STDs Expert Forum
General Bad Stuff/HPV/New Partner
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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General Bad Stuff/HPV/New Partner

Hello doctors

I’ve been in a fantastic and passionate new relationship for over two months now, but am worried about my past.
In the few weeks before me and my new partner met (and, I’m shamed to admit, during the first few weeks we were together) I had some wild times: protected oral and vaginal sex with three prostitutes (plus unprotected cunnilingus)/several incidents of naked genital rubbing and unprotected oral sex with lapdancers/a couple of one night stands.

The months before all this saw a few (protected, except for oral) one-night stands and a couple of brief (unprotected) flings too.

I’m cool with nearly every STD – tested after the right windows, all clear.  
But cannot test for HPV.

Perhaps it sounds crazy but I can’t help wondering whether she would be safer from cancer with someone with a tamer recent background. It’s very OCD (I have history of it) but my brain tells me I should sit down with a pencil like a bookmaker and work out the odds of bettering her chances were I to release her – i.e. how many future partners she’d likely have before settling down, how many they might have had before etc etc…

I guess you’ll say I should look for psychological help.

But at the very least, would you suggest my new partner should insist on HVP testing with their next (and perhaps all future) pap smears?

Thank you, M
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Welcome to our Forum.  Let me first say, I think your caring approach to your partner is quite a good thing.  I wish all people felt similarly about their partners, the world would be a better place.

As for your concerns about harming her through possible HPV infection, please don't be. For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future.  Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions).  HPV is the most commonly acquired STD.  Over 85% of sexually active women will have HPV infection at some time in their lives and interestingly, partner number or type (i.e. "risky" or not) has very little impact on the likelihood of infection.  The figure for men is less well studied but similar.   In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears.  In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months.  Related to your concerns, in a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be readily and effectively treated.

Thus, for starters, it is far more likely than not that your GF already has HPV.  There are several important things she can do that will essentially guarantee that she will not go on to get cervical cancer from it. These are to take the HPV vaccine, particularly if she is less than 26 years of age, and to follow recommendations for regular PAP smears and gynecologic evaluations. In doing this, neither she, nor you should worry about HPV or consider her to be at high risk for cervical cancer.

I hope these comments are helpful.  EWH
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Hello again Dr Hook

Thanks for your generous and really informative response. It really helps put the matter in perspective.

Just two more questions, if that's okay: "Partner number or type (i.e. "risky" or not) has very little impact on the likelihood of infection." - I'm a bit confused by this... I've always assumed that having more recent partners (and partners having had more recent partners) is kinda like buying more tickets for a lottery no-one wants to win?

And is the HPV test a routine part of a pap smear or something that needs to be (and in my GF's case should be) asked for especially?

Thank you so much!
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