[Question #4938] Follow up to 4890

27 months ago

While I understand from your response that disclosure to the past partners I was intimate with while I had hpv is not recommended, is there any health benefit to my notifying them now, after all these years?  What can I say to them and should they then tell all their partners? I understand this is not necessary but are there any potential health benefits of letting them know that we were intimate while I was hpv positive? How can I be ethical about this?

27 months ago
Sorry, one more thing.  Each of the three unprotected interactions during my active infection was solitary events and I was not intimate with them more than that one unprotected sexual encounter.  

Is there a chance they may not have even contracted the infection. Even though it was unprotected and I was hpv positive?

Also, my doctor may have mentioned hpv when he told me I had cin-1 but I never saw it as anything I needed to disclose or something that could affect others. He told me the cin 1 would go away and not to worry.  Honestly, I was young and I can't recall what I understood about the risks or even what was happening.  In your professional opinion, was I negligent in my actions? Should I have done more research? How can I make this right? I just feel that disclosure to these partners now would be unfair to them if they would not benefit from the information. 

Thank you for your help.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
Welcome back, but sorry you round it necessary.

This has already been answered by Dr. Hook, who wrote "We do not routinely recommend telling partners about PAP smear abnormalities or HPV diagnoses for several reasons including that they are so widespread in unvaccinated sexually active persons...and that they are of little health consequence for more than 99% of persons with HPV of any type.  I would suggest that you look at some of our past comments on the forum to others with questions about HPV on the forum for additional detail on our perspectives on HPVand partner notification but again, to repeat the 'bottom line', we do not see a pressing need for routine notification of partners regarding HPV infections and I do not feel that you need those em out prior partners to otify them, no matter what the results of your next PAP smear show."

I agree exactly. Since almost everyone has or had had HPV, your past partners are no more at risk for having HIV because they had sex with you than thay would be if you had never met them. You happened to be diagnosed, but you were no more a risk to your past partners than all their other partners.

Ten years ago, many physicians either didn't understand that abnormal pap smears are almost always caused by HPV, or they didn't say it to their patients. But even if you had known about your HPV back then, our advice to you would have been the same:  say nothing to past partners. It is simply unnecessary for their health or the health of there other sex partners; the main likely outcome would be anxiety and uncertainty. You should not take that chance.

If your pap smears remain normal, you should just move on and forget about your past HPV infection. It's no longer an important issue your life, and for sure not in the lives of your past partners.

Best wishes--  HHH, MD
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27 months ago
Thank you for your answer, Doctor.

I guess my specific concern is that I had unprotected intercourse with these people after I was told I had the cin-1, and feel I should have educated myself and disclosed my status as well as used protection.  I feel as if I stole their ability to consent and I am going to need to learn to accept my actions as my perception of myself has changed. Yet I understand how, from a medical standpoint, my irresponsibility and subsequent guilt does not increase the health risk the exposure posed to my partners.  I was also 20 years old at the time of both my abnormal paps and almost wish I had not been tested so young.  Ignorance would have been preferable given the futility of disclosure post-exposure.  I think in order to protect my partners in the future, I will disclose my status to current and future partners regardless of the negative pap as part of a healthy discussion regarding healthy sexual practices.  I will not disclose to these partners as I feel it is selfish in that it would only ease my guilt and, according to your opinion, not prevent them from developing complications in the future. 

Again, I appreciate both your and Dr. Hook's responses.  
27 months ago
By "these partners" I mean the people I was intimate with during after I was diagnosed with cin-1. 

Also, just out of curiosity, and to answer a question for a friend, is it common to spread hpv through vaginal fingering?


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
I understood what partners you were taking about. This does't change my opinion and advice.

Fingering is a very unlikely HPV transmission route. I've never seen such a patient.
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27 months ago

Thank you for your reply.

 

I also had a question regarding genital warts.  When I was about 18 old I had three or four pinhead sized flesh colored bumps near my vaginal opening.  They were not irregular and were not at all painful. I treated them myself with apple cider vinegar and they disappeared within a month I believe.  From what I saw online they looked very much like molluscum and not genital warts as they were small and perfectly round.  They did not appear to be cauliflower like and did not grow in size. Does this sound more like mollusum or gw to you? I have never disclosed to partners before as I am very confident they were molluscum.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
27 months ago
I agree this sounds like molluscum contagiosum, not genital warts. At that time, it would have been appropriate to discuss with your sex partner(s). But for sure no need to do so now. (And as already discussed, that would be true even if they were warts.)---

That concludes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful.---