HPV and Relationships
The emotional toll of dealing with HPV is often as difficult as the medical aspects and can be more awkward to address. This may be the area where you feel most vulnerable, and the lack of clear counseling messages can make this even more stressful, especially where relationships are concerned.
We regularly receive questions about what to tell either a current or future sex partner about HPV, for example. The better educated you are about HPV, the easier it is to give partners the information needed to answer common questions. Use the information in this section (and elsewhere on NCCC’s Web site) to give yourself a good foundation of knowledge.
Talking to a Partner
Before discussing things with a partner think about addressing any of your own questions or issues about HPV. This is to help establish your own comfort level and is where knowledge really does equal power. One of the most important aspects of coping with HPV, and helping partners develop a good understanding of the virus, is getting factual information and avoiding myths and hype. It may also be a good idea to have resources to which you can direct a partner, so you know they turn to trustworthy sources for information. In addition to NCCC’s Web pages, see our Resources page for more sites with HPV information.When talking to a partner, first remember that having HPV does not mean you have done anything wrong. As mentioned above, most sexually active people are likely to be exposed to HPV at some point, though most never have visible symptoms and remain unaware. Having HPV simply means you, like so many others, have been exposed to a common virus. It is not a reflection on you, your character, or your values, and conversations with partners should not be viewed as making a “confession” or offering an “apology”. With a new relationship it may be good to date for a while and allow aspects of the relationship besides sex to develop as you get to know one another and become closer.
Most sexually active couples share HPV until the immune response suppresses the infection. Partners who are sexually intimate only with each other are not likely to pass the same virus back and forth. When HPV infection goes away the immune system will remember that HPV type and keep a new infection of the same HPV type from occurring again. However, because there are many different types of HPV, becoming immune to one HPV type may not protect you from getting HPV again if exposed to another HPV type.
Key Points to Share
- HPV types: There are over 100 types of HPV, about 30 of which are primarily associated with anogenital skin and sexual transmission. Of these types, some can cause genital warts (“low-risk” HPV) while others may cause abnormal cell changes, most commonly of the cervix (“high-risk” HPV).HPV Latency: It can take weeks, months, or even years after exposure to HPV before symptoms develop or the virus is detected. This is why it is usually impossible to determine when or from whom HPV may have been contracted.
- A recent diagnosis of HPV does not necessarily mean anyone has been unfaithful, even in a long-term relationship spanning years.Medical Impact: The medical risks of genital HPV do exist and should not to be overlooked, but a key point is that for most people, HPV is a harmless infection that does not result in visible symptoms or health complications.
- Very few cases of “high-risk” HPV will lead to cervical cancer, for example, primarily because the immune response is usually able to suppress the virus before cancer develops. In some cases, HPV may cause cell changes that persist for years, and the cells can eventually become cancerous if not detected in time. However, regular screening (such as Pap tests) can almost always find abnormalities so they can be treated, if needed, before cancer occurs.Some other cancers associated with “high-risk” HPV include those of the anus, penis, vagina, and vulva. These cancers are not common and are very rare in industrialized nations, however.
Testing Partners for HPV
Current partners are likely to share HPV, but this may be difficult to prove. Testing options for HPV are limited and most cases are never diagnosed.Pap tests, for example are not specific screening for HPV; they are designed to detect abnormal cell changes of the cervix. HPV DNA testing is not currently approved to test infection status. HPV tests are approved for clinical use with women as 1) follow-up with unclear Pap test results or 2) as primary screening for those over age 30.Screening for men usually consists of a visual inspection to look for lesions (such as warts). Some health care providers apply an acetic wash (vinegar) as a means of highlighting lesions, but this is not a specific test for HPV and may lead to overdiagnosis.Most cases of HPV, in either gender, remain unconfirmed clinically.
Passing on HPV after treatment
Much remains unknown about HPV transmission when symptoms (lesions such as warts or cell changes) aren’t present, so experts cannot fully answer this question. However, studies show that in most cases a healthy immune system will be likely to clear, or suppress, HPV eventually. Some cases may persist for years and result in recurrent lesions, but this is not the norm. The bottom line is that most who have genital HPV DNA detected in research studies eventually test negative, often within a year or two.Many researchers and clinicians do believe “subclinical” HPV (virus may be in skin cells but no lesions are present) is less likely to be transmitted than when warts or cell changes are detected, probably due to a reduced viral load, and subsequently think it is reasonable to say the chances of transmitting virus years after the last clinical episode (where lesions were detected) will become increasingly remote over time. This is not easy to prove and the lack of a solid “yes or no” answer is frustrating. Still, HPV does not seem likely to always be active.