Thursday, June 04, 2009

Talking About HPV

Hi Dr. Kate,

Sadly, I went to my annual OB-GYN appointment 2 weeks ago and was told that HPV was present in the swab that was taken. My oh-so helpful doctor's office couldn't tell me which strain it was, only that it was present and that I needed to come back in 6 months for another checkup, so I'm guessing it's not the genital warts one, just the cancer causing one?
It is really frustrating to me, as I've only been with two people in my whole life, and condoms were used both times. Plus, I've sat through the three Gardisil shots as well before I got busy with either one of my partners.

My main concern is the relationship I'm in now. We aren't seeing anyone else, and so far it's been going great, until now.... What is the protocol here? I understand with a regular STD you need to tell your partner and I'm prepared to fess up here as well, but it's hard to since I don't know what kind I have. Anyway, since my doctor isn't helpful, I was wondering what the correct behavior is here.


Tongue-Tied


Dear Tied,

Let's talk about you first. You've done all the right things to protect yourself, but as we know, nothing takes the risk away completely...which is why screening is so important. The majority of HPV testing looks only for high-risk strains. There are multiple versions of HPV that put you at risk for cervical cancer, but since they're all managed the same way, they're tested for in a batch. So unfortunately, yes, you've got a strain that puts you at risk. The Gardasil will still offer you protection from getting those strains in the future, though, so the shots weren't in vain. BTW, docs don't test for low-risk strains for two reasons: 1) we don't treat them directly unless warts appear, and 2) you don't need more frequent pap testing for the low-risk ones.

Now the tough question--if and how to discuss your diagnosis with your boyfriend. It's likely that he too has the virus, though you'll never know which one of you had it first. You can look at this situation in two ways:
  • Since 80% of sexually-active adults have or will acquire HPV, your boyfriend likely had the virus (and gave it to you) or would have gotten it from someone else. Since the virus won't affect his health, there's no need to tell him about it while you're together. And if you break up, you can tell him then, so he'll know to warn future partners.
  • HPV is still an STD, and most of us want to know about any infection that we've been exposed to, whether or not we can do anything about it.
Personally, I believe that the best course of action is generally openness and honesty. If you're close enough to someone to get naked and swap bodily fluids, you should be able to share bad news as well. You can bring it up when you're not in bed (or at least not post-coital), at a moment that you've got time to talk. And you can give him resources about where to go for more information, like here and here.

How have you handled a diagnosis of HPV? Have you told all to your partner? How did you do it?

Photo credit: kimberlyfaye

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