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What Does An HPV Diagnosis Mean For My Relationship?
If you or a partner receive an HPV diagnosis, it may be time to revisit your safer sex practices. Being honest about your status can help reduce the risk of transmission between partners. Here's how to navigate this chapter of your relationship.
HPV refers to a group of more than 100 viruses. About 40 strains are considered to be a sexually transmitted infection (STI). These types of HPV are passed through skin-to-skin genital contact. This typically happens through vaginal, anal, or oral sex.
HPV is the most common STI in the United States. Almost 80 million Americans currently have a strain of the virus. Each year, 14 million more Americans contract an infection.
Almost all sexually active Americans will have HPV at some point in their lives. And anyone who is sexually active is at risk for contracting the virus or spreading it to a partner.
It's possible to have HPV without showing symptoms for several years, if ever. When symptoms do appear, they usually come in the form of warts, such as genital warts or warts of the throat.
Very rarely, HPV can also cause cervical cancer and other cancers of the genitals, head, neck, and throat.
Because HPV can go undetected for so long, you may not realize that you have the STI until after you've been in several sexual relationships. This can make it difficult to know when you first contracted the infection.
If you find out that you have HPV, you should work with your doctor to come up with a plan of action. This generally includes talking with sexual partners about your diagnosis.
Talking with your partner may cause more anxiety and concern than the diagnosis itself. These key points can help you prepare for your discussion and make sure that both you and your partner understand what's next.
1. Educate yourselfIf you have questions about your diagnosis, your partner will likely have some, too. Take time to learn more about your diagnosis. Find out whether your strain is considered to be high or low risk.
Some strains may never cause any issues. Others may put you at a higher risk for cancer or warts. Knowing what the virus is, what needs to happen, and what it means for your future can help the two of you avoid unnecessary fears.
2. Remember: You didn't do anything wrongDon't feel tempted to apologize for your diagnosis. HPV is very common, and if you're sexually active, it's one of the risks you face. It doesn't mean that you or your partner (or previous partners) did anything wrong.
Partners tend to share strains of the virus between them, which means it's almost impossible to know where the infection started.
3. Talk at the right timeDon't blindside your partner with the news at an inopportune time, such as while you're grocery shopping or running Saturday morning errands. Schedule some time for just the two of you, free from distraction and obligation.
If you're worried about answering your partner's questions, you can ask for your partner to join you at a doctor's appointment. There, you can share your news, and your doctor can help explain what has happened and what will happen moving forward.
If you feel more comfortable telling your partner before an appointment with your doctor, you can schedule a follow-up discussion with your doctor once your partner knows about your diagnosis.
4. Explore your optionsIf you did your research before this discussion, you should feel fully equipped to tell your partner what comes next. Here are some questions to consider:
An HPV diagnosis shouldn't be the end of your relationship. If your partner is upset or angry about the diagnosis, remind yourself that you've done nothing wrong. It may take some time for your partner to absorb the news and process what it means for your future together.
Although HPV doesn't have a cure, its symptoms are treatable. Staying on top of your health, watching for new symptoms, and treating things as they occur can help the two of you live a healthy, normal life.
When you're preparing to address your diagnosis with a partner, it's a good idea to know the most common myths surrounding HPV — and how they're wrong.
This will help you and your partner better understand your risks, your options, and your future. It will also help you prepare for any questions your partner may have.
Myth #1: All HPV infections lead to cancerThat's simply wrong. Of the more than 100 strains of HPV, only a small handful are connected to cancer. Although it's true that HPV can cause several types of cancer, this is a very rare complication.
Myth #2: An HPV infection means someone wasn't faithfulAn HPV infection may remain dormant and cause zero symptoms for weeks, months, even years. Because sexual partners often share the virus between each other, it's hard to know who transmitted the virus to whom. It's very difficult to trace the original infection back to its origin.
Myth #3: I will have HPV for the rest of my lifeAlthough it's possible to experience recurrences of warts and abnormal cervical cell growth for the rest of your life, that isn't always the case.
You may have one episode of symptoms and never have another issue again. In that case, your immune system may be able to clear the infection entirely.
If you have a compromised immune system, you may face more recurrences than people whose immune systems are otherwise strong and fully functioning.
Myth #4: I always use a condom, so I can't have HPVCondoms do help protect against many STIs, including HIV and gonorrhea, which are shared through contact with bodily fluids. Still, HPV can be shared through intimate skin-to-skin contact, even when a condom is used.
If you're sexually active, it's important to get screened for HPV as directed by your doctor.
Myth #5: A normal STI screening will detect HPV if I have itNot all STI screening tests include HPV as part of the standard list of tests. Your doctor may not test for HPV unless you show signs of a possible infection.
