[Question #6981] Girlfriend tested Positive for High-Risk HPV, next steps?

11 months ago
My girlfriend  have been together for 5 months - we have used condoms diligently this whole time and recently decided to get STD tested so we could stop using them. Her test came back positive for high-risk HPV, and a subsequent pap smear showed an abnormality (LSIL). We were both negative for everything else.

A bit confused about what reasonable steps I should take. We both got the vaccine immediately after finding out, just in case it would help prevent complications.

Is it almost certain that I already have it/will get it soon? Would avoiding certain acts (oral on her) or continuing condom use indefinitely even help or just delay the inevitable? I've read here that condoms wont improve the cumulative risk in long-term relationships, does the fact that it is cervical and not external warts change that? Should we wait until a clear pap smear or until the completion of the vaccine cycle? 

Are there any lifestyle choices that may help clear it faster, such as stopping occasional alcohol/marijuana use

Thank you!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
11 months ago
Welcome to the forum. Thanks for your confidence in our services.

We get many questions like yours. My replies are somewhat brief -- please scan other threads in the HPV for a lot more detail.

Getting and having genital HPV is a normal, expected consequence of being sexual. Almost everybody is infected at one time or another, often several times. At any point in time, roughly half of all persons age 20-50 have detectable HPV DNA in the genital or anal area, and the high risk (cancer causing) types are among the most common. Fortunately, the large majority of high risk HPV infections do not lead to cancer -- and LSIL rarely progesses to cancer. (LSIL stands for Low grade Squamous Intraepithelial Lesion -- "low grade" meaning not advancing nor likely to progress.) So your situation is very common and not a serious health concern for either you or your girlfriend.

Having had regular sex together for several months, you have already been repeatedly exposed to her infection (which likely has been present for months or even years) and probably infected. Or you might be the source of her infection. You'll never know. Keep your eyes open for penile warts, but probably nothing will show up. The high risk HPV types rarely cause visible warts. There is absolutely no need to change your sexual life or practices in any way and no need for condoms. The two of you already are sharing the infection and repeated exposure is not harmful in any way. In fact, it is likely you are now immune to that HPV type. 

It's a good idea for both of you to be vaccinated against HPV, which will prevent infection with any of the 9 types prevented by the vaccine -- not counting any types that have already infected you. But there is no need nor point in changing your sexual practices together while vaccinated.

Healthy lifestyle choices like limiting alcohol intake, avoiding tobacco, staying in good phyisical condition, and balanced diet always are good and in gerneral terms will help to keep your immune systems healthy. However, they will have no effect at all on your and your gf's current HPV infection or her pap smear results going forward. (Tobacco smoking does tend to prolong HPV and increase the risk of progression toward cancer. But it's a small effect. Nothing like this has been reported for marijuana, to my knowledge.)

So the only thing important at this point is for your gf to follow her doctor's advice about follow-up pap smears or any other recommendations s/he may have. Otherwise your life together should be entirely unaffected.

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

HHH, MD
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