[Question #7021] HPV

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62 months ago
I recently got tested for my Pap smear. My results came back that I have HPV 16/18. I am 30 years old. I’ve seen the older you are the harder it is to get if my system. I have been seeing the same guy for a year now and he is 32. We have protected sex but we dot have protected oral sex. I scared that I have given him oral cancer because I see HPV is linked to throat cancer. I told my friends and they say I need to tell him and that I’m a bad friend for not disclosing this information. I have a colposcopy scheduled for next and I wanted to wait for the results. I know I need to tell him but I’m afraid he is going to blame me for having oral cancer if he does in the long run. 
1. How do I go about telling him I have HPV?
2. Will he automatically get oral cancer since we have had unprotected  oral sex for the past year? 
3.  Am I going to infect everyone that I come across? 

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62 months ago
We also stopped having sex because I don’t want to increase his chances of oral cancer 
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H. Hunter Handsfield, MD
62 months ago
Welcome to the forum. Thanks for your confidence in our services. I'll make several general comments about your situation and then answer your speicfic questions. 

Apart from HPV, what was the pap smear result? If only HPV, without abnormal cells, the chance of progression to cancer is even lower. The report should say whether there is dysplasia (abnormal cells) and, if so, whether it is suspected to be low- or high-grade. 

You're not alone -- your situation is very common! 90% of all people get genital area HPV at least once, usually several times; and the high-risk types (like 16 and 18) are among the most common. Happily, the large majority of HPV infections, including infection with high risk types like HPV 16 or 18, never progress to cancer, even if not treated. And when women follow their doctors' advice about follow-up and sometimes treatment to remove possibly precancerous cells, cancer is never a problem. That's the most important advice I have for you:  follow your doctor's advice after the colposcopy about repeat paps and/or any treatments she may suggest. With or without any treatment required, your HPV infection will be cleared by your immune system. HPV DNA often persists, and recurrent active infection isn't rare. But if or when it happens, it also does not cause serious health problems. (It is true that HPV persistence is more common in older than younger women. But 30 is on the young side -- you're not very likely to have any future problem once the current infection has cleared up.

You really shouldn't be nervous about discussing this with your partner. And you certainly do not need to stop having sex with him. Having had recugar sex for a year, he has been repeatedly exposed and likely infected; or maybe infected previously and the source of your infection. It's usually not possible for a couple in your situation to ever know who was infected first or from whom it was acquired. Condoms do not prevent HPV very well;  regular condom users get HPV almost as often as non users. For all these reasons, stopping sex makes no sense now, and no harm will come to either of you from repeated exposure to an infection they already have.

As for throat cancer due to HPV (almost always HPV 16), cases have been rising in recent years and there's been a lot of media attentio about it, but it remains an uncommon cancer -- far less common than others like cancer of the breast, lung, colon, prostate, and so on. Becasue oral sex is so common, most people have been orally exposed to HPV but most don't get infected, and actual disease is even rarer.

And talk with your doctor about immunization. You're still at risk for additional infections, and undoubtedly still are susceptible to some of 9 HPV types prevented by the vaccine. (But be aware the vaccine won't have any effect on the infection you already have.)

To your specific questions:

1) Just have a straightforward discussion of the facts, and be prepared to discuss the things I've said above. Before you tell him, read up about HPV; there's a lot to know, far beyond what's practical on a forum like this. Two excellent resources are CDC (www.cdc.gov/std) and the sponsor of this forum, the American Sexual Health Association (www.ashasexualhealth.org).

2) Many million people get oral HPV, including HPV 16, and the vast majority do not get cancer, oral or elsewhere. As discussed above, he has been repeated exposed already -- and probably infected, if he wasnt already infected before you first hooked up. There's no point in stopping now.

3) As discussed above, you can expect your cervical HPV infection to clear up. You are not likely to have much chance of infecting future sex partners.

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

HHH, MD
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62 months ago
Thank you so much for your response. My Pap smear came back normal. (Negative for intraepithelial lesion or malignancy). She did talk about the vaccine and I got the first shot last week.  I was more scared about him because I just didn’t  want to be the cause of an oral cancer. 
1. So if we continue to have oral sex, it won’t  make his risk higher? Is that because I’m the same partner? 

I know we discussed sex before and he started much early than me. He started when he was 14. I however started at 20.  I guess that’s why I’m scared because I know he has had oral sex before me so now that we are having oral sex I just feel he is at a much higher risk. 
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62 months ago
Also, how do we know if it will clear in my boyfriend’s system if he can’t tested? He is 32 but I don’t know if that means anything. Is it possible that he is immune to the virus but can still transmit? 
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H. Hunter Handsfield, MD
62 months ago
It's good to hear your pap smear is normal except for HPV. The usual advice in this situation is to repeat the pap smear in a few months; I'm not certain why your doctor is advising colposcopy. It probably will be normal. Or he might see wart-like tissue that can be removed or otherwise treated. Either way, your risk of cancer is very low.

You need to work to stop your obsession with oral sex and throat cancer. These really are not important issues in this situation. In the US, there are millions of oral infections with HPV 16 every year and only a few thousand cases of throat cancer caused by HPV 16; the vast majority of oral HPV infections do not lead to throat cancer. Continuing oral sex at this time will not change his risk. Anyway, it is likely he is the source of your cervical infection. If so, he is immune to a new infection with HPV16 or 18 and cannot catch it again. 

There is no reliable way to know whether or not oral HPV is prresent or absent, or whether his likely past infection has cleared up. And it really doesn't matter. Just accept the fact that all humans carry HPV, often high risk types like HPV 16 or 18. Happily, it's rarely harmful. His immune system probably has already cleared it up.
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62 months ago
Thank you so much. I know I need to stop thinking about it. I appreciate your feedback and feel a lot better. Thanks again 
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H. Hunter Handsfield, MD
62 months ago
I'm glad to have helped. Thanks for the thanks -- that's why we're here!---