Possible signs include warts or the presence of abnormal cervical cells during a pap smear. If you're worried about the infection, you should discuss HPV test recommendations with your doctor.
If your partner shares their positive diagnosis with you, you may be wondering if you should be tested, too. After all, the more you know, the better prepared you can be for future issues and concerns.
However, getting an HPV test isn't as easy as testing for some other STIs. The only HPV test approved by the U.S. Food and Drug Administration is for people assigned female at birth. And routine HPV screening is not recommended.
HPV screening is done in accordance with ASCCP guidelines, in folks over the age of 30 in conjunction with their Pap smear, or in people younger than 30 if their Pap shows abnormal changes.
Pap smears are generally done every three to five years for normal screening intervals, but can be done more often in patients with cervical dysplasia, abnormal bleeding, or changes on physical exam.
HPV screening is not performed as part of an STD screen without indications noted above. This test can help your doctor decide if you should undergo additional diagnostic tests for cervical cancer.
Make an appointment with your doctor or visit your county's department of health to discuss HPV screening recommendations.
HPV can be spread through intimate skin-to-skin contact. This means that using a condom may not protect against HPV in all cases.
The only real way to keep you or your partner protected against an HPV infection is to abstain from sexual contact. That's rarely ideal or even realistic in most relationships, though.
If you or your partner has a high-risk strain, you may need to discuss your options with your doctor.
If the two of you remain in a monogamous relationship, you may share the virus back and forth until it goes dormant. At this point, your bodies may have built a natural immunity to it. You and your partner may still need routine exams to check for any possible complications.
HPV is the most common STI in America. If you've been diagnosed, you can be sure that you're not the first person to face this issue.
When you find out about your diagnosis, you should:
Smart strategies for talking to your partners — both current and future — can help you be honest about your diagnosis while also caring for yourself.
HPV Vaccine: Some Studies Say One And Done Might Be Better
CNN —
This week, at the World Health Organization's 76th World Health Assembly, health leaders from nearly 100 countries will join with thousands of others who have signed off on a global initiative to eliminate cervical cancer.
Globally, cervical cancer is the fourth most common type of cancer in women, according to WHO, but many cases are completely preventable with the human papillomavirus vaccine.
HPV is a group of more than 200 related viruses. Many don't cause any symptoms at all. Some strains cause warts, and some cause cancer. The HPV vaccine protects against the strains that cause most HPV-related cancers.
"Vaccines are bringing the dream of eliminating cervical cancer within reach," WHO Director-General Tedros Adhanom Ghebreyesus said in his remarks to the World Health Assembly on Monday.
The vaccine is recommended for children because it works best before someone has been exposed to the virus. HPV is often spread through sexual contact, and the US Centers for Disease Control and Prevention says that almost every sexually active person who is not vaccinated will get HPV at some point.
The vaccine's introduction to the US in 2006, along with more regular screening, has led to a notable drop in cervical cancer cases and deaths in the US, according to the American Society of Clinical Oncology. Cervical cancer rates among the first American generation to get vaccinated have dropped significantly. Among women ages 20 to 24, cervical cancer incidence rates declined 65% from 2012 through 2019, according to the American Cancer Society.
But not every country has the same vaccination options, which is part of the reason WHO has been pushing to change the way doctors give the HPV vaccine.
The organization has ambitious goals. By 2030, WHO hopes to get 90% girls around the world fully vaccinated against HPV by the time they turn 15. At the moment, coverage is just 13%, according to WHO.
Currently, in the majority of countries including the US, the vaccine is given in a series of two or three shots. The CDC suggests vaccination around age 11 or 12, but the process can be started as early as 9.
In 2022, WHO's Strategic Advisory Group of Experts on Immunization decided instead that based on the latest science, one shot would provide enough protection, and countries should offer a one- or two-dose schedule for girls and women ages 9 to 20 and a two-dose shot with a six-month interval for women older than 21.
This single-dose approach could be a game-changer for the prevention of cancer, WHO said. Logistically, one dose is a lot easier to administer and would be much cheaper than multiple doses. Studies also show that when people need a series of shots over time, they're less likely to get them all.
The UK, Ireland, Australia and at least 18 other countries have switched their protocols to align with WHO's recommendations.
A recent study provided additional evidence that one shot of the vaccine is highly effective over three years, if not longer. A single dose has an efficacy of 97.5% a year and a half later and is comparable to multidose regimens 24 or 30 months out, the researchers found.
The study, which has not been fully published, focused on a randomized double-blind controlled trial – the gold standard of research – to see whether one shot would protect healthy young women who were vaccinated at three study sites in Kenya. It involved 2,275 participants: A third got a vaccine that protects against two HPV types, a third got a nonavalent vaccine that protects against nine types, and a third got a control, a meningococcal vaccination.
