• Wed, Mar 10 2010

Relationship Ninja: Should I Reveal My HPV?

Q: I’m 24, and I just found out that I have HPV. I’ve apparently had it for months without knowing, during which time, I started sleeping casually with a guy. I still see him about twice a month. Unfortunately, the first time we banged, we were both pretty blitzed and didn’t use a condom. After that, I felt weird asking him to wrap up, so we haven’t. I know! Terrible!

So now, he may or may not have HPV. There’s no test for men, the only way for a guy to know if he has it is if he gets warts (and many people don’t), or if a woman knows for sure that she got it from him and then tells him. The only way he’ll know if I gave him this STD, basically, is if he screws a virgin and at her next pap smear, she has it.

What should I do? If I were starting a new relationship, it wouldn’t be such a big deal, but it’s been months. And it’s not like I was cheating on him (not that we’re monogamous). So my question is: how much do I actually have to tell him?

A. You don’t.

There, wasn’t that easy?

Don’t get me wrong: In most cases, I will never, ever advocate for anything less than total honesty when it comes to STD confessions. If you’re mature enough to have sex, then you must also be mature enough to tell potential partners about that little extra something you picked up during spring break in 2003. But HPV is a special case. Why? Because for most people, being infected with the virus is just part of the deal when it comes to having sex. Think of it as a freebie! … A lousy, occasionally wart-covered freebie that nobody wants.

The facts are as follows: The majority of sexually active adults will contract HPV at some point in their lifetimes — 80% of ‘em, according to some estimates. Sleep with more than one person, and the likelihood jumps close to 100%. Some people get warts; most people will never know they have it. So basically, the whole wide sexually-active world has HPV, and the chances are good that this guy (presumably not a virgin) already had it when you met him. And while (cue morally-charged shouting) YOU SHOULD ALWAYS PRACTICE SAFE SEX, condoms wouldn’t necessarily have helped much in this case, because HPV isn’t technically an STD — it can be transmitted via skin-to-skin contact, not just by fluids. Which means that your dude’s hypothetical Future Virgin Bride could still be infected pre-sex if she’s ever so much as bumped into a naked penis.

For the record, my answer would be different if you knew that you had a strain that’s high-risk for cervical cancer, or if you were sporting an archipelago of warts, or if you hadn’t actually slept together yet. But there’s nothing to be accomplished by telling this guy — who you’ve already had sex with, and who more than likely is already toting his own version of the virus — about your infected status. (For the record, there’s no argument AGAINST telling him either, except for the fact that you that you obviously don’t want to. I doubt he’d be surprised; a smart guy in his mid-twenties is going to be aware that HPV is a pretty likely result of casual sex.)

And while you might want to be upfront about this with future partners, for karma’s sake, this probably won’t be an issue forever. An HPV diagnosis doesn’t mean that you’re in for a lifetime of contagious ladyparts; many infections will clear from your body naturally within a couple of years.

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  • canonizer

    I dunno – she might as well tell him that he’s going to infect every future sex victim. Also, probably not the worst idea to start wrapping up.

  • LilyL

    What I want to know is why the answer would be different if she had a cancer-causing type? And also, from her question you can’t even tell whether she does.

    Also, this girl seems convinced that she gave this guy HPV, but how does she know she didn’t get it FROM him???

    • Kat Rosenfield

      Because a cancer-causing strain means that passing along the virus would be putting your partner’s future partners at risk for more than just an asymptomatic stowaway. Most strains of HPV don’t have any impact on the health of the infected person; they’re just there. But when there’s a risk to someone’s health, then the stakes change.
      I assumed the writer doesn’t have a high-risk strain of the virus since she didn’t mention it, but that’s why the caveat for warty or cancer-causing strains is there, just in case. And yes, depending on the incubation period, she certainly could have gotten it from him.

  • shegi

    Wow, what a casual response that was. I do not agree with the first poster. I believe as soon as you know that you have a STD, you should tell the person you are sleeping with. It is not as casual of thing as the first poster would like us to believe. If you get the wart kind, those procedures are very uncomfortable, painful and costly. Also, the medicine is very expensive that you have to use to treat the warts. If you have the strain that can cause cervical cancer, the doctor has to do pap smears to see if there has been any cell changes. If the doctor finds cancerous cells, those procedures are painful and costly as well. If you get infected in the mouth, HPV can lead to throat cancer. If you get infected in the rectum, you could get anal cancer. These last two are rare, but it can happened. It has happened to other people. The poster did mention that the high risk strain has been linked to cervical cancer. Women have died from HPV due to the high risk strain. Nothing about this is casual. Yes, many people are infected and do not know about it, but there are many that do know and chose not to say anything. I feel that if what you are going to do is going to affect someone else, that person has a right to know that by having a sexual encounter with you will change their live as they know it. People want to get hung up on hey this is my business. I do not have to tell them about my body. I think having sex is very intimate and personable as you can get, so if you can share your body, I think you have lost the right to say that your sexual health status is private. Many people do clear the infection, but they will never clear the virus. HPV is incurable. By the way, there are many women who are not clearing it within 2 years. If you have the high risk strain, the longer it takes for you to clear it as well as some other factors, you are more likely to be at a greater risk of getting cervical cancer. Even people who think that they have clear up the infection can have flare ups. Also another fact that the first poster left out is that there are like 130 different strains out there, and some of those strains are the cancer causing kind. Some of the warts strains can be cancerous. A person can get infected with new strains as they trade up sex partners who are carrying these different strains. Last two facts, yes you can get infected by HPV by way of skin to skin contact. Condoms do not 100% protect you from becoming infected. As far as giving birth, there are concerns that as you are delivering your baby if you have the wart kind, your baby could contract the virus and have respiratory problems because the baby could have warts in her throat area. What an awful stressful way to have to live. People should not be so amoral. Really just tell people your status. Like I said having sex with another person is more of a raw exposure and vulnerability than opening your mouth and saying I have a std. If people start taking HPV more seriously, maybe more people can make an informed decision is this a risk I want to take and less people will stock and devastated at the doctor’s office

