of its approval upwards by nearly 20 years for both men and women.  Once again however these recommendations are based on population averages and average risk.  If cost were not a concern (as you may have to pay for the vaccine yourself ~$500.00 for the series), I would consider it for you both, despite the fact that you are over the somewhat arbitrary upper limit of recommended age.  This is a personal opinion but perhaps worth considering.  EWH
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