Scientists collected cervical swabs every six months that were tested for HPV DNA. They also looked at the effectiveness of the vaccine in each young woman after three years.
"We reported that at three years, efficacy continued to be very high, and the effect of the vaccine was durable, with no waning effect," said Dr. Ruanne Barnabas, co-principal investigator on the study and chief of infectious diseases at Massachusetts General Hospital. "These results add to the growing body of evidence to support use of a single dose, especially to facilitate access and coverage for HPV vaccines, which are among the most effective vaccines that we have. They work so well, and we know that they prevent cancer. And so this is another tool we can use to reduce cervical cancer."
Another slice of this study, published last year in the journal NEJM, had similar results.
An official from the Gates Foundation, which funded the research, said that if the HPV vaccine were a single dose, twice as many people could get protection in an ideal situation.
"This data is really cementing confidence around the durability of that protection," said Peter Dull, who leads the foundation's work supporting HPV vaccine development
Dr. Kathleen Schmeler, a professor in the Department of Gynecologic Oncology and Reproductive Medicine at MD Anderson, agreed that the study found "really good evidence" that one shot would work.
Schmeler, who was not involved with the new research, said observational studies from 2014 and 2020 also showed that immunity with one dose is lasting.
"Some could argue that the WHO decision to recommend just one was premature and that we need to wait for years and years of data, but sometimes the enemy of good is perfect, as they say," she said.
It may be helpful for researchers to check in after a decade to see whether protection is falling off and whether people need to be revaccinated.
"The US has the luxury of having a lot of resources, but not everywhere is so lucky. If you could just have to do one dose, it just simplifies things so much and brings the cost down so much," Schmeler said.
Dr. Ted Teknos, an otolaryngology-head and neck specialist at University Hospitals in Cleveland, is more cautious.
He said the findings of the study are "encouraging," but he wants to see longer-term results.
"These patients will need to be studied longer to ensure that one shot is sufficient for a lifetime for protection," said Teknos, who is also a clinical professor in the Department of Otolaryngology at Case Western Reserve University's School of Medicine and who was not involved in the research.
Dr. Quintin Pan, who is working on HPV research at University Hospitals Seidman Cancer Center, is also reluctant to change the current protocol. His concern is that one shot may not protect against all the strains of HPV.
"So [it's] really similar to the Covid vaccine, where one vaccine appears to be only effective for certain variants, and then you can have other variants that are not going to be eliminated with only certain vaccines. This is certainly the case with HPV as well," said Pan, a professor in the Case Western Department of Otolaryngology who wasn't involved with this study.
A one-and-done approach to the HPV vaccine could be a huge help around the world, experts say. Dull said a large number of countries haven't even introduced the vaccine, in part because of the cost and the implementation challenges of multiple doses.
"In many of these geographies, giving two doses a year apart is really complicated. So this just reduces the barrier to countries that really want to introduce the vaccine but have logistical challenges or cost challenges, that it helps to remove one critical barrier to bring additional countries into into use of this important vaccine," he said.
Teknos said he hopes more people – girls, boys and men – get the shot. The CDC recommends it for everyone, but WHO considers boys and older females "secondary targets" who should get vaccinated only "where feasible and affordable."
Globally, the number of boys who have gotten it has lagged. A 2019 study found that about 4% of boys had received the full course of the vaccine, compared with 15% of girls.
HPV doesn't just cause cervical cancer. It can also lead to cancer in the back of the throat or in the anus, penis, cervix, vagina or vulva.
Despite the success with reducing rates of cervical cancers, Teknos said, the US has seen a huge surge in HPV-related head and neck cancers. Cancers of the throat have gone up 300% since 1988, he said. There's also been an increase in other HPV-related anal and penile cancers.
"HPV-related head and neck cancers has become an epidemic in the United States," Teknos said.
Dr. Anisha Abraham, chief of the Division of Adolescent and Young Adult Medicine at Children's National in Washington, said she too would like to see more long-term data before switching to a different vaccine schedule. But she'd also like more people to get the HPV vaccine.
"Starting the vaccination series early can really protect kids from cancers and diseases that are caused by HPV and potentially could save their lives. So I think that's really, really important," Abraham said.
HPV Is Putting Men At Risk Of Cancer. So Why Aren't They Getting The Vaccine?
AN ALARMING NUMBER of men— 45%, by one recent study's count —are walking around with a sexually transmitted infection (STI).
And, one of those STIs could be putting both you and your partners at risk for several kinds cancer. The human papillomavirus (HPV) has been linked to anal, penile and oropharyngeal cancers. Doctors have recently experienced an uptick in oropharyngeal, or throat cancer, cases that are related to HPV. Nearly 70 percent of oropharyngeal cancer cases are linked to HPV, according to the Centers for Disease Control and Prevention.