  • LilyL

    Yes, most HPV strains do nothing. But this girl’s strain must do something, or she wouldn’t have been diagnosed with it. She either 1) has warts or 2) had an abnormal pap or positive HPV test (probably was given the test do to an abnormal pap). She never would have been diagnosed with HPV if she had strain that did nothing.

    I have no idea why you would assume she had the low risk types. She doesn’t mention that she had a high risk type, but she doesn’t mention developing warts either. She seems positive that she had this before him, which kinda makes me think that she had a positive test or at least an abnormal pap and that’s how she found out. (I mean, come on. If she started having sex with him and then developed warts, I really think she would be thinking this came from him.) The test most commonly given to women only tests for high risk strains. If she had a positive test, she has high risk HPV. If she just had an abnormal pap, then it could be either.

    Men can actually be tested for HPV, those tests just aren’t available. Mostly that’s because the medical community does not care if men have HPV because it’s not a risk to their health. Practically everyone guy will have it at some point and nothing happens.

    Plus, the only people actually diagnosed with high risk HPV are women. So you think that women who have high risk HPV are supposed to tell their partners, but when it comes to having sex they just have to risk getting a high risk strain because men cannot get tested??? Even though the risk of a high risk strain is much greater for women???? And they don’t have to tell their partner about genital warts, which he is much more likely to actually experience consequences of? The logic of that baffles my mind.

    If men needed to know about their HPV infections, they would get tested. If you think they should get tested, start lobbying the medical community or whatever. The burden of informing men of their HPV infection shouldn’t be on their female partners. That is just ridiculous.

    • Kat Rosenfield

      “But this girl’s strain must do something, or she wouldn’t have been diagnosed with it.” — I’m sorry, this just isn’t true. Many doctors will ask whether you’d like to be tested for HPV during your yearly pelvic exam, independent of any other factors. It’s a good way of identifying a high-risk strain of the virus before it results in an abnormal pap smear, so that a woman knows she’s at risk and can be diligent about getting checked. So, again, I assumed the writer didn’t have a high-risk strain but mentioned that if she does, then that changes things and she should disclose that information. Hopefully, a man who knowingly sleeps with a woman with a high-risk strain will pass that information on to his future partners as well, but we’re getting a bit beyond the scope of the question here. I also clearly state in the column that my answer would be different in the event of wart-causing strains of the virus. It may be unfair that women bear the burden of HPV — and given that there’s now a vaccine, this whole subject will hopefully become moot within a few generations — but having the information means informing your partner when necessary.

  • LilyL

    Okay please stop because you’re HPV ignorance is really showing.

    I stated: “But this girl’s strain must do something, or she wouldn’t have been diagnosed with it.”

    That is 100% true.

    “Many doctors will ask whether you’d like to be tested for HPV during your yearly pelvic exam, independent of any other factors.” That’s true, but you will not get a POSITIVE result unless you have a strain of HPV that actually has the POTENTIAL to DO SOMETHING. They do not test for strains that don’t do anything. I’m not saying that the strain she had actually caused symptoms for this girl, I’m saying it must have had the POTENTIAL to cause symptoms or she wouldn’t have been diagnosed.

    Even you yourself say that HPV testing is a good way of identifying a high risk strain. High risk=potential to cause cancer. You say in your article, “my answer would be different if you knew that you had a strain that’s high-risk for cervical cancer.” No strain has a “high risk” of causing cancer. Even the high risk strains mostly do not cause cancer. Are you just saying that she should tell if she has one of the two worst strains (16 or 18)? Well then she’s in luck because strain-specific testing isn’t offered by most doctors. (Even my doctor at Johns Hopkins doesn’t offer it, and she’s testing a therapeutic HPV vaccine.) She’ll never know that she has 16 or 18 and thus never have to tell.

    “I also clearly state in the column that my answer would be different in the event of wart-causing strains of the virus.” No you don’t. You said, “if you were sporting an archipelago of warts.” Are you now saying that she DOES have to tell if it’s a warts-causing strain? Because if you are saying she must tell if it’s a wart-causing strain, and she must tell if it’s a cancer-causing strain, then she must tell. If she had a strain that could not cause warts or cancer, she would not have been diagnosed. If that’s what you’re saying, you really need to rewrite the advice you gave.

    PS the vaccine does not protect against all strains. It doesn’t even protect against all cancer-causing strains. This is not moot and won’t be until HPV has been eradicated.

    • Kat Rosenfield

      I’m afraid my own experience and information on this issue doesn’t match up with yours. I’ve done my best to answer your original question and nobody else seems to be confused by my advice to this girl, so I think we’re done here. Thanks.

  • LilyL

    Maybe you should stop answering questions on a subject you don’t know about. No one else is confused probably because they are as ignorant on this subject as you. Either that or they just didn’t bother to comment.

    We are done here. You’re welcome.