[Question #512] Distant past HPV

105 months ago

I had a LEEP procedure about 14 years ago to remove moderate to severe dysplasia. I have had clear PAPS for several years. Am I still contagious? What are the chances I could transmit this to people? Do I need to disclose this partners at this point? I'm suffering a lot of guilt and shame about this. Thank you.

H. Hunter Handsfield, MD

105 months ago

Welcome to the forum. Thanks for your confidence in our services.

The body's immune system clears HPV, usually in a few months. Between that and your LEEP, there is little chance you still have an active HPV infection. HPV DNA can persist longer, perhaps for life -- which is the origin of statements that HPV never entirely goes away. However, late reactivation from persisting DNA is rare and it is unlikely to happen to you. And there is also no significant chance you can transmit the infection to current or future sex partners.

Having had genital HPV does not mark you in any special way, from a sexual standpoint -- perhaps the reason for your feeling guilt and shame. Everybody (at least 90% of sexually active persons) have genital HPV at least once; it's a normal, expected part of being human! And it's just as common in women with say 3-4 life partners as in those with 100 or more. Look around at your friends, co-workers, and family members: 9 of 10 of them have had it; for those under age 25 or so, 30-40% have active infections right now; and a quarter of the women have had abnormal pap smears or genital warts due to HPV. So you're not exactly alone!

From a medical or prevention perspective, definitely there is no need to inform potential partners of your past abnormal pap. Even if you still had an active HPV infection, informing partners would not reduce their risk. Getting genital HPV is so common that any particular relationship rarely raises the chance of infection to a significant degree. And when HPV appears in one or both members of a committed couple, it's rarely possible to even know when or from whom either one was infected first.

That said, from a relationship standpoint, many couples choose to tell their partners about their past sex lives, STDs, abnormal paps, and such things -- not to protect them, but as an indication of commitment and intimacy. On that basis, maybe you'll discuss it in a committed or highly promising relationship. This is entirely up to you.

I hope these comments have been reassuring and otherwise helpful. Let me know if anything isn't clear.

Best wishes-- HHH, MD

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105 months ago

Do you have any studies that substantiate that distant past HPV infections cannot be transmitted? In your experience, how likely are people still infectious after a long period of time? Do you think its morally right to tell people or is it truly not necessary? Thanks!

H. Hunter Handsfield, MD

105 months ago

I am unaware of specific studies on this. However, it is the clear clinical experience of all ObGs who provide care to women in your situation, and to STD experts, that partners of people like you rarely are diagnosed with new HPV infections. In my 40+ years in the STD business, I don't recall any patients in whom it seemed clear that they had been infected in situations like yours. It think it is morally correct (and usually preferred) to NOT tell partners. I'm quite confident that doing so has the primary effect of creating unnecessary anxiety and potentially damaging effects on relationships, and that these negative effects far outweigh any benefit in reducing new HPV infections in the partners.

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H. Hunter Handsfield, MD

105 months ago

To clarify so there is no misunderstanding: I should have said it is morally correct and preferred to not tell partners of past HPV infections that have cleared up. Of course partners should know about current, likely transmissible HPV infections like genital warts or newly abnormal pap smears.

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105 months ago

Thank you for clarification. I have so much lingering guilt about not telling my ex boyfriend about it ( we just broke up). The last pap I had in May was clear as were the ones several years prior. In your opinion, I should have nothing to feel guilty about? He has had numerous partners in the past. Is there a chance I could get reinfected? Or at 45, is it unlikely since I have 13 partners? Thank you.

H. Hunter Handsfield, MD

103 months ago

I have to apologize that I missed this follow-up comment. Sorry for the long delayed reply.

Indeed, you have nothing to feel guilty about. Why would anyone feel guilty for having something that everybody gets at one time or another? Your partner is no more at risk for HPV because he had sex with you than he would be otherwise. HPV is not more common in "promiscuous" persons (those with many partners); it's just as frequent in people with, say, 4-5 lifetime partners. Could you get a new infection someday? Yes. However, new HPV infections are quite uncommon after age 25 or so.

I do hope you can let this go. It's reallly a non-issue in your life at this point, or should be.

Best wishes-- HHH, MD

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