HPV is sexually transmitted, and so, the main risk factor for oropharyngeal cancer is number of oral sex partners. In fact, research has found that those who participate in oral sex are 8.5 times more likely to develop throat cancer than those who do not.
Most people who acquire HPV are able to clear it out of their system successfully. But, some people do not, likely due to a "defect in a particular aspect of their immune system," says Hishem Mehanna, M.D., professor at the Institute of Cancer and Genomic Sciences at the University of Birmingham, in a story he wrote for The Conversation. "In those patients, the virus is able to replicate continuously, and over time integrates at random positions into the host's DNA, some of which can cause the host cells to become cancerous."
The good news is there's a vaccine that significantly reduces that risk. The kicker? Not that many young men realize it's available and that they should get it.
HPV is now the most common STI in the country, with approximately 43 million people in the United States infected. Because certain HPV strains increase the risk of various types of cancer, the Centers for Disease Control and Prevention recommends that boys and girls get vaccinated between the ages of 11 and 12.
But according to data that was presented at an Annual Meeting of the Society of Gynecologic Oncology, 65 percent of girls have completed the vaccination schedule for HPV, versus 56 percent of boys—even though the vaccine has been widely available for more than a decade.
For context, HPV is a group of approximately 200 viruses that spread via vaginal, oral, and anal sex. (It can also be spread via "heavy petting," per the CDC's somewhat anachronistic language.)
Usually, people with HPV show no symptoms. But the low-risk strains can cause genital warts, while the high-risk strains can lead to cervical cancer, oral cancers, anal cancer, and rarer forms of genital cancers. In fact, the CDC estimates that, in men, about 89% of anal and rectal cancer cases can be attributed to two strains of HPV, along with 72% of oropharyngeal cancer cases.
You might already have HPV and not know it.
Currently, an estimated 80 million people living in the United States — or about a quarter of the population — are infected with HPV, with about 14 million new infections among teens and adults alike each year. In fact, it is so common that the CDC warns that if you're having sex but are not vaccinated, you're probably going to get HPV at some point. (The CDC recommends men get vaccinated before they're sexually active, preferably before the age of 26, but it is possible to get it if you're older.)
In fact, you might already have HPV and not know it. For men, there's no approved test (although some health care providers do offer anal pap tests, if you are a man who receives anal sex).
So why don't all boys get the vaccine?Well, a few reasons. For starters, the HPV vaccine simply hasn't been around that long: the U.S. Food and Drug Administration approved the first HPV vaccine, Gardasil, in 2006. At that point, the CDC recommended it only for girls and young women, due to early data asserting a link between HPV and cervical cancer. So doctors focused on vaccinating young women, explains William Schaffner, MD, a professor of preventive medicine and infectious diseases at the Vanderbilt University Medical Center.
The data on boys and HPV didn't come in until later, Schaffner says. So in 2011, the CDC expanded the patient pool to include boys and young men ages 11 to 26. Although health care providers were encouraged to recommend the vaccine to young men from that point on, HPV's association with so-called "female" cancers still lingers to this day.
"For the first time, we had an anti-cancer vaccine. It was an extraordinary triumph. But that kind of got lost."
What's more, Schaffner adds, the fact that HPV is an STI carries a lot of stigma, particularly among parents who are loath to the suggestion that their kids could be having sex. "Rather than the emphasis on cancer prevention, there was so much more discussion, initially, on how the virus was transmitted, which seems to me to be beside the point," he told MensHealth.Com.
"For the first time, we had an anti-cancer vaccine against a whole series of cancers. It was an extraordinary triumph. But that kind of got lost."
What should parents and doctors do next?Due to that stigma, many doctors don't consider the HPV vaccine a routine procedure for young men — and that may be putting them at risk.
"People are people, and that includes health care providers," Schaffner says. "Talking about cervical cancer is easy, but then you start talking about vaginal cancer and penile cancer and anal cancer, that starts to be more of a sticky wicket." Think of it this way: if parents get persnickety at the suggestion that their child should be vaccinated against a sexually transmitted infection, it is not terribly hard to imagine how they might react to the suggestion that their son be vaccinated for a disease spread via anal sex specifically.
The solution to all this, Schaffner suggests, is easy: regardless of the mode of transmission, doctors should treat the HPV vaccine the same way they would a tetanus shot. Providers should be prepared to answer questions, but needn't call any special attention to HPV. The shot should simply be part of a standard vaccination menu offered to all patients, regardless of gender.
"If we could address provider hesitancy," Schaffner says, "we would win the day